16 year old cat diagnosed with Cholangiohepatitis and Liver Disease. Hasn't pooped in a week!

Hello,

My 16 year old kitty, Moses, was diagnosed with Cholangiohepatitis and liver disease on Tuesday, September 6.  Before his diagnosis I noticed his stools were hard and dry.  Then I noticed one day he was straining to poo but nothing was coming out. He started acting lethargic but was still eating and drinking normally. I bought pumpkin and hairball formula to see if that would help with his issue.  Two days later, he still hadn't pooped so I knew I needed to take him to the vet.  I was worried he was impacted.

Obviously, this all happened during the Labor Day weekend. (Why do they always get sick on a weekend?!)  I didn't take him to the E-Vet because I didn't think the issue was dire so I called the only vet that was open, the Petco PetVet clinic, and scheduled an appointment for that day (Saturday, Sept.3)  Needless to say, as soon as I hung up the phone Moses pooped a nice one.  He immediately perked up, played in his empty box with his toys, and then ate some food.  I cancelled the appointment, thinking the issue was resolved.

The next morning, however, he became lethargic again. He pooped 4 tiny, rabbit-like pellets in his box.  THEN I noticed his urine was really concentrated, a deep yellow color, almost a tinge of orange.  That worried me greatly.  I called the Petco vet clinic again and took him in immediately.  This is where things went wrong.  The vet took a look at him and said nothing was wrong.  I told him about his change in urine color and he brushed it off as saying that was normal.  He didn't even palpate his stomach until I asked him to!  He said he wasn't feeling hardly any stool in there at all, so he wasn't impacted.  I said I was worried he might be dehydrated and he did the skin test and said he wasn't really dehydrated.  Why, he said, he wouldn't be surprised if Moe lived until he was 20!  Said he looked great for a cat his age.  He offered to give a little subQ fluids to ease my mind and I agreed. 

That night he didn't eat or drink, most likely because of the fluids he received, so I wasn't too worried.  The next morning, Labor Day, he still wouldn't eat and then became lethargic again that evening.  I resolved to take him to my regular vet the next morning.  His urine was still deep yellow.

Tuesday morning, I was very alarmed when I caught the color underneath his tongue while he was cleaning himself.  It seemed to be slightly yellow.  This was UNDER his tongue.  I panicked and got him into my vet immediately.  Sure enough, he was becoming jaundiced and the tests revealed the devastating diagnosis of cholangiohepatitis with liver disease.  He has a bacteria infection in his liver and was given clavamox to fight the infection and prednisolone to bring down the inflammation.

My vet also said he didn't feel much stool in his colon, maybe a small firm one, but he wasn't impacted.  I took him home and have been force-feeding him to keep him from losing more weight.  He is drinking but is very lethargic still.  And still hasn't pooped.  I talked to the vet about this and he said it was strange and mentioned a stool softener but giving him one would draw water away from his body and into his stool, which wasn't a good idea.  I am trying to keep him hydrated by syringe feeding him extra water.

He hasn't pooped in a week.  I've been syringe feeding him and giving him his pills.  The prednisolone is supposed to jump start his appetite and make his pee more but that hasn't happened.  He is going to the bathroom about every 7 hours.  No pooping, though.

Any advice to get him to go?  I'm a little surprised my vet didn't mention an enema?  Is it too dangerous to give with a cat with hepatitis and liver disease?  Is a "dig out" the same as an enema? 

Thank you all for reading my long post and I would greatly appreciate any suggestions!

***My cat had a urinary obstruction when he was 3 years old and will not go in a litter box that has litter in it.  He does, however, go in an empty box (without cat litter). He doesn't urinate anywhere else in the house and I have three empty boxes in the laundry area for him to use.  Crazy, yes, but that is how I discovered his urine changing color!

huh... the only thing that I could think of would be to continue with the force feeding. Definitely make sure that he is drinking! The more water=the softer the stool. There is definitely more to it though... wait for another member to answer for sure

Thank you for responding! Yes, I've been force-feeding him since Tuesday and it's exhausting but worth it. We both hate it! I live alone so it's just me doing it.

I don't trust vets very much and I'm a little unsure of the one I have now, but I am absolutely furious with the vet at Petco. If he had done a blood test and urinalysis like I asked, this would have been discovered much sooner! But the vet told me it wasn't necessary.

Someone on this site mentioned a while back that butter is bad for liver disease. Why is that?

I should also add that he's not attempting to poo. He does his potty business in the box and then runs straight to my bedroom and hopS up onto the bed. He has no interest in pooping!

I'm taking him back in to the vet today, as he seems to be dehydrated.  He has been drinking water, though.  I am also asking about the poop situation, since he still hasn't pooped!!    THIS IS MOSES.

our senior cat has kidney disease.  we give him a laxative twice a day (probably going to increase to 3x now) plus we give him 100 to 125ml of subcutaneous fluids 5 days per week.  that helps with his pooping and keeps him from becoming constipated, although we're increasing the laxative because yesterday was hard pebble poop.  we give him his laxative in the gravy or juice from a flavor of cat food, and find a few hours after his sub-q fluids, his appetite increases.  overall i'm really glad we learned to do the sub-qs ourselves.

that being said, he sometimes feels somewhat nauseous, from either the kidney disease or IBS, and we can either give him pepcid or an anti-nausea med from the vet.  we haven't used an appetite stimulant, although perhaps you could ask your vet about that, but we go through an unbelievable number of cans of cat food as - as with many kidney patients - HK has become a VERY picky eater, loses interest in flavors and then won't eat them.  yesterday it took 15 cans to get his meds in him twice, solid food plus some gravy mixed in.  all in all, he actually ate over two cans worth, which is his normal amount.

Josiegirl said:

   THIS IS MOSES.

Click to expand...

if he's dehydrated, that's not unexpected with kidney disease, and can cause constipation, of course.  good luck with your kitty!

No, he has liver disease. Kidneys are fine. But I do agree that he's constipated. He just tried to go for the first time in a week and nothing came out! He's got to be backed up!

He ran back to my bedroom and jumped up on bed to his favorite spot.

He's still not eating on his own but now I'm pretty sure it's because he's full of stool!

Thank you for your story and for responding. It really helps because my nerves are frayed.

man, i shouldn't post when i haven't slept.

still, if your cat is dehydrated, it's going to cause constipation and other issues.  sub-qs would take care of that and help your cat feel better.

I just came back from the vet and Moses had an enema performed.  He was really backed up!!  The vet even had to do a "dig out".  Moses was also very dehydrated and was given fluids, poor baby.  They showed me how to do subQ from home and I admit I am nervous about that.  It's a long needle!

Hopefully, this is the reason why he was not eating on his own and will start to eat in the next few days.  Meanwhile, I will continue to force-feed him until he does. 

The vet wants to wait on the stool softener for now.  I guess I just have to wait and see how he does.  I just love him to pieces and hope he gets better!!

our cat takes miralax - what stool softener did the vet give moses?

i suggest if you're going to be doing this periodically you order your own needles.  the ones our vet gave us were too thick and too thin, and the ones we use now (terumos) re thinner with a bigger hole, so less pain but faster drip.

read these before giving fluids - they helped us a LOT.

http://www.felinecrf.org/subcutaneous_fluids.htm

http://www.felinecrf.org/subcutaneous_fluids_tips.htm

also watch this


these made things easier for us. 

btw, we heat our lactated ringer solution in a large bowl of hot water till it reaches 91 degrees f.  we got this thermometer


put a piece of blue tape on the bag of lactated ringers.  after the bag has been in the hot water for 4 to 6 minutes for a full bag, we take out the bag, dry  the tape thoroughly, shake it gently to mix the cooler inside with the warmer outside, then shoot the thermometer at the tape.  if the temp is over 92,. i cool it slightly.  you can also shoot a little at your wrist to make sure it's gently warm, not uncomfortably hot.

Thank you so much for the tips on giving subQ fluids!  I am a little nervous but confident I can do it.  It didn't seem to bother Moses when he received them at the vet but I think warming it up is a  great idea.

The vet held off on giving a stool softener for now in the hopes he will pass stools more normally, but I do have a brand new container of Miralax in my cupboard for future use.

I know it's early in the morning but there doesn't seem to be any change in his demeanor, he is still acting lethargic.  This whole ordeal is upsetting and my vet isn't encouraging, saying if he doesn't start eating on his own the next few days then I really need to consider doing what's best for Moe.  It's very hard to consider that possibility, he's been in my life for so long and I nursed him when he was a little baby.  He plays fetch, sits and shakes hands on command.  When my parents died he was there to lick the tears off my face and loves it when company comes over.

I just can't stand the possibility of losing him.

are you trying tasty foods and foods with gravy?  we have 16 flavors of fancy feast in our place, some with gravy and some (the grilled ones) with shreds in gravy.  when he won't eat one, i wait a little and offer him the next.  when HK was barely eating, we had good luck with the variety of fancy feast. 

best of luck to you and moses, and you're doing a great job!

Yes, I was doing that before his enema yesterday with no luck whatsoever.  His favorite fancy feast is the beef classic pate and he refused that.  The last few days I've put the FF chicken Florentine and other saucy flavors before him but he just turned away.  Tried human tuna a few days ago just to see if he would be interested.  It's very distressing.  This is a boy who will eat anything!

His bum seems sore this morning, too.  He tried to lick it but then abruptly stopped.  I force fed him 1 syringe of food earlier at 6am and will do another one right after his pills at 7:30.  He's a good boy when I feed him; I don't need to wrap him in a towel or straddle him.  I squirt the syringe into a little dish and then feed him by finger while sitting next to him.  He lets me do it and doesn't pull away.

I may need to consider the possibility it's cancer.  If I ask for an ultrasound when do I get the results?  Immediately?  Or is it a couple of days?

How do you remain strong and resilient when everyone around you is telling you to consider letting him go?

poor little kitty and you 

try the gravy lovers and grilled - i have better luck with those.  HK's favorite flavor is tender beef classic, but when he wasn't feeling well, he wouldn't eat any of the classic flavors.  and like i said, i rotate through EVERY flavor every meal if i have to - sometimes he won't eat 3 or 4 in a row but will lick up some of flavor 5.  and every time i do this, i think "oh, my god - what will i do if he doesn't eat this time?"  obviously this is a feeling you're too well acquainted with

when they did an ultrasound on HK, they couldn't tell us if he had cancer or IBS for sure, and told us they didn't recommend the expensive and intrusive tests that would let them know which it was due to his age.  but since both meant a steroid - in his case, prednisolone - they treated it the same.  since your cat is taking pred, has your vet tried an appetite stimulant or pepcid?  pepcid could improve things if the problem is too much stomach acid, which is sometimes the case.

it's very hard to remain strong.  sometimes it's almost impossible, but we're doing it for them!  they love and trust us.  i don't let go as long as they seem to have quality of life AND only when i'm sure that the problem isn't something the vet missed.  there's a user here who put her cat to sleep after she was told by urgent care that it was hopeless, only to be told the next day by her vet that the thing the urgent care dr told her her cat had was shown by blood tests not to be the case.  she was devastated. 

keep finger-feeding your kitty.  and if possible, get a second opinion.  doctors of all sorts are sometimes wrong or just don't see past their medical prejudices.  but if you can't, just keep loving your cat, finger feeding, petting and cuddling. 

and know you're not alone.  since 2010, i've cared for my late mother, who had dementia and health problems, our heart patient cat, who required frequent chest taps and a plethora of meds (not to mention the expense and fear of frequent trips to the cardiologist).  my husband developed dangerous kidney issues that required a lot of care and hospital stays.  and now HK and his kidney and tummy issues, weight loss and the rest.  it's overwhelming and i just want to curl up in a hole.  but when it's time to help him, i feel stronger.  then it's over and i just want to fold up.  but we're making our loved ones - cats and humans - feel better.  we're helping.  we're letting them feel and know how much they are loved.  and that counts for something, bigtime!

It's with a very heavy heart I have to announce that Moses passed away yesterday.  The drugs weren't working and he got worse.  He still wouldn't eat and got very weak.  I had to carry him to the litter box and he could hardly stand.  We both knew it was time.  We put him to sleep yesterday and he joined my angel, Josie, at the rainbow bridge.  I feel honored to have been with him while he passed. 

I have never had such an outspoken, demanding, loving cat.  He will be missed badly.

Thanks to the posters who tried to help.  It was appreciated very much.

that's very sad news, but you did all you could and he passed away knowing just how loved he was.  thank you for letting us know, and loving thoughts to you and moses.

patti

Im so sorry to hear that ):