Elevated Liver Enzymes, no root cause yet

I searched the site for some advice on what to expect over my sick cat. Moli is a 11 year old female, indoor cat for last three years, very food motivated but always a thin cat. Jan 5, not overly interested in food, some vomiting, starting to hide. Other indoor finicky cat turned away from food but we recently changed brands (dry and wet). Jan 10, blood tests showed very HIGH liver enzymes. Jan 12, hospitalized and ultrasound showed no mass in liver and no bright gall bladder and waiting on PLI, you could see the yellow mouth from across the room. She's been on IV fluids, antibiotics, anti-nausea, has been eating on her own since Saturday, looks less yellow. I visit twice a day. I'm happy with hospital agressive care but I've seen 10 different technicians, only I can "see" the improvement. Temp down to 101.9. She's purring and eating and probably tired of getting poked. Another set of bloodwork scheduled tomorrow. Dr's agree that she is improving but warned about seriousness. What can I expect? Thank you.

Vet Andrew Knight as well as vegan MD's recommend
drastically reduced animal products

Originally Posted by tigresa

I searched the site for some advice on what to expect over my sick cat. Moli is a 11 year old female, indoor cat for last three years, very food motivated but always a thin cat. Jan 5, not overly interested in food, some vomiting, starting to hide. Other indoor finicky cat turned away from food but we recently changed brands (dry and wet). Jan 10, blood tests showed very HIGH liver enzymes. Jan 12, hospitalized and ultrasound showed no mass in liver and no bright gall bladder and waiting on PLI, you could see the yellow mouth from across the room. She's been on IV fluids, antibiotics, anti-nausea, has been eating on her own since Saturday, looks less yellow. I visit twice a day. I'm happy with hospital agressive care but I've seen 10 different technicians, only I can "see" the improvement. Temp down to 101.9. She's purring and eating and probably tired of getting poked. Another set of bloodwork scheduled tomorrow. Dr's agree that she is improving but warned about seriousness. What can I expect? Thank you.

Click to expand...

Hi Tig,
Here is an excellent article on what I suspect would be one concern - Hepatic Lipidosis. http://www.thecatsite.com/Cats/Cat_H...Lipidosis.html
I realize your cat may have a different diagnosis, but think you'll find the article interesting. Best wishes to your kitty getting better soon, whatever the problem is.

We came home today. Liver enzyme levels dropped by 50% but still elevated. (ALT 273 down from 628, target is 130) Ultrasound revealed no cancer or fatty liver disease. Liver aspirate showed a non-specific liver disease but have elected not to take biopsy given that she is responding to meds. Waiting on PLI results to confirm pancreatitus. 2 more weeks with anti biotics and anti nausea and a pill gun. Any advice on getting pills in her 3 times a day?!?! She's getting more pink-like and not so yellow. She gain 1/2 lbs in 4 days. I'm glad she's home where its quiet. Still cautious

Can you hide her pills in a tiny meatball of wet food? Usually a pill gun works best. Glad to hear she gained weight and that you had some good news from the biopsy.

If the food trick doesn't work on her, get some empty gel caps. It's easier to slide them down the back of the throat, and she won't be able to taste the bitter pills. When they ran the blood tests, did they do a thyroid panel? High T4 levels can cause liver problems.

ok, I'm 75% successful with the pill gun. She's not eating now and I think that I have to take her back to hospital. I'm not certain about the T4 levels. I feel like I have let Moli down. The hospital was trying to be sensitive to the costs and she really was getting better. I feel bad. Does anyone know if a 2 week stay is normal? We did 4 days with significant improvement. Its so sad to watch her withdraw.
Update: Dr called tonight and confirmed pancreatitus which could be 14 days aggressive care at home. She's not eating now so I think that I will take her back to the hospital for fluids and IV. Dr gave option of TPN support in Critical Care Unit (very expensive) but I feel that she will bounce back like last week. I don't know what to do...we may have to make the hard decision this weekend.

Tig, can you do the IVs at home? I'm in the 3rd week of IV-ing & force-feeding my 7 year old Bob, who apparently has come down with fatty liver disease. (we don't have the biopsy results back yet, but like Moli, he's totally jaundiced & has every other symptom, along with elevated enzyme levels) Believe me, I understand when you say you feel like you've let Moli down. I feel the same way about Bob--as if there's more I could be doing for him. Don't beat yourself up, you know you're doing what you can. Good luck with Moli.

Thank you for encouragement. I think that I could do IV's but my hub is a little squeamish about needles so I might have to go it alone. Could you describe how you do the IV process? Vet ruled out fatty liver disease and I just got back from hospital and she did eat on her own. (1 tsp of baby food). She's looking much better. Hospital is trying to feed her every 4 hours. We were at a crossroads of whether to introduce a nasal feeding tube (supposedly they get used to it) or insert a stomach feeding tube (again, supposedly not as invasive as you would think) which would make injectable medicine and food much easier. I go to visit her twice a day to try to get her to eat. I'm trying to get a read from the specialist if cats in Moli's shape survive but I believe that pancreatitus is really just a generic term so there is never really a specific diagnosis or treatment. I don't want to be just making her eat in preparation for a prettier death. Vets still think that we're on a positive but tenuous path. Thanks again.

Actually, the hardest thing about giving the IV is getting your cat to sit still long enough. You just pull up on the skin between the cat's shoulders & slip the needle under the skin. I hang the bag on a coat hanger so that I can move it around to wherever Bob might be. Sometimes it's super easy if I can get him while he's sleeping. This is the 3rd kitty I've had to give IVs to (the first 2 had chronic renal failure), and I still worry about doing it right. But you know, you do what you have to do. My husband won't help with it, either, or with the forced-feedings.
Our vet has recommended a feeding-tube several times, but I just can't get myself to do that for some reason. From what I read, the biggest complication could be a major infection. With 3 other cats in the house, I don't have a clue how I could keep the tube in place or keep it clean. Feeding Bob by hand & syringe is tough, and I get thoroughly frustrated sometimes. But, I believe he's more comfortable at home than he would be at the vet's.
I'm not surprised you can't get a definitive answer from your vet; I can't either. I wish I had some words of wisdom to give you. I believe that as long as your pet isn't in pain you have to do whatever it takes. You'll make the right decision about the feeding tube; just look at it logically, not emotionally.
I'll be keeping my fingers crossed for Moli.
Libby

Thank you very much Libby. I go back to visit Moli tonight.