18 year old diabetic cat with liver failure

babygiz

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My partner's been treating his 18-year-old male senior cat for diabetes for the last four months, but we haven't yet seen him go into remission. His blood sugar's been up and down since he got on insulin, but his appetite and behavior have both been very good. The main change we've noticed has been weight loss (which started before he got diagnosed with diabetes), which started getting more pronounced a couple weeks ago. We started getting worried when he dipped under 7 pounds, and noticed that his skin had started to turn noticeably yellow.

We were able to get him into the vet today, and they recommended euthanasia after reading the lab results - his abdomen is filled with fluid and his ALP, ALT and bilirubin levels are extremely high (I've attached photos of his lab results). Our interactions with the vet were really brief though, and we're not sure euthanizing is the right choice at this point in time. My partner's cat, despite his age and condition, is still behaving like his usual self. He still has a healthy appetite, is drinking plenty of water, is vocal when hungry, has no noticeable signs of lethargy, is still cuddly and affectionate with loved ones, and using the litterbox normally.

The vet basically said he had a few days left though, and suggested we euthanize him today. We opted to bring him home instead, because he literally does not "seem" sick - euthanasia just seemed too soon at this point, because his quality of life doesn't seem to be suffering (he ate as soon as he got home from the vet and has been doing his usual cuddling with family). He doesn't seem in pain or distressed, so we were thinking of taking him in to another vet tomorrow for a second opinion.

He's always been a healthy cat with virtually no health problems, and really only started slowing down and showing his age about a year ago. Apart from his diabetes he was diagnosed with kidney disease in the last year, but his numbers have been fairly good. We currently have him eating chicken and premix only, with no dry food, and dose him with insulin every twelve hours (between 0.25 - 1 unit). Is there anything else we could be doing for him? And what can we expect moving forward?
 

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LTS3

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You should also post on the FelineDiabetes . com message board Feline Diabetes Message Board - FDMB

Diabetes isn't discussed often or in much detail here on TCS.

Some diabetic cats just never go into remission and that's ok as long as they are being treated with insulin and diet.

Did the vet say what liver disease your cat has? Fatty liver or something else?
 

mrsgreenjeens

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I would agree that if my cat were acting as this cat is, it would be extremely hard to justify euthanizing him at the moment. It sounds as if he's still enjoying life and he doesn't appear to be in pain, so why not let him continue.

You mentioned the visit with the Vet was brief. Did the Vet realize this cat still has a great appetite, and is basically behaving normal in all aspects? (I'm assuming there is no vomiting, no diarrhea, none of the usual markers of an ill cat other than the jaundice). I'm kind of shocked they are recommending euthanasia right off the bat. Can you get a second opinion? Even with liver failure there are medications/supplements that can be given to try to combat it. The liver is the one organ that can regenerate if it's not too far gone, and with this boy acting so normal it doesn't sound like it's too bad. (plus I've seen worse numbers than his)
 
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