Alternative to Cerenia and Possible Liver Problems

stephanietx

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Please note: I have a vet appointment scheduled tomorrow morning at the cat only vet.

My cat, Tumbles, is a 13 yr old neutered brown tabby. (He's also a TCS kitty and you can read his rescue story here: Tumbles' Rescue Story)

About a month ago, I noticed that Tumbles was picking at his wet food. He has a history of gastrointestinal issues and is currently managed by RC Gastro wet and dry food. He then stopped eating his wet food, but will eat his dry food, but only in reduced quantities. He went to the vet 5/12 and couldn't find any obvious signs. They ran bloodwork, took his temp, and said that even though his liver enzymes where high (ALT was 101), the vet wasn't concerned because she was thinking it was from stress and from not feeling well. She gave him a Cerenia shot to help settle his tummy, thinking indigestion and gastro problems were the cause. Brought him home, he refused to eat his wet food. He continued to eat dry food.

The following day, we started him on Fomatadine (per the vet's instructions). He began eating the chicken/venison mix we feed our other kitties and his dry food. We can't feed him too much of the chicken/venison mix or he'll either get diarrhea or gastroenteritis. On Monday, 5/15, I picked up Purina EN from the vet and he LOVED it. He scarfed it down. That lasted for 2 days and he was back to picking at his wet, eating manily dry. We called the vet on Thursday 5/18, and let them know what was going on. The vet gave us more Cerenia, but it hasn't seemed to help as much as previously and still wasn't concerned with his liver levels

He continues to not eat either of his RX foods, but eats the chicken/venison fine, except for this morning. He is not vomiting, doesn't have diarrhea, is sleeping well, not uncomfortable when sitting, and he is using the box normally. I've noticed that he's drinking more water (presumably from nausea/tummy issues), but not a ton to indicate diabetes. He also seems to be more lethargic and not as spunky as normal.

So my question is when we go to the vet tomorrow, what tests do I need to ask for? Will an x-ray show anything? Is there something more effective than Cerenia? If it's his liver, are there any good supplements to try to help him?

Some pics of my boy.

Baby Tumbles.jpg Tumbles 5.23.jpg
 

maggie101

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Elura was suggested for my cat but I have trouble using a syringe. I can give her a pill so he gave me mirtazapine appetite stimulant. I also give her fortiflora. He is guessing she had inflammation from her ibd
An xray will help
 

Furballsmom

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Hi
I can't help much, except for a gut feeling after reading your post;
the vet wasn't concerned because she was thinking it was from stress and from not feeling well.
...this reaction bothers me a lot, because combined with the reluctant eating, it seems to me that the vet should be looking at the liver numbers as a possible cause of his not feeling well, rather than the other way around :(

The good thing about the liver is that unlike most body organs, it has the ability to heal itself given the right conditions. Supplements to support the liver are milk thistle which doesn't require a prescription, and denamarin;
Denamarin For Cats: Overview, Dosage & Side Effects - Cats.com
 

FeebysOwner

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It seems to me, based on all that I have read, that ondansetron might be a better option than Cerenia for nausea. The latter seems to work more for vomiting than for nausea. The former, the opposite. Of course, every cat is different, so experimenting is usually necessary. I also have found that many vets don't prescribe a large enough dose of ondansetron to make a difference. Thankfully, that was not the case for me. My vet said to give 4mg 2-3 times a day. That might be a bit much, depending on what Tumbles weighs. But you certainly need at least 2mg 2-3 times a day.

If the vet doesn't think the liver numbers are related to Tumbles lack of eating, then I agree with the above that a more concerted effort needs to be placed on that aspect. The other members have offered some ideas in that regard.
 
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stephanietx

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Thank you all for your responses.

He is a very sensitive kitty and doesn't do well in stressful situations. There's been some stress in our home the past couple of months--depression and anxiety, death of a family member, a long trip for my husband to attend the funeral and help with the estate, and then I was off for 4.5 months and have recently returned to work. His normal response with stress is pooping outside the litter box, which he has done over the past several weeks, but only a few times. I can understand that my vet was thinking that stress was contributing to his problems. I've only been back to work for a couple of weeks and this started the week I returned. I don't mind her not being concerned, but I do think it's something that she should've been more concerned with, even if it's just, "Let's re-check his numbers in a few weeks" and then if things had changed, to address it.
 
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stephanietx

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Hi
I can't help much, except for a gut feeling after reading your post;

...this reaction bothers me a lot, because combined with the reluctant eating, it seems to me that the vet should be looking at the liver numbers as a possible cause of his not feeling well, rather than the other way around :(

The good thing about the liver is that unlike most body organs, it has the ability to heal itself given the right conditions. Supplements to support the liver are milk thistle which doesn't require a prescription, and denamarin;
Denamarin For Cats: Overview, Dosage & Side Effects - Cats.com
Do you have a favorite milk thistle brand? I am open to trying this and will talk with the vet tomorrow about it, if it turns out to be liver related.
 

furmonster mom

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Do you have a favorite milk thistle brand? I am open to trying this and will talk with the vet tomorrow about it, if it turns out to be liver related.
I’ve used milk thistle as a liver supplement. The thing you need to look for on the nutritional label is the silymarin content. Some brands have a lower percentage than others. I believe you can also get it as a liquid/tincture, but be sure to get non-alcohol.

I have also used SAM-e as s-adenosyl, instead of the vet brand. Only thing on that is cutting the tablets into quarters could be challenging.
 

furmonster mom

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I used this brand. I didn't know to check the silymarin content, so I don't know how good it is ;


Milk Thistle – Herbsmith
This info was at the bottom of that page, in a collapsed link:

Silymarin Math
  • There is approximately 3% silymarin (based on the dry weight of our Milk Thistle) per serving size (1/4 tsp).
  • A ¼ teaspoon contains 550mg of our pure, organically grown Milk Thistle
  • (550mg = ¼ teaspoon)
  • There is approximately 3% silymarin (based on the dry weight of the product) per 1/4 tsp.
  • So, take 550 mg and multiply by .03 (the amount of our active ingredient, silymarin)
  • 550x.03=16.5
  • There would be about 16mg to 17mg of silymarin in each ¼ teaspoon.
  • ¼ teaspoon = 550mg of ground milk thistle = 16.5mg of silymarin

Good info for when you talk to the vet about using it and considering dosage. It’s nice that they included that info, just wish they hadn’t hidden it.
 
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stephanietx

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We went to the vet today, a different clinic than previously. This is a cat-only practice and they are great, but expensive. The vet was impressed with his bloodwork for his age and wasn't overly concerned about the liver numbers, since only 1 of them was out of normal range and not by much. However, she did run a test for pancreatitis and it came back positive. He got some fluids with B12 and ondansetron. She also put him on some steroids to calm down the inflammation and sent us home with an appetite stimulant and ondansteron to use as needed. He has eaten his regular lunch portion and is laying on the couch with my husband, but he's very unsettled and hasn't napped since coming home.

The vet was fantastic with him and did mention that if this becomes more chronic, then we would need to do a sonogram and more in-depth bloodwork that would have to be sent off to Texas A&M. She also mentioned that he has IBD, which we've never been told before.
 
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