Liver levels high in senior cat

[profcat]

Our Rose (yes, named after the Golden Girls) is 17 and has been in the early stages of kidney failure for over a year. Her kidney numbers are stable (we give her fluids every night) and her appetite has been great. But the last few weeks we noticed her getting pickier about food so we brought her to the vet -- it was a month before we would have had her blood checked anyway, so we checked her bloodwork. The good news is that her kidney levels still remain stable and she did not lose any weight, BUT her ALT and AST (liver levels) were elevated. Not alarmingly-- the vet said she had seen 10 times higher. But elevated enough the vet was worried. The vet said it could be an infection and put her on a cocktail of metronidazole and orbax, with a small dose of steroid.

She's been on the medications since Tuesday. At first, her appetite seemed to improve a bit, but now she's not wanting to eat anything. I read that both of those antibiotics can cause a lack of appetite. She did eat some dry food this morning which made me happy, and we plan to offer her anything she wants to eat (sardines, fancy feast, churos, etc.). She's not vomiting at all and is acting like herself.

Has anyone dealt with this? Any advice for getting her to eat? We do plan to get the bloodwork repeated in a couple of weeks and to get an ultrasound if she's not any better.

 

[StephMo]

I'm sorry to read what you and Rose are going through...hugs to you. It's so emotionally tiring. I'm new on here, but just went through something similar and the things I learned from people here might help you. Lack of appetite was a huge problem. With my kitty, none of the inflammation markers were ever 'alarmingly high' - they were always just slightly elevated. So reading that in your post caught my attention. Throughout the couple months he was sick, he also had a belly-shave ultrasound - which showed promising results. If you're thinking about an ultrasound and she continues to not eat, I wouldn't wait two weeks to redo the labs and get the ultrasound. A lot can change in 2 weeks if they aren't eating. With my kitty, his inflammation blood markers even showed signs of improving... but despite that, his body still started shutting down because I just couldn't get enough food and water in him. Whatever she will eat, is better than nothing at all. Members on this forum advised me to make sure my kitty got the supplement Taurine, since for a while all he would touch was boiled chicken, boiled shrimp, boiled scallops, scrambled eggs, etc. The heat of cooking destroys the natural taurine in foods. To add taurine, I took Nupro Nuggets OR FortiFlora (both have taurine), mixed them in a shot glass with 6-7 drops of HOT water, stirred until smooth, and drew it up in a little syringe that went right into his mouth. The Nupro nuggets were harder to crush/melt, so I gave up on those pretty early and just stuck with the FortiFlora. He liked the FortiFlora syringes, and often times, after he swallowed one he would go to his bowl and pick at his food - so I think it may have some appetite stimulant properties. There's also an ear cream called Mirtazapine (I may have that spelled wrong) that is used as an appetite stimulant sometimes. The ear cream didn't work on my kitty, but it works on most kitties from what I've read. For food, I had decent luck with chicken thighs, chicken breast, canned tuna, scrambled eggs (weird one!) to get my boy to eat. He refused most "cat food" for the greater part of two months. Staff members who go by FurballsMom and FionasMom offered a lot of good advice on nutrition and manual feeding if you want to read their comments in my post asking for help: "Triaditis" leading to urinary food aversion...

Again, hugs to you and I hope Rose starts eating and makes a full recovery.

 

[FeebysOwner]

Hi. I would make sure that Rose is eating something - anything - with those antibiotics. It isn't so much that they actually cause lack of appetite, it is that they are tough on the stomach which ends up resulting in a lack of interest in eating. So, yes, feed her whatever she will eat, especially while on those antibiotics - and, most importantly with each dose of them.

Re: the high ALT and ASP - these numbers can also be elevated due to things like diabetes, hyperthyroidism, pancreatitis, inflammatory bowel disease, systemic infections (e.g., dental disease). Not saying Rose has any of these, but these are other things that impact these liver enzymes besides just liver disease.

Until blood work is redone (and, possibly an ultrasound), you might ask the vet about giving Rose an appetite stimulant and/or anti-nausea meds. Not all cats who feel nauseous vomit.

 

[daftcat75]

Ask your vet about an anti-nausea drug called ondansetron. My Betty White seems to have nausea issues and ondansetron really helps. I would also ask your vet about a prescription food called Hills A/D. It is high calories and especially appealing for just this sort of thing: getting sick cats eating again. If she likes A/D, I would mix it with her wet food as soon as you can get her to eat a mix. That’s because A/D is very rich. Although highly appealing, cats don’t tend to eat as much of it as a regular food. Mixing it will get you the best of both worlds: a highly appealing food that she can eat enough of to get her through the antibiotics course or whatever else is ailing her. This also spares pure A/D for when not even a mix appeals to her. If you just let her eat the A/D by itself, she may not eat enough of it and you have nowhere else to go if she gets sick of it. At least with a mix, you can tune the ratio as needed. Betty ate 1 part A/D to two parts I/D (stew, not pate) for a long time until one day she felt well enough that she just wanted the I/D by itself. Now I save the A/D just for coating capsules and if she ever goes off her food again. In a pinch like the other day when I had to give her an ondansetron outside her normal med schedule (usually I give her pills first and then a regularly scheduled meal), I was able to make sure she had some food in her stomach for that capsule by letting her finish a mound of A/D I had scooped out to coat her capsule.

 

[profcat]

Hi. I would make sure that Rose is eating something - anything - with those antibiotics. It isn't so much that they actually cause lack of appetite, it is that they are tough on the stomach which ends up resulting in a lack of interest in eating. So, yes, feed her whatever she will eat, especially while on those antibiotics - and, most importantly with each dose of them.

Re: the high ALT and ASP - these numbers can also be elevated due to things like diabetes, hyperthyroidism, pancreatitis, inflammatory bowel disease, systemic infections (e.g., dental disease). Not saying Rose has any of these, but these are other things that impact these liver enzymes besides just liver disease.

Until blood work is redone (and, possibly an ultrasound), you might ask the vet about giving Rose an appetite stimulant and/or anti-nausea meds. Not all cats who feel nauseous vomit.

Thanks for all this info!

She actually ate some wet food this morning with chicken liver sprinkled on top! So if she eats that much a few times a day, I'll be happy!

It's good to hear those levels can be elevated for multiple reasons-- I worry this is the beginning of her being really sick and I don't even want to think about that. She had the I-131 radiation treatment for her thyroid years ago, so no issues with that. Her teeth looked good (she doesn't have many left). I hope she continues to eat for the entire course of antibiotics. Otherwise, we can check about an appetite stimulant. And will definitely get an ultrasound.

 

[furmonster mom]

Adding a little raw egg yolk to her wet food can also sooth the stomach as well as give her a little vit. B boost.
You don’t need to use an entire yolk, between a teaspoon and tablespoon should do. You can keep extra yolk in the fridge; I’ve found that adding a few drops of water seems to help it keep for an extra day or two.

 

[daftcat75]

Egg yolk can also have a laxative effect. Start small and let the litterbox tell you if she can have more. Egg yolk is also great for hairballs. Sadly Betty doesn’t care for egg yolk.

 

[profcat]

Adding a little raw egg yolk to her wet food can also sooth the stomach as well as give her a little vit. B boost.
You don’t need to use an entire yolk, between a teaspoon and tablespoon should do. You can keep extra yolk in the fridge; I’ve found that adding a few drops of water seems to help it keep for an extra day or two.

That's a great idea! Whenever I have a sunny side up, she loves licking the egg yoke that's left.

 

[daftcat75]

That's a great idea! Whenever I have a sunny side up, she loves licking the egg yoke that's left.

My Krista used to enjoy licking the scrambled egg bowl after I poured the egg into the pan. That’s when she was still allowed egg before IBD crossed that off her list. And while she only enjoyed this for a brief time, she would forever after come running into kitchen whenever she heard the fork and bowl sound of scrambling eggs.

 

[profcat]

An update: We finished the antibiotics for Rose and they definitely made her not want to eat-- but we were able to get her to eat enough each day. As soon as she came off them, her appetite returned but not 100%. Her mood has also improved and she's up and around more.
She's getting bloodwork repeated today to see what her liver levels are and also getting an ultrasound. I'm praying it's not bad news.

 

[profcat]

Another update: She does have a tumor on her liver. We'll get the full report and blood work today.

 

[furmonster mom]

Another update: She does have a tumor on her liver. We'll get the full report and blood work today.

So sorry to hear this.
Hopefully it can be removed?

Our angel Pippen had severe liver damage at 3 years old, and the vet saw growths on the ultrasound. When she went in for surgery, she saw the liver was cover with these growths. She sent some in for evaluation, and they turned out not to be cancerous, but rather the livers attempt to repair itself. This is when I learned that the liver is the only self repairing organ in the body. We put him on a liver support regimen, and he stayed with us for several more years.

Keeping hope for you.

 

[profcat]

So sorry to hear this.
Hopefully it can be removed?

Our angel Pippen had severe liver damage at 3 years old, and the vet saw growths on the ultrasound. When she went in for surgery, she saw the liver was cover with these growths. She sent some in for evaluation, and they turned out not to be cancerous, but rather the livers attempt to repair itself. This is when I learned that the liver is the only self repairing organ in the body. We put him on a liver support regimen, and he stayed with us for several more years.

Keeping hope for you.

She's 17 so we're not going to put her through any major surgery. We got the full ultrasound report and she has a few small tumors on her liver, and also her gallbladder has some sludge and the bile duct is partly blocked. There was also evidence of pancreatitis. The good news is her AST and ALT levels went down from 2 weeks ago.

She's now on a steroid and denamarin and ursodiol. We'll retest her bloodwork in a few weeks and see how she's doing. For now, her appetite is ok (she's always been a picky eater) and she hasn't lost weight. Her kidney values have been the same (she gets fluids every day). So we are just planning to keep her happy and comfortable as long as we can, but the vet made it sound like this wasn't good news overall.