Meet Zoe - questions on high blood test results

[TriciaH]

Hi everyone! I'm new here. My cat Zoe, 14 yrs. was recently seen and has some not so great blood test results. The high numbers are:

• Glucose 171 mg/dL - normal 63-148
• Creatine 2.6 mg/dL - normal .6-2.2
• BUN 42 mg/dL - normal 15-40
• Globulins 5.1 g/dL - normal 2.8-4.9
• ALT 244 U/L - normal 26-143
• AlkPhos 106 U/L - normal 12-65
• LOW Platelets - "Many small platelet clumps seen. Many medium platelet clumps seen. Rare large platelet clumps seen. Platelet morphology is unremarkable. The value reported above is the automated platelet concentration and presents the minimum platelet concentration due to the platelet clumping."

In April 2020, Zoe had a stroke, or so the hospital thinks. Amazingly, she recovered almost 100%. They found her blood pressure high so put her on 1/4 of a 2.5 mg tablet of Amlodipine. I checked it again after a month and she was doing better. Then COVID really broke out and we haven't seen a vet since. Then she had this weird incident of throwing up but it was just foam. I called her vet and she asked some questions and said, well, let's wait and see. A few months later it happens again. That's when I decided she needed to be seen.

Instead of her usual vet (she does really badly in the car), I found a mobile vet to visit us. While he seemed to know his stuff, he was a little rough with her and is completely unresponsive. He called and said she had Stage 2 chronic kidney disease and probably liver cancer. I find that last one a bit much as I understand that's hard to diagnose off blood alone. He went thru some options really quickly and pointed me to his website that provides really expensive r/x diet food. Needless to say, I called our usual vet and am waiting for her to call me back. I'm wanting a 2nd opinion.

In the meantime, I'm not giving up. I love Zoe, so so much. I'm going to work hard at giving her a good life and keeping her as healthy as possible. I've always given her dry food. That's what she likes and it's what the shelter gave her when we got her 14 years ago. I didn't know any different. I hear wet is better but until I figure it out as to which one I'm giving her the usual.

These numbers are really concerning to me. Does anyone have any experience with similar numbers, age of cat? Thank you so much.

 

[fionasmom]

Welcome to The Cat Site! First of all, Zoe apparently has survived this long on dry food, so don't go down that road of beating yourself up over her diet. Is foamy vomiting the only symptom you are seeing? I can understand some kidney involvement in a cat that age, but the guess at liver cancer is based solely on numbers. Did the vet feel a mass? While it is true that early stage liver cancer can be asymptomatic, it can only be definitively diagnosed by xray, ultrasound, FNA, or some other diagnostic. Talking to the vet you prefer may help clarify this but usually a next step is needed. Sometimes blood work is repeated and, if it is consistent over time, the possibility of liver disease becomes more likely. Liver cancer has various forms; of course, we are hoping that Zoe has none of them. The next step would be an ultrasound more than likely to determine exactly what is going on.

 

[TriciaH]

Hi, and thank you!! The foamy vomiting is the only out of ordinary thing, and why I called a vet. Plus, she was overdue for a checkup. It was so strange. It's happened 2 times in the past 6 months or so. She first hacks up a hairball, then does it again and again only foam comes out. She then acts quite wobbly and looks as if she can't really get comfortable to lay down. After about an hour, she calms down and then acts like nothing happened. She sleeps a lot, but gets up routinely, drinks, goes to the bathroom, snacks and back to bed. I will say her food intake has gone down, but it's not like she's not eating. She's always been petite at 7 lbs. She eats about 1/2 cup of food per day.

He did not feel any mass. He did talk about an ultrasound, but we are very hesitant to put her through any kind of procedure like that. Before the stroke we had a MCT removed, and that was benign. BUT, I think it might have helped the stroke come along, paired with the high BP. At her age, an ultrasound doesn't seem appropriate given she'd need anesthesia.

To me the most concerning is the BUN, ALT and Alk/Phos. While I know that numbers change in cats, they aren't static, I'm worried about it and unsure what to do.

 

[fionasmom]

Would your cat allow an ultrasound without anesthesia? It is not a requirement if the animal is calm enough and I have had dogs and cats remain unsedated for that procedure. If you don't want to do that, I would repeat the blood work in whatever interval the vet recommends. If the results are the same, I would assume liver disease of some sort and keep her as comfortable as you can. Have your vet work with you on a best guess of what is going on and how to treat it. If a dietary change is needed, they could advise you.

 

[mrsgreenjeens]

Totally agree with fionasmom . My last kidney cat used to get a much higher that Zoe's ALT number, and we would put her on antibiotics and that would fix the issue, at least for awhile. Granted, eventually the ALT would rise again after a year or so and we would do the antibiotics again. Since she already had chronic kidney disease, we decided against an ultrasound of her liver because if she needed to have major surgery for anything they found, we were not going to put her through that. Our girl was a little older than Zoe at that time. That being said, I do think there is something going on with Zoe's liver since her Alk/phos is also fairly high. If you want to try to find out what, I think you need to discuss next steps with your Vet. I'm thinking they will suggest ultrasound, but could be wrong. From reading your latest post, you may want to take the same route we did, and treat with antibiotics and see what happens.

As to Zoe's glucose level, it is a little high, but if she was stressed out, that could easily account the higher number. Infections can also contribute to high glucose in cats.

In reading the BUN, Creatinine, I would say she definitely has kidney disease. Here is another website to take a look at. It was my "go to" anytime I needed information about meds, fluids, etc. Tanya's Comprehensive Guide to Feline Chronic Kidney Disease - Everything You Need to Know to Help Your Cat. It's very full of information, including non-prescription wet AND DRY foods that may be lower better for her. I will say that we never fed kidney foods to any of our kidney cats and they still lived at least three more years after diagnosis.

Keep us posted on what your Vet says.

 

[LTS3]

I wouldn't worry about glucose. Many cats are super stressed out at the vet's office (or even at home with a strange mobile vet) and that causes blood glucose levels to skyrocket. 171 isn't a bad number with stress factored in. If diabetes is a concern, the vet can do a fructosamine test which gives an average of blood glucose levels over the past few weeks, sort of like a AC1 test for Human diabetics.

 

[TriciaH]

Hi again fionasmom and mrsgreenjeans (love your sweet angels):

I don't know if she'd allow for ultrasound with no anesthesia. Her usual vet is great and removed the cyst with just a local and no general anesthesia. But Zoe is a really active cat! She's squirely and doesn't like to hold still. But this >>>

Since she already had chronic kidney disease, we decided against an ultrasound of her liver because if she needed to have major surgery for anything they found, we were not going to put her through that.

is exactly where we are. We don't want to put her through that kind of thing. It's not like we will do major surgery on her. And like you said mrsgreenjeans, she probably has CKD. BTW, I've gotten familiar with Tanya's site, it is a wealth of info!

She was definitely stressed. This new vet was not handling her well. He first took her BP and insisted on 3 tries, but she was fighting on the first try, so the other two didn't go too well. The average was 200. So he told me to up her Amlodipine to 1/2 of a 2.5 mg pill.

 

[TriciaH]

Hi LTS3 - I missed your post. See above. Thanks so much for your thoughts. I think the glucose is less concerning to me than the ALT and BUN numbers

 

[MissClouseau]

Then she had this weird incident of throwing up but it was just foam. I called her vet and she asked some questions and said, well, let's wait and see. A few months later it happens again. That's when I decided she needed to be seen.

Does she go long hours without food? Liver-gallbladder issues alone can make a cat puke like that but with that, or something acid reflux, puking like that is pretty common. Even without any chronic health issue puking more than their younger years is common among senior cats (or senior humans, any species really.) Their digestive system gets more sensitive too.

He called and said she had Stage 2 chronic kidney disease and probably liver cancer.

Liver cancer?! Did they do a special blood test to check cancer? Did they do ultrasound? There are quite a few liver diseases that can cause elevations. Both liver disease and kidney disease are common but manageable for years with special food, supplements, and care.

 

[TriciaH]

MissClouseau, lovely name btw. Interesting about the puking. She does go awhile without food. Sleep for an hour or two or three, get up, drink/eat, pee/poo, sleep.

I'm guessing that this vet took the test results and my report of puking and turned that into liver cancer.

This vet was not my favorite. No ultrasound, no special blood test. Just the quick call. Then when I tried to get more questions answered, no response. I'm so done. I'm now calling around for another vet to review the results. Since I need her BP checked (2-3 weeks on upped medication should show results of that, right?) I thought maybe then I could get them to review.

 

[fionasmom]

I agree with you on the usefulness of an ultrasound that will not result in any treatment. I told my vet several years ago that we were done doing diagnostics just for academic purposes if the cat in question was not a good candidate for treatment.

 

[mrsgreenjeens]

I think 2 - 3 weeks should be plenty of time for the upped amlodipine to work. Keep us posted on Zoe's health.

 

[TriciaH]

Thank you so much loves. I feel so welcome here and honestly, I have moments of extreme sadness and lost feelings. It's great to come here and hear from you and get experience, strength and hope.

 

[TriciaH]

I agree with you on the usefulness of an ultrasound that will not result in any treatment. I told my vet several years ago that we were done doing diagnostics just for academic purposes if the cat in question was not a good candidate for treatment.

Thing is, it sounds like ultrasound is done to confirm suspected cancer and that's it. If that's the case, then definitely not putting her through that. "Academic purposes" - yes, absolutely.

 

[MissClouseau]

MissClouseau, lovely name btw. Interesting about the puking. She does go awhile without food. Sleep for an hour or two or three, get up, drink/eat, pee/poo, sleep.

I'm guessing that this vet took the test results and my report of puking and turned that into liver cancer.

This vet was not my favorite. No ultrasound, no special blood test. Just the quick call. Then when I tried to get more questions answered, no response. I'm so done. I'm now calling around for another vet to review the results. Since I need her BP checked (2-3 weeks on upped medication should show results of that, right?) I thought maybe then I could get them to review.

I will put this chart here in case you haven’t seen:

The list of things that can cause liver enzymes to go high is long. My own cat is going through liver issues currently and as every vet tells me it’s difficult, sometimes impossible to tell the cause. I got ultrasound done on my cat. They didn’t see a tumor, and with that they outruled cancer/blockage, and outruled gallstones. She got diagnosed with Cholengiohepatitis and mild fat around the liver after the ultrasound. Just to share one case.

 

[TriciaH]

Interesting. The list is indeed long. Thanks for sharing. I'm on the search for a good vet and hopefully can get Zoe the help she needs.

 

[mrsgreenjeens]

I got ultrasound done on my cat. They didn’t see a tumor, and with that they outruled cancer/blockage, and outruled gallstones. She got diagnosed with Cholengiohepatitis and mild fat around the liver after the ultrasound. Just to share one case.

Glad they didn't find a tumor and were able to rule out cancer/blockage and gallstones. Just curious, how are they treating her Cholangiohepatitis?

 

[MissClouseau]

Glad they didn't find a tumor and were able to rule out cancer/blockage and gallstones. Just curious, how are they treating her Cholangiohepatitis?

Cholangiohepatitis and little fat around the liver.
She currently gets VedaVet Cleansing tea product in the morning, then by the noon BioPetActive Silycumin (a milk thistle-curcummin product.) In the afternoon ursodiol. In the evening with food ZooVital LiverVital which is another supplement.

She’s been getting supplements since April.

also she was prescribed Hepatiale Forte Advanced but she refused it. The vet changed it to the VedaVet product. In Turkey we don’t have another liver medicine to give at home under the medicine category. I heard from another vet in some cases they use an injectable medicine they have.

My cat’s ALT was 800 back in April. Last month it was 440. And she’s around 5 years old.

 

[mrsgreenjeens]

Cholangiohepatitis and little fat around the liver.


My cat’s ALT was 800 back in April. Last month it was 440. And she’s around 5 years old.

Glad to hear she's improving

 

[TriciaH]

Hi everyone, just a quick update. I finally got the records from the mobile vet. He was terrible. It shouldn't be that hard. I almost had to threaten. My regular vet reviewed and mostly agreed with the diagnoses. She says Stage 2 CKD is considered early. Whether or not that's true it gives me some peace. She disagreed with simply assigning liver cancer based on elevated enzymes. She said the enzymes were barely elevated so whatever the case, it's probably not bad. She's recommending renal diet too.

Zoe drinks a ton of water, always has. So that's not really a problem. It hasn't waned either. Her eating, however, has gone down. She weighs 9 lbs and eats about 1/4 cup of dry food per day. I've read about how to switch her to wet food and might try that soon. I usually feed her Crave or Merrick grain-free, but I know I need to switch. I routinely see Hill's Science Diet brought up. She loves chicken flavor.

I read Tanya's website a lot but thought I'd ask here - should I just start with Hill's? Which has been more palatable for your cat? Is my cat going to hate it? Bring out your crystal ball! LOL