Very high ALT, possible IBD flare up?

[PrincessCardia]

Hello, I am desperately seeking support and insight. My 8-year-old cat, Winona, has had recurrent episodes of vomiting and inappetance for several years now. They almost always resolve on their own within about a day and she acts like nothing ever happened. Twice she had a harder time recovering and went to the vet, and once to the ER. They never diagnosed her with anything conclusive, and she’s bounced back each time with Cerenia.

She started throwing up Wednesday of this week, then really perked up Thursday morning and was eating and playing again. Thursday afternoon into the evening she began vomiting again and acting more lethargic, so I brought her to the vet first thing this morning. They did bloodwork and her ALT came back very high at just over 2000. I am terrified of liver disease. The vet sent her home with fluids, a Cerenia shot, an appetite stimulant, an antibiotic, and a probiotic. She wants me to take her to the ER if she does not start eating again within 8 hours. If all goes well and she does eat and begin feeling better, she’ll go back to her normal vet on Wednesday to re-evaluate her blood work.

I am scared out of my mind. I have seen some research that IBD can cause elevated ALT during a flare up and then return to normal after it passes. Does this seem like a possibility given her history of the recurring vomiting? I appreciate any help. I lost my oldest cat earlier this year and having a health emergency now is not something I am handling well, I feel like I’m going to fall apart.

 

[FeebysOwner]

Hi. What is the lab reference range for ALT?

Usually, other liver enzymes will be high as well for a number of liver disease issues, but most common with just a high ALT reading are IBD, hyperthyroidism, and diabetes. There are some others, but most any of these conditions would typically have impacts on other blood work elements as well.

If her weight and urine/stools are good - and, she does perk up - I would wait until the follow up with your regular vet before going into panic mode.

 

[Furballsmom]

Hi
As mentioned, hang in there with this. Cats are highly attuned to our emotions and she will be aware of your upset but won't understand it

 

[PrincessCardia]

Thank you both for your reply. The normal range on her paperwork is supposed to be 12-130. The rest of her labs were pretty normal, except her TBIL was also elevated at 8.6 (normal range 0-.9). I am trying to hold myself together but this came on out of no where, even Thursday morning she was eating and playing like normal. She unfortunately hasn’t wanted to eat yet so I’m preparing to take her to the ER now for nutritional support.

 

[FeebysOwner]

Please keep us posted.