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Help!!! My 4year old kitty has fatty liver disease!!

beckiandthetrio
September 18th, 2009, 07:55 PM
Well the drama continues!! I was gonna update this in my original thread but I wasnt sure if anyone would see it??

Anyhow, I got Janie's lab results back. All her labs were normal except for the liver panel. The vet and I think something happened to stress her out and she stopped eating abruptly and in turn caused her liver to fail. And now she is probably very nauseated also.

The vet has told me that I need to force feed her 1 and 1/4 can a day of EVO 95% because of its high protein content. I also have to give her Vitamin E 1 capsule a day (squeezed into the food of coarse). She said that the more calories the better and its imperative for her to get better which may take several weeks for her to recover. She gives her a 70% chance which I guess is alright but still scares the crap outta me. I got her from a rescue and she only weighed a pound:sad:

I know some of you especially Sugarcatmomma are very well versed in cat issues so here are the lab values the vet gave me, she gave me more than these but I didnt write it all down in my state:(

Her alk phos was 382 and her billirubin was very concerning at 5.4.

The vet was pretty concerned about her but thinks with time and food she will be ok. I will have to bring her in next week to check labs again and possibly a short term feeding tube if the force feeding doesnt go well. Although I got her to eat a bit on her own and force fed her the rest which she did alright with.

Anything else I should be doing?? Anything to help with the nausea?? She is on an appetite stimulant through tomorrow so the vet said that should help.

Im sorta at a lost cause she is my baby and im scared of losing her!!!

Thanks in advance,

Becki

nljnky
September 18th, 2009, 10:11 PM
So sorry about your kitty.
I went through this twice with my cat. They can recover from this very scarey disease.
Sugarcatmom had suggested mirtazapine as an appetite stimulant. It worked like a charm. The one that was given to me origianlly was making her foam at the mouth and not eat at all.
I bought one can of everything I could find just to try and find anything that she would eat.
Don't give up, she can get better.

sugarcatmom
September 18th, 2009, 11:47 PM
I will have to bring her in next week to check labs again and possibly a short term feeding tube if the force feeding doesnt go well. Although I got her to eat a bit on her own and force fed her the rest which she did alright with.

Sorry you're going through this, fatty liver sucks (been there, done that). Glad that Janie did okay with the force-feeding, and that she's eating a bit on her own. Those are good signs. I would definitely consider a feeding tube if force-feeding becomes overly stressful or you find you can't get enough food into her. Here is some info on feeding tubes: http://www.catinfo.org/feedingtubes.htm

I agree with nljinky that you might want to ask your vet about mirtazapine (http://www.VeterinaryPartner.com/Content.plx?P=A&C=301&A=2552&S=2) instead of cyproheptadine. For one, it also controls nausea, which the crypo doesn't. It also only needs to be given once every 3 days, rather than twice a day, which is much less stressful for the cat (unless Janie is an anomaly and doesn't mind being pilled).

Some info for you on fatty liver: http://maxshouse.com/Feline_Hepatic_Lipidosis.htm

And lots of excellent info on feline assisted-feeding: http://www.assistfeed.com/FelineAnorexia.htm

Please keep us updated on Janie's progress. :grouphug:

hazelrunpack
September 19th, 2009, 12:16 AM
So sorry to hear about Janie, Becki! No advice for you except to hang in there! :grouphug: Sending some :goodvibes: along for the little Miss, too, for a quick recovery!

growler~GateKeeper
September 19th, 2009, 12:24 AM
Sorry to hear Janie is ill :grouphug:

Alkaline Phosphatase (ALP) is an enzyme produced by the biliary tract (liver). High levels indicate bone disease, liver disease or bile flow blockage. An ALP elevation is definitely suggestive of liver disease and requires follow up testing such as a bile acids liver function test.

I'm guessing the other liver enzymes (ALT & AST) were also high, these elevate relatively easily and are not as important in liver evaluation as ALP elevations but a substantial increase may also warrant follow up liver testing. In the event of hepatic lipidosis or fatty liver, the elevation in ALP is often dramatic

Bilirubin is a component of bile, and is secreted by the liver into the intestinal tract. High levels can lead to jaundice and indicate destruction in the liver and bile duct.

If there are any changes in Janie most especially if she starts looking a bit yellowish around the eyes, nose, mouth - get her in to the vet.

For the nausea - raise her food & water dishes up between 2-4 inches off the ground so when she eats her head is higher than her stomach, this will help to keep the acid down.

I wanted to suggest to try tempting her with tasty treats before you put her food down or slightly away from the food, sometimes it works better if the cat thinks they are just getting a treat on it's own instead of always ontop of the food since the cat food smell will overpower most things.

Cooked chicken always worked well for one of my previous cats, and my grrl Duffy loves any cereal :rolleyes: so if Janie has a taste for Cheerios or whatever try crushing one on top of the food.

:goodvibes: :goodvibes:

beckiandthetrio
September 19th, 2009, 08:19 AM
Hello--

Well the force feeding is going ok i guess. I did 2 sessions last night and 1 this am. I give her about a 1/4can at a time and spread it out about 30min total to not stress her out to much.

This am though she decided to hid on me and i of coarse thought the worse but I did find her under the couch.

My vet is open on saturdays so im going to call about that other med and see if they will give that to me. the other med she is on doesnt seem to be doing anything anyhow. I gave it to her bout 30min prior to feeding her this morning and she still wanted nothing to do with her food.

Thanks for all the advice too!!! I have a couple of different kinds of canned food but I think Im going to go out and get some baby food too!! Maybe try putting something on top of the food but i dont think that will work cause she is not interested at all in the food anyhow.

Becki

beckiandthetrio
September 21st, 2009, 09:02 PM
Hello--

Well I took Janie back to the vet today to check her well being and its not good. She is more jaundice and physically is not acting right. She doesnt seem to be in pain just has no energy.

The vet and I went through a whole bunch of options and diagnosis. We did do some abdominal xrays which didnt show anything horrible. No gallstones, just some dialated bowels which may or may not mean anything.

We came up with a plan to insert a feeding tube tomorrow morning and go from there. She is also on 3 meds and the vet is treating it like pancreatitis for now.

I cant afford and dont want to put her through much more. Exploratory sugery is not an option or liver biopsy.

We are just hoping and praying that the feeding tube will turn her around!!

I thought id list the meds cause I know some of you are well versed on pet meds.

Ursodiol
Denosyl
Metronidazole

The last is an antibiotic and the Denosyl is to help the liver, cant remember what the other is for. Crying all afternoon has kinda left my head mush.

If anyone has been down this road I would appreciate some advice or just some encouragement:)

thanks again,

Becki

EndOfFashion
September 21st, 2009, 09:36 PM
Hi Becki,

I just went down this road. Unfortunately, what started out as a possible fatty liver diagnosis ended with us having to put down our 4 year old cat, Charlie, because he had advanced cancer.

However, if your x-rays didn't show anything obvious, I don't think cancer is likely (especially since your kitty is only 4, but then again, so was Charlie). But unfortunately I don't think you should really avoid doing a biopsy. We tried to treat Charlie for fatty liver initially because that's what the emergency vet thought it was, and four days later our regular vet was telling us we had no other options after taking some x-rays. :sad:

Because there are so many different things that could be causing this, empiric therapy (treating the illness before getting a firm diagnosis) is really not the best option. Your case sounds very similar to ours, and we heard possible diagnoses of fatty liver, pancreatitis, cholangeohepatitis, and ultimately, cancer. In fact, even if your kitty has fatty liver, it could be secondary fatty liver, meaning it's been caused by another disorder or illness. Yes, stress could have caused her to stop eating, but she could also have stopped eating because she wasn't feeling well...

I really don't mean to scare you but if there's any way you can scrape together some money for further tests, that's probably your best option. Could you ask some friends/family for a loan, sell some jewelry, etc?

Did the vet suggest at least doing follow-up blood tests every so often while your cat is being treated for pancreatitis?

EndOfFashion
September 21st, 2009, 09:41 PM
Sorry, I do also want to say that I'm hoping and :pray: for your little one. I didn't mean to be such a Debbie Downer, but the pain is still so fresh for me (it just happened earlier this month). Hopefully you'll have a much better outcome, and from the sounds of your kitty's x-rays, she has a fighting chance. Don't give up on your little girl :cat:

beckiandthetrio
September 22nd, 2009, 10:10 AM
Thanks for the advice. Im sorry to hear about your Charlie:angel2:. I know that this feeding tube may not work and really that is the end of the road for us. I have already borrowed money and am basically delaying bills so I can do this for her.

The vet did recommend a specialist but again that would cost way over 1,000 dollars. I cant do all that financially and because i dont want her to go through much more!!

She has been a great cat and i love her to pieces but at some point I have to make the choice about how much is too much. It kills me to say this but its reality.

I hoping and praying that the feeding tube is the ansewer and the meds but if not I know that I did everything I could do.

Becki

EndOfFashion
September 22nd, 2009, 02:23 PM
Thanks for the advice. Im sorry to hear about your Charlie:angel2:. I know that this feeding tube may not work and really that is the end of the road for us. I have already borrowed money and am basically delaying bills so I can do this for her.

The vet did recommend a specialist but again that would cost way over 1,000 dollars. I cant do all that financially and because i dont want her to go through much more!!

She has been a great cat and i love her to pieces but at some point I have to make the choice about how much is too much. It kills me to say this but its reality.

I hoping and praying that the feeding tube is the ansewer and the meds but if not I know that I did everything I could do.

Becki

If it's fatty liver, then the feeding tube is the best thing you can do! The feeding tube should also help the pancreatitis, as long as you also keep her hydrated and possibly on meds for vomiting, nausea, etc...of course I'm not a vet, so I'm just speaking from my experience! Is she going to be hospitalized for all her treatments, or are you planning to administer meds, etc. yourself? It's important that you treat this aggressively. If you're dealing with either pancreatitis or fatty liver, then you do have a good shot with the feeding tube as long as you're dedicated.

In terms of putting your kitty through "more"...she's only 4, and while she's probably feeling pretty lousy, chances are good that you're not dealing with a death sentence here. We didn't get to the liver biopsy stage with Charlie, but I don't think it's too horribly invasive. Would an ultrasound be an option? That might give you more information and may be less expensive than the other options.

Anyway, ultimately I understand that everyone has financial limits. After all, I've only just graduated university and have only had a full-time job for 6 months, so the $2,000 we spent on Charlie's care (over a 4-day period! :eek:) was certainly no small change. `Here's hoping your dedication to the treatment plan will win out over whatever is ailing your kitty!

My thoughts are with you both! :goodvibes::goodvibes::goodvibes::fingerscr

beckiandthetrio
September 22nd, 2009, 03:03 PM
Thank you so much EndofFashion!! I know you are only giving me good advice and I appreciate it.

I got a call a couple of hrs ago that the procedure went well. I will be picking her up in about an hour and manage her at home. Im not sure exactly how this will all work out yet though. Im just praying the God will help me figure this out and do whats best for my girl.

My sister is going to help me (bless her heart) to feed her when Im not available. Im a single person and I work full time and I cant afford not to work for obvious reasons!! I wish I could bring her to work with me but thats not really an option since I work in a hospital and im sure she would be freaked out!! I know I will try my best if it means getting up in the middle of the night to feed her so when im gone for 8hrs it wont be such a shock!!

My vet has been nothing short of amazing and Im so pleased that vet's like her exsist. She has been SOOOO compassionate and caring and loving with both of us and she is so genuinely concerned about Janie. SHe took her chart home last night just so she could more throughly research and plan to make sure we were doing the best possible thing for her.

I will make sure that nausea meds are given if the vet feels its needed.

Becki

hazelrunpack
September 22nd, 2009, 10:09 PM
I hope the feeding tube does the trick, Becki, and Janie recovers quickly :goodvibes:

:grouphug:

beckiandthetrio
September 23rd, 2009, 09:18 AM
Thanks for the well wishes Hazel!! Im happy to report she is doing very good. She was alittle doppy yesterday but shes coming around. the feedings have been going very well and its such a stress relief too!!! She even purred on my chest this morning before I got up for work:lovestruck:

By the way, Where in Wisconsin do you like Hazel?? I live in Oshkosh.

Becki

EndOfFashion
September 23rd, 2009, 09:35 AM
Glad to hear she's doing well. Just make sure that even though she's on the feeding tube, you give her access to food in her bowl, too...because you eventually do have to get her eating on her own again.

You might want to talk to Meow, or check out her thread "Cat's teeth removed - won't eat" for lots of helpful information about having success with a feeding tube.

Best of luck! :fingerscr

beckiandthetrio
September 23rd, 2009, 12:58 PM
Thanks for the thread suggestion!! I read through alot of it and it was very helpful.

My sister just called and said she just fed her and she did great!!! Its a relief to know Im not the sole provider for her.

I leave food out for her and my other cats a couple of times a day, she has smelt them but hasnt eaten herself that I know of. The vet said it could take from days to months before she is eating enough on her own.

hazelrunpack
September 23rd, 2009, 02:02 PM
:highfive: Glad to hear the feedings are going so well! Before you know it, she'll be back on her feet and back to normal! :goodvibes:

We're about 50 miles east of Eau Claire. :D My gramps still lives in New London, not that far from Oshkosh.

beckiandthetrio
September 23rd, 2009, 03:16 PM
Thats neat though that we dont live that terribly far apart and we are on a Canadian website:D

Thanks for the wishful thinking!!! Janie needs all the prayers and good thoughts she can get. She still has about a 70% chance of being ok according to the vet.

Becki

hazelrunpack
September 23rd, 2009, 03:20 PM
Small world, eh. :D

Janie's got all those :goodvibes: and good wishes headed her way--all that has to help, too, doesn't it? :thumbs up It's so wonderful that she's purring again! :cloud9:

chico2
September 23rd, 2009, 05:27 PM
I just read all the post about your sweet kitty and I just wanted to add my :pray:that your little girl will be ok:grouphug:

Love4himies
September 23rd, 2009, 06:22 PM
Glad to hear the feeding went well. Your kitty should be just fine now :goodvibes:

sugarcatmom
September 24th, 2009, 12:08 AM
Way to go with the feedings!! Glad you have some help, doing it solo can be an exhausting job. My cat's brother had HL when he was 3 and we went the feeding tube route (a PEG-tube). He did great, but it did take 3 months before he was eating on his own enough that we could remove the tube. There's no way he would have survived without it for that amount of time. The other awesome thing about tubes is the ability to put some meds or supplements down them (pulverized and diluted with water - can't do it with all meds though, ask the vet first). Takes away the stress of pilling.

Hang in there, you're doing fantastic!

growler~GateKeeper
September 24th, 2009, 01:41 AM
Glad to hear Janie is doing well :thumbs up :goodvibes: for rapid improvement

beckiandthetrio
September 24th, 2009, 09:40 AM
Still doing pretty good over here. She woke me up at 330am scratching like a mad women on her scratch post!!! Never thought Id say I was happy when my cat woke me in the middle of the night:D

I do give all the meds I can through the tube. Just one only comes in a pill form so I have to give that to her by mouth plus she has to have an empty stomach as well. She happily tried to fight me off this morning when I gave it to her though:)

A couple of questions though, first, if you have had a cat on a feeding tube how much food did you give at one sitting?? Ive got her up to 30cc about 5 times a day right now. I have a call into the vet about this but just wondering what others have done. Second, does anyone have any ideas on how keep the feeding tube wraped up/covered so she doesnt bother with it?? Its stiched in several places but Im still scared she will pull it out, the vet suggested a baby onesie but I havent tried that yet.

Thanks,

Becki

Love4himies
September 24th, 2009, 10:18 AM
Oh that is such a good sign. :thumbs up.

Sheri H
September 24th, 2009, 12:26 PM
Just read your thread and I'm glad that your little girl is doing better. :)

beckiandthetrio
September 24th, 2009, 09:24 PM
Well, I think i got ahead of myself a bit. My sister just called and said that Janie vomitted right after she fed her earlier:sick: She said it wasnt that much and when she flushed her with some water she kept that down. The vet was thinking that she may have some vomitting so I guess it is sort of to be expected. I will tame down her feedings for the evening and tomorrow am and if she vomits again Ill call the vet's office.

Becki

PS: Thanks for all the well wishes!!!

growler~GateKeeper
September 24th, 2009, 11:51 PM
Did the vet wrap the incision area with Vet-Wrap? It wouldn't cover the entire tube but it would give some stability to the body end of the tube so it doesn't move and irritate the sutures. As for something to cover the whole thing, you can try a onesie (good thinking :thumbs up) just make sure it isn't too tight & end up pulling on or moving the end of the tube. An E-Collar from the vet is another suggestion if she's trying to lick it or pull it out with her mouth.

Vomiting could be caused by the food being either too warm or too cold, giving to much to fast, or giving to much at one time or she may be a bit nauseous from either to long between feedings or excess stomach acid. It could also be just a one off thing.

:goodvibes: for good days ahead

beckiandthetrio
September 29th, 2009, 03:47 PM
Hi all--

thought id come back and give another update on Janie's progress. We had a rough weekend because she was vomitting after the 1st feed in the morning both days. But I think it was related to the pill I had to give her on an empty stomach and going alittle to long between feeds.

The last 2 days she has been doing pretty good:fingerscr!! She seems to have more energy and is purring all the time and not hiding nearly as much as she was.

thanks for everyones prayers and well wishes, i think it may be working:)

Becki

hazelrunpack
September 29th, 2009, 04:45 PM
:goodvibes:

Keep up the good work, Janie! You make your Mom very happy!

And hang in there, Becki. :grouphug: You're doing a great job with your girl!

Love4himies
September 29th, 2009, 06:17 PM
Awww, that is great news. Any idea how long she has to have the feeding tube in?

Sending some :goodvibes: Janie's way.

beckiandthetrio
September 29th, 2009, 06:46 PM
We are not sure how long she will have it in for. Today is a week and she has to have it in for atleast another week if not more. sometimes it can take months from what I hear.

I forgot to mention this to, she eat for me last night too!!! It wasnt much, just alittle canned food but it was more than she has eaten on her own in a week:thumbs up Gotta celebrate the small victories right:)

Becki

sugarcatmom
September 29th, 2009, 10:02 PM
I forgot to mention this to, she eat for me last night too!!! It wasnt much, just alittle canned food but it was more than she has eaten on her own in a week

Excellent! :thumbs up That's a really good sign. Egypt wouldn't even look at food for a couple of months, he'd just turn his head away in disgust like I was trying to poison him.

growler~GateKeeper
September 30th, 2009, 12:08 AM
becki that's wonderful news :thumbs up :goodvibes: for more interest in food to come soon & no more vomiting :fingerscr

rainbow
September 30th, 2009, 02:23 AM
I just read this thread now ....glad that Janie is doing well and hope her progress continues. :fingerscr :goodvibes:

lilycat
October 1st, 2009, 09:15 PM
Hi!

I am going through the same problem with my cat! you can see my thread in this forum but its called "help kitty eating food not for him" ....(if you read the thread and posts you'll understand)

i guess the best advice i can give you is to FIND A GOOD VET! if you already have i congratulate you, bcz my first vet was pure hell, he didn't even care, i think the vet is one part bcz its the one who is going to guide you in the right direction, and the other part is of course yourself, keeping up with the medicine the feeding, i mean there is only so much you can do, you'll have to leave the rest to your cat and pray that he or she gets better :pray: i know i have done everything in my hands to help my cat and it is paying off bcz she is getting better...but the last few weeks have been really scary, it is sooo scary to have a sick pet, bcz they are your family! so please hang in there!

so cheer up keep trying :fingerscr ! i hope you and your kitty the best and hopefully she'll recover completely!!

p.s. feel free to send me a msg if you wanna share stories or compare medication...or just for support!

beckiandthetrio
October 2nd, 2009, 08:33 AM
Thanks for the advice Lilly. I love my vet and Im so grateful for her!! I agree that it is very important to have one that is on top of things and cares.

Does your kitty have a feeding tube also?? I havent read your thread yet but I will.

As for Janie she is pretty status quo right now. She is tolerating about 6oz of food a day which makes me happy. She hasnt attempted to eat again that I know of but Im not to worried, I set it out but she just turns her nose up and away kinda like what sugarcatmom's cat did:D Her jaundice has almost completely gone away!! I try not to be to obsessed with checking HEHE. She doesn't like it too much when i fold her ears down and check her gums alot.

Thanks for all the thoughts and prayers, they are working!!

Becki

lilycat
October 2nd, 2009, 05:38 PM
No, my vet told me that she preferred the force feed bcz of the general anesthesia of the feeding tube and didn't want to put the liver at any risk also bcz she said if the cat is eating and not vomiting from the force feed we need to try that first, if it doesn't work then we put on the feeding tube, but actually the force feeding works for me and my cat, bcz she just takes it in, and it is not that stressful for her (i think) just the first couple of times but then she got used to it, also she is eating quite a lot now for her self, so i have to force feed her now even lesser, i am being very careful with the force feeding, i want to give her enough to help her get some food in, but not too much so she can feel a little hungry and eat on her own, and it's actually working :D

and don't worry if janie isn't eating right now, the important thing is that you are getting some food into her and that she is not throwing up! that's a great sign! hopefully in a few weeks your janie will start eating on her own, just like my mena did!.... it took her about 2-3 weeks to even show interest in her wet food, now she is actually eating, so just give it some time!...

lots of luck!! my best wishes for you and janie!!

sugarcatmom
October 2nd, 2009, 05:53 PM
No, my vet told me that she preferred the force feed bcz of the general anesthesia of the feeding tube and didn't want to put the liver at any risk

The liver would be more at risk if not enough nutrition was being consumed than from the anesthesia. It's great that the force-feeding is working for you, but it can be extremely stressful for many cats (and their caregivers), sometimes leading to food aversions. It's also much more difficult to ensure enough calories are consumed with force-feeding than with tube-feeding, and the time wasted while trying to force-feed a sick cat may result in further decline of that cat's health.

The decision to tube or not to tube should be made on a case by case basis, factoring in how sick the cat is, how stressed they are, the degree of inappetance, etc. I'm glad you've found a good balance with your kitty and my fingers are crossed that she makes a full recovery.

beckiandthetrio
October 11th, 2009, 07:04 PM
hello all--

Your well wishes and prayers worked!!! My Janie is now completely recoverd. Last weekend she started eating some more canned food so last Tuesday I did a trial to see if she would eat if I wasnt feeding her in the tube and it worked!!! She has not had a feeding since and is her normal active playful loving self.

Words can not describe how happy I am that she is alright. She will go back to the vet this week to have the tube removed.

To all the other cat owners with problems, Im hoping your story has a happy ending too!!!

Becki and Janie

sugarcatmom
October 11th, 2009, 07:22 PM
That's great news! Way to go Janie, and way to go YOU, for helping her through this. :highfive:

hazelrunpack
October 11th, 2009, 08:24 PM
Way to go, Janie!! Good job, Becki! :highfive: What a wonderful update!

Love4himies
October 11th, 2009, 08:38 PM
Wahoo :highfive:, that is so wonderful. Way to go, Janie, you have made your momma happy.

growler~GateKeeper
October 11th, 2009, 09:17 PM
Becki that's great news :highfive: WTG Janie :thumbs up