Charlie is sick

[Love4himies]

Oh EoF, I am so sorry Charlie is so sick and some . I don't have any advice for you as I have never gone through this with any of my kitties.

It was me that posted about Wellness and my cats turning their nose up to it. And not one cat, all at the same time with the same can. It takes a lot for Sweet Pea to not eat . It happened quite a few times and so I just stopped buying it and now buy Instinct which I have never had a problem with.

[meow]

simba did not like wellness and threw up from it too.

Did they give you medicine for the liver? The GI, pancreas and kidneys all work very closely together in cats. If the liver is not doing well I would suspect one of the other organs to not be doing well either. If they are all fine then the liver itself is the problem??If a ICU vet can't give you an answer how will a regular vet? I am not sure how boarding him at the vet will help. If he eats/drinks tonight can't you just take him in for tests tomorrow and then take him home?

Change the food. It is the easiest, quicklest thing to see if this stops!

Did they check the thyroid????
http://www.sniksnak.com/cathealth/liver.html

[EndOfFashion]

Hey guys,

Well we just got home with Charlie. To answer your questions, we've never had an issue with the Wellness before, he's been on it for months...but I did just try feeding him Merrick's BG, warmed a little, and he had only a small bite.

Meow, we're just taking him to his regular vet because we've been instructed that he really should be hospitalized so he can remain on IV fluids, but our regular vet will be less expensive (I hope). We're obviously going to have to pursue an ultrasound, though...because it doesn't sound like they know exactly what's wrong with him. The vet that I spoke with when we picked him up said she's not 100% convinced it's fatty liver because his most recent blood test results are are not totally consistent with a fatty liver diagnosis.

The only thing we can really do at this point is further tests, because now they're really not sure if it's fatty liver, cholangeohepatitis (she said that's the big worry now), or even pancreatitis...but likely not. She said cancer is also a possibility, but it's lower on the list because of Charlie's age (he's about 4). The thing is, we only got an estimated age from the Humane Society, because he was a stray...what if he's older than we thought?

So we were sent home with 4 meds:
Amoxicillin, 4 mls every 8 hours
Metronidazole, 0.8 mls every 12 hours
Zentonil, 1 tablet (100 mg) daily
Metoclopramide, 0.5 tablet (I think 2.5 mg) every 12 hours

I also have the results from his first and second blood tests, if anyone is interested.

If anyone has any feedback at all, I would really appreciate it. Yesterday he looked so good, today I'm more worried...:sad:

[growler~GateKeeper]

Originally Posted by meow

I am not sure how boarding him at the vet will help. If he eats/drinks tonight can't you just take him in for tests tomorrow and then take him home?

Being boarded at her reg vet tomorrow will ensure any changes to his symptoms especially if he needs more IV fluids, Vit injections or a change in antibiotics will be dealt with swiftly.

Liver disease is something that needs aggressive nutritional support as quickly as possible.

Originally Posted by meow

Did they check the thyroid????

Charlie is not showing signs commonly attributed to HyperT. Plus he's only 4, HyperT generally affects cats 7 and older.


http://marvistavet.com/html/body_hepatic_lipidosis.html
http://marvistavet.com/html/body_fel...hepatitis.html

[growler~GateKeeper]

Originally Posted by EndOfFashion

I also have the results from his first and second blood tests, if anyone is interested.

What is abnormal on the tests and what is the reference range for those values?

[EndOfFashion]

Originally Posted by meow

Did they check the thyroid????
http://www.sniksnak.com/cathealth/liver.html

Oh and no, I don't think they checked the pancreas.

[EndOfFashion]

Originally Posted by growler

What is abnormal on the tests and what is the reference range for those values?

Okay Growler, I'll just post what I've got as I'm clueless as to how to read this...

Repeat Bloodwork
TP 58 (60-85)
T bili 105 (0-4.5)
C bili 63.3 (0-2)
ALP 130 (10-85)
ALT 198 (5-110)
AST 110 (5-71)
CK 1121 (15-295)
Chol 1.0 (2-7)
K 3.5 (3.7-5.8)

It says his liver values have increased since the last blood test (Sept 5).

I'm not sure what the bracketed numbers mean. I thought they might be the reference ranges but then none of his numbers fall within the range...

Please help! At least I know I'm doing the right thing taking him back to the vet...:sad:

[EndOfFashion]

Here are his numbers from Sept 5:

T bili 62.6 (H M3)
C bili 41.2 (H M3)
ALP 108 (H M1)
ALT 162 (H M2)
AST 92 (H M1)
GGT (WNL)
Chol 1.0 (L)

There are others that weren't re-tested.
I'm guessing the H and L in the brackets indicate whether it's high or low. Not sure if M1-M3 indicate how far out of the normal range the numbers are...?

[growler~GateKeeper]

The numbers in the brackets are the reference range H & L would indicate high & low. I've never come across the M1-M3 though - was that an in-house test or sent to the lab?

TP 58 (60-85) Total protein Increases indicate dehydration or blood cancer, bone marrow cancer; decreases indicate malnutrition, poor digestion, liver or kidney disease, bleeding or burns.

T bili 105 (0-4.5) total bilirubin A component of bile, bilirubin is secreted by the liver into the intestinal tract. High levels can lead to jaundice and indicate destruction in the liver and bile duct.

total bilirubin = conjugation bilirunbin + unconjugated bilirubin

C bili 63.3 (0-2) Conjugated or direct bilirubin Conjugated bilirubin has been transformed from fat soluable to water soluable, water soluablility is mandatory for excretion in the urine. It has been suggested that increases in c bili in hemolytic icterus may be due to compromise of the excretory system of a previously normal liver injured by anemic anoxia (absence of oxygen in inspired gases or in arterial blood or in the tissues)

ALP 130 (10-85) Alkaline Phosphatase 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

ALT 198 (5-110) Alanine aminotransferase An enzyme that becomes elevated with liver disease

AST 110 (5-71) aspartate aminotransferase Enzyme normally held inside liver cells, increases shown when liver disease is present

ALT & AST These enzymes 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

CK 1121 (15-295) Creatinine Kinase Damaged muscles produce creatinine kinase, which goes into the bloodstream. High values indicate problems with muscle, possibly including the heart. Most of the time it's high due to stress, struggling when blood was taken or dehydration

Chol 1.0 (2-7) Cholesterol Decreased levels are found in an overactive thyroid gland, intestinal malabsorption. Elevated levels of cholesterol are seen in a variety of disorders including hypothyroidism and diseases of the liver, kidneys, cardiovascular, diabetes, stress

K 3.5 (3.7-5.8) Potassium Essential electrolyte assisting in regulating nerve impulse & muscle contractions, blood pressure & heart function not a significant decrease but should be monitored, they may add K+ to the IV fluids if they haven't already to brring the level back up.

In my opinion from what I see I would say you are looking at liver disease (leaning more towards liver issues), pancreatitis or possibily IBD, but definately you are right to bring him back in tomorrow.

I would ask about the Bile Acids Liver function test when you bring him in.

[Tundra_Queen]

EOF, I'm so sorry that Charlie isn't doing as well as he was.


When u take him back in to the vet, could u bring some of his food with his name on it so he won't get the other junk? I have done that for Willie, so his tummy didn't get more upset from the change of food. Just an idea.

Debbie

[EndOfFashion]

Originally Posted by growler

The numbers in the brackets are the reference range H & L would indicate high & low. I've never come across the M1-M3 though - was that an in-house test or sent to the lab?

TP 58 (60-85) Total protein Increases indicate dehydration or blood cancer, bone marrow cancer; decreases indicate malnutrition, poor digestion, liver or kidney disease, bleeding or burns.

T bili 105 (0-4.5) total bilirubin A component of bile, bilirubin is secreted by the liver into the intestinal tract. High levels can lead to jaundice and indicate destruction in the liver and bile duct.

total bilirubin = conjugation bilirunbin + unconjugated bilirubin

C bili 63.3 (0-2) Conjugated or direct bilirubin Conjugated bilirubin has been transformed from fat soluable to water soluable, water soluablility is mandatory for excretion in the urine. It has been suggested that increases in c bili in hemolytic icterus may be due to compromise of the excretory system of a previously normal liver injured by anemic anoxia (absence of oxygen in inspired gases or in arterial blood or in the tissues)

ALP 130 (10-85) Alkaline Phosphatase 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

ALT 198 (5-110) Alanine aminotransferase An enzyme that becomes elevated with liver disease

AST 110 (5-71) aspartate aminotransferase Enzyme normally held inside liver cells, increases shown when liver disease is present

ALT & AST These enzymes 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

CK 1121 (15-295) Creatinine Kinase Damaged muscles produce creatinine kinase, which goes into the bloodstream. High values indicate problems with muscle, possibly including the heart. Most of the time it's high due to stress, struggling when blood was taken or dehydration

Chol 1.0 (2-7) Cholesterol Decreased levels are found in an overactive thyroid gland, intestinal malabsorption. Elevated levels of cholesterol are seen in a variety of disorders including hypothyroidism and diseases of the liver, kidneys, cardiovascular, diabetes, stress

K 3.5 (3.7-5.8) Potassium Essential electrolyte assisting in regulating nerve impulse & muscle contractions, blood pressure & heart function not a significant decrease but should be monitored, they may add K+ to the IV fluids if they haven't already to brring the level back up.

In my opinion from what I see I would say you are looking at liver disease (leaning more towards liver issues), pancreatitis or possibily IBD, but definately you are right to bring him back in tomorrow.

I would ask about the Bile Acids Liver function test when you bring him in.

Thanks Growler. I did a bit of poking around on the net myself but the way you've presented this is far easier to understand. I'll definitely ask about the bile acids liver function test when I go in. I wonder if that test would tell us more about the kind of liver problems he has than an ultrasound...or whether we'll have to do both?

You're awesome. Thanks so much for the help.

[EndOfFashion]

Originally Posted by Tundra_Queen

EOF, I'm so sorry that Charlie isn't doing as well as he was.


When u take him back in to the vet, could u bring some of his food with his name on it so he won't get the other junk? I have done that for Willie, so his tummy didn't get more upset from the change of food. Just an idea.

Debbie

Thanks, TQ, I'll do that.

[EndOfFashion]

So Charlie has been hospitalized with our regular vet. He recommends we do an X-ray of his abdomen and chest as well, since he's been breathing rather heavily. He wants to rule out cancer that has metastasized to his lungs. (He agrees with the other vet that it may not be fatty liver.) The X-ray may provide a diagnosis as well, so there's a chance he may not need an ultrasound.

I asked if we could skip the X-ray and do an ultrasound, in case he ends up needing an ultrasound after the X-ray anyway. My vet said of course we could. So now I'm not sure what to do. If we go the X-ray route, we may be able to nail down a diagnosis for the ridiculously low cost of $100. However, we may spend that $100 in vain if he ends up needing an ultrasound or even an ultrasound-guided biopsy anyway.

If I skip the X-ray then I'll have saved myself $100 and will likely get a diagnosis as well, but if it's something that we could have learned from the X-ray, then I may have spent $500 rather than $100 for the same info.

Blah, I hate acting so petty about this money. It's not that I don't have $500, it's just that I'm SO concerned that we'll end up needed more for treatments and possibly further testing, that I'd like to conserve where I can. I don't want to spend willy-nilly only to end up not being able to afford all the treatments.

Sorry for the rant. Actually just reading this post over, I think I may know what I'm going to do...

[chico2]

EoF,Rant away,I would do the same and I know you'll get nothing but support from us.
I know nothing of the problem Charlie has,so I can be of no help,but I have read every post and Charlie will be ok

[EndOfFashion]

Originally Posted by chico2

EoF,Rant away,I would do the same and I know you'll get nothing but support from us.
I know nothing of the problem Charlie has,so I can be of no help,but I have read every post and Charlie will be ok

Thanks Chico2 I'm on the phone to the vet now and I'm going to tell them to do the X-rays. I hope to dog it isn't cancer

[Love4himies]

EoF, I really don't have any advice. Like Chico, I read every post and am thinking of you and charlie.

[lUvMyLaB<3]

EOF i just want to say that i have been keeping a close eye on your thread, and we are praying for you and charlie, i dont know enough about what you are dealing with to add anything. . I used to feed wellness but tickles started to not eat it and lose weight so i switched to innova evo. If you wanted to take him home, even for the nights they should be able to give a dose of subq fluids under the skin between his shoulder blades that would be slowly absorbed and keep him hydrated till you take him back, if you think that would make him more settled and likely to eat. I do however think you are doing the right thing. Did he ever eat any of the food that was in the recall? My thoughts are with you both, i pray for a simple diagnosis soon!

[EndOfFashion]

Originally Posted by lUvMyLaB<3

EOF i just want to say that i have been keeping a close eye on your thread, and we are praying for you and charlie, i dont know enough about what you are dealing with to add anything. . I used to feed wellness but tickles started to not eat it and lose weight so i switched to innova evo. If you wanted to take him home, even for the nights they should be able to give a dose of subq fluids under the skin between his shoulder blades that would be slowly absorbed and keep him hydrated till you take him back, if you think that would make him more settled and likely to eat. I do however think you are doing the right thing. Did he ever eat any of the food that was in the recall? My thoughts are with you both, i pray for a simple diagnosis soon!

Thanks for your support, LML (and everyone else!). If Charlie gets better, maybe I'll switch him to a different brand, just to be on the safe side. I'll see about taking him home for the nights, but I guess it might depend on the X-rays...thank goodness I'm not working this week (except I'm also not getting paid :sad. I would be a royal mess if I had to be on set.

I don't know what food was recalled. He's never eaten anything that was mentioned in the news, but it's possible there have been recalls I haven't heard about. Was Wellness recalled recently, or something?

[lUvMyLaB<3]

Oh poop! Wanted to add that metronidazole, an antibiotic,if given by mouth, especialy on an empty stomach can cause tummy upset and a terrible taste in the mouth that may make him not want to eat, again, good luck.

[EndOfFashion]

Originally Posted by lUvMyLaB<3

Oh poop! Wanted to add that metronidazole, an antibiotic,if given by mouth, especialy on an empty stomach can cause tummy upset and a terrible taste in the mouth that may make him not want to eat, again, good luck.

Hmmm good to know. Should I ask if they can put him on something else? I was told they put him on antibiotics (the metronidazole as well as the amoxicillin) because his immune system might be compromised. I have no idea if he really needs to be on both...

I just called the vet back to see when they had scheduled the X-ray, and they're already doing it! that they call me soon with a (treatable) diagnosis.

OMG I'm going to be one of those nightmare owners that calls every few hours to check up on my furbaby...

[lUvMyLaB<3]

Glad u are getting the xray! Was he breathing heavy before you took him to the vet? Perhaps the liver is irritated from not enough oxygen? Just thinking out loud. . You know you have lots of us here waiting with you! He is your baby! Dont you have a second thought about calling all the time! I will be praying.

[Love4himies]

GOOD LUCK, CHARLIE

[EndOfFashion]

Originally Posted by lUvMyLaB<3

Glad u are getting the xray! Was he breathing heavy before you took him to the vet? Perhaps the liver is irritated from not enough oxygen? Just thinking out loud. . You know you have lots of us here waiting with you! He is your baby! Dont you have a second thought about calling all the time! I will be praying.

I never noticed him breathing heavily before. It was once he was at the emerg hospital that the vet noted an elevated respiratory rate, and open-mouth breathing (which apparently cats should never do). And then when I had him home last night I noticed he was breathing quite heavily. It calmed down, but when the vet was palpating his abdomen this morning, he started breathing heavily again...

L4H and LML, thanks again for all the good wishes and understanding...nobody else understands this, my entire family can't understand why I would go to so much trouble for Charlie, and the bf hasn't been much help because he's super-stressed about the cost of everything, so I have to reassure him

[EndOfFashion]

*sigh* so the vet just called and unfortunately I don't have any good news. He says it looks like there's a "space-occupying lesion" in his lung and that he's not sure whether it's cancer. This accounts for the breathing difficulties and he's not sure if these lesions may have started in the liver and metastasized to the lungs, or whether the liver problems are caused by the lesions in his lungs (i.e. it would be secondary fatty liver, not primary).

The liver looks "dense", not healthy but he didn't mention how abnormal. Apparently the lungs look quite abnormal. I'm supposed to go in later to look at the x-rays with the vet and discuss our next step...



I think I'm going to go get sick now...

[hazelrunpack]

Sending for you and Charlie. You'll need to focus when you talk to the vet, so till you see him, write down as many questions as you think you might need to ask--it'll be harder to remember them when you get there, so we always write them down.

Lots of , and s winging your way from here, EoF!

[EndOfFashion]

Originally Posted by hazelrunpack

Sending for you and Charlie. You'll need to focus when you talk to the vet, so till you see him, write down as many questions as you think you might need to ask--it'll be harder to remember them when you get there, so we always write them down.

Lots of , and s winging your way from here, EoF!

That's a good idea, but my brains are so scrambled I can't even think of any questions right now. I've never been good at managing stress...what should I ask? Augh I'm a mess

[Love4himies]

Oh, I am so sorry the news wasn't better .

[EndOfFashion]

Thanks, L4H.

Does anyone know anything about space-occupying lesions? I can't find anything about pulmonary SOLs, just intracranial SOLs - and it says they can mean cancer, but also hemorraghes (sp?). Don't know if that's a possibility in the lungs, or what other tests would have to be done to figure it out...

[hazelrunpack]

There's a good question for the vet right there! Lungs are also very vascular, so there could be blood or serum leaking from the tissues.

[chico2]

EoF,I am so sorry you did not get good news,however it is still a little confusing,does Charlie have cancer or nothow are they going to find out?
Don't worry about anyone elses opinion,some people just don't understand how much we love our animals,you and only you can make the decisions about Charlie and what needs to be done.
You have a huge support-group right here