liver issues in older cat

[chicknmania]

Hi we have a cat who is about 12 years old, we don't know her age for sure because she was a stray when we adopted her. She's had problems lately relating to her liver and kidneys..huge weight loss and severe problems with vomiting. She's had vet care and he has her on scrip canned catfood and Purina Sensitive Stomach dry food. She'll go along for a few days with no vomiting, then start up again, and she vomits as much as five times in one day! And, of course, it's gross orange vomit on my light blue, supposedly stain proof carpet...most of the time! Then she's starving and looking for anything...ANYTHING...to eat. She's literally starving. The vet is running out of ideas to stop the vomiting besides having her come in every few days for anti-nausea injections and fluids. He's had her on a few different antibiotics and Prednisone, but he stopped the prednisone because he thought it was contributing to her kidney problems. A friend suggested high dose Vitamin E once a week. I researched this and apparently Vitamin E can be a benefit in treating liver issues....although high doses can cause nausea. I also read that Milk Thistle and other vitamins can be beneficial I used Milk Thistle a few years ago for gall bladder problems and it completely cleared up my gall bladder problem over a course of about six months, so I wondered about giving it to her. I messaged the vet with this question but haven't heard back.

Weirdly, she also vomited yesterday morning what looked like a big load of worms, but we're baffled as to what the heck they really were. She'd been dewormed a month ago, so she shouldn't have any...and when we did a fecal yesterday it came up negative. The vet said it looked like maggots, and that maybe she found something dead outside, as she's been venturing outside on a few nice days we've had recently. We dewormed her again, jic, but he said it doesn't look recognizable as a parasite.

Despite all her problems, she continues to enjoy life...eating,taking walks outside...even playing on good days. She's a tough little creature and so tiny...we are trying everything to try and help her.

Does anyone have any experience with liver issues in cats and what might have helped? I really want to try the milk thistle, but just not sure how much to give.

 

[CatWhisperer]

Have you had bloodwork done? It sounds like your cat would benefit from a liver ultrasound and ultrasound guided liver biopsy. You probably need to see a specialist or go to a school of veterinary medicine. The second option would be more economical.

 

[chicknmania]

yes, bloodwork has been done several times. I don't want to put her through that kind of stress of taking her to a strange place...and we've spent a lot of money on her care already. . Our vet has offered to do a liver biopsy and I'm reluctant to do that because I think it might kill her. . We have a handle on what her problem IS...I'm just looking for ways to make her last a little longer and not be so nauseous. Liver issues are pretty common in cats, from what I've read.

 

[CatWhisperer]

Have you tried ondansetron for nausea/vomiting? Or mirtazapine as an appetite stimulant if that is needed. It can be made into a transdermal ointment. An ultrasound guided biopsy is really the best route to a diagnosis at this point.

 

[chickens really]

Seriously if you don't allow the vets to do a full panel on her you won't know? Possibly putting her down is a better route?

 

[chicknmania]

I don't know why you think we don't have a diagnosis. The vet has given her anti nausea medication; it is injectible and not something you do daily. She has plenty of appetite. The vet HAS done a full panel on her. i just wondered what others experiences were with cat liver issues. Liver issues and Pyelonephritis cause extreme nausea. That's what we're dealing with here. . My question dealt with ways to ease her upset digestive system.

 

[chicknmania]

Have you tried ondansetron for nausea/vomiting? Or mirtazapine as an appetite stimulant if that is needed. It can be made into a transdermal ointment. An ultrasound guided biopsy is really the best route to a diagnosis at this point.

I'll have to refer back to see if that's the anti nausea med the vet gave her. Whatever he gave her is what he felt he needed to use though. The main reason he wanted to do a biopsy was to positively rule out liver fluke, but he has treated her for it anyway, and the treatment made no difference. He does not think she has cancer. She has failing liver function ...cirrhosis... probably attributable to her age, among other factors. That's all he needs to know to treat her. I have researched treatment for her condition and he is doing exactly what he should be doing. I just wanted to know what other people's experiences were... and ideas to slow down the vomiting...apparently there aren't any other experiences, so never mind. The vet has already told me he does not think she's at 11th hour yet. He will tell me when he thinks it's advisable to have her euthanized. He has been our vet for over 22 years and has an excellent reputation in the community. The cat still plays and is fairly active. Yes, she is sick, but she is not suffering yet. Thank you for the suggestions.

 

[CatWhisperer]

Ohio State has a school of veterinary medicine in Columbus. I highly recommend you take your cat there for her best chance of pulling through this.

 

[Peaches Lee]

Is she on a prescription kidney diet or liver diet?

 

[Dinogrrl]

Is she on Denamarin or another liver support supplement? Double-check what anti-nausea med she's getting, all the ones I know of are given daily or twice daily. Antacids may be helpful if her kidneys are being affected, kidney disease can really throw off the pH of the GI tract and make cats nauseous. Anyway, if one anti-nausea med isn't working then it's worthwhile trying something else. It sounds like your vet has tried all the standard things, short of intensive hospitalization with IV fluids or whatever. Has a GI panel been run to test for pancreatitis and malabsorption issues? It's possible she has two completely different things going on at once, ie liver issues and IBD.
At any rate, definitely ask your vet for his suggestions as far as what meds and dosing would be appropriate.

Honestly I agree that an ultrasound is the next step. There are things other than liver flukes that can cause liver problems. To be perfectly honest, I've never even seen a cat (or dog) with liver flukes in my area (NC), however things like pancreatitis, infections, IBD, and cancer pop up all the time. They are all potentially treatable, but again you don't usually see those without an ultrasound or specific blood tests, and the sooner such things are diagnosed, the sooner they can be treated.

Good luck with whatever you decide! This is a tough situation to be in, for sure.