liver issues in older cat

[chicknmania]

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.

Yes I know about ohio state I live here. The last experience I had with them was not a good one..and they are outrageously expensive besides.

 

[chicknmania]

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.

I will ask about denamarin thank you. He thought of liver fluke first because feral cats can and do get it from eating frogs etc. She was living on her own for quite a while pretty successfully. As I said he has ruled out liver fluke but I will ask about the ultrasound.

 

[chicknmania]

Is she on a prescription kidney diet or liver diet?

she is on a prescription diet yes. It is a high calorie, vitamin enhanced food.

 

[Dinogrrl]

@chicknmania Oh yeah I know liver flukes do happen, I just haven't seen them personally! They may be more common in your area than mine. It certainly never hurts to rule out parasites since they're usually easier to fix than other things.

 

[chicknmania]

Yes, and we have ruled liver fluke out. . I am not quite sure why he has not suggested a liver supplement. I have personal experience with Milkthistle working for gall bladder, and working miraculously, actually. I believe Denamarin has Milkthistle extract in it. I left a message with him Friday about supplements, but have not heard back. I will call him Monday and ask again. I think he is focusing on her gut because he says although liver and kidney issues cause nausea, he doesn't feel she should be that nauseous, and also she has a raging appetite, where most liver cases have the opposite problem. The anti nausea medicine he gives her as an injectible seems to work well, as it works for several days. I just don't remember what it is. He HAS done the blood panel and knows her liver enzymes are elevated, althougn not hugely. He's done bloodwork twice and the second time they were slightly more elevated. He has done an XRay to look for bowel obstruction and whatever else, I'm pretty sure he does not have the capacity to do an ultrasound on the liver, although we could take her to a bigger hospital elsewhere. He can do a biopsy however, but I really feel that the stress of this would be detrimental to her health at this point until we can get her fattened up some. That is why I have put off doing that. I understand that it would be useful to find out what exactly her problem is....maybe. But it wouldn't necessarily make any difference in how the issue is treated. He has treated her with prednisone, antibiotics, dewormer, and fluids. From what I have read about treating cat liver issues, regardless of what they are, the main thing that can really be done is provide supportive care, and sometimes the liver will regenerate itself. And that is what he is doing...supportive care... except for the liver supplements. I'll just have to talk to him again. Thank you all for the input.

 

[BloomBunny]

I understand that it would be useful to find out what exactly her problem is....maybe. But it wouldn't necessarily make any difference in how the issue is treated.

You and your vet have covered your bases. Nothing you can do will make her immortal. No need to continue to indulge in stressful tests. Follow your best instinct and give her nurturing care to maximize her comfort in her decline.

Consider if there's a level of small frequent meals that don't trigger her vomitting. Conversely, several hours of water only fasting might be healing. Try variants on your water. Distilled? Spring? A little ACV or baking soda added? These have all been known to add comfort to some. Mixing warm water in her food ("mouse-body warm") might settle it better. I've had luck with that in several situations.

The milk thistle sounds promising. I hope you hear from the vet on it. It sounds safe to me.
Let her guide you. Cats tend to be more sensible about end of life and palliative care than we are.

 

[CatWhisperer]

Has she been checked for hyperthyroidism? I honestly wouldn’t try a liver aspirate without ultrasound to guide me to a diseased looking area of the liver. My personal experience with veterinary colleges is that they are less expensive than private practice. It may seem more expensive because they get the more serious cases and have the equipment and manpower to treat things more effectively. Knowing an exact diagnosis makes treatment likely to be much more successful.

 

[chicknmania]

Has she been checked for hyperthyroidism? I honestly wouldn’t try a liver aspirate without ultrasound to guide me to a diseased looking area of the liver. My personal experience with veterinary colleges is that they are less expensive than private practice. It may seem more expensive because they get the more serious cases and have the equipment and manpower to treat things more effectively. Knowing an exact diagnosis makes treatment likely to be much more successful.

Hyperthyroidism has been ruled out, that' is what I thought she had when we first took her to the vet, because the symptoms are so similar.

And no, sorry. Ohio State University vet hospital is very expensive and has a reputation of being so. They need to make money just like anyone else, and they do intend to. And, as I said from my previous experience, they are not necessarily the magical answer, any more than any vet is. They do have more sophisticated equipment, which is why they charge more. But my experience with them was less than satisfactory.

I had an experience with one of our other cats where the high powered clinic we took him to was totally baffled...he had a weird eye condition that was threatening loss of his eye. They couldn't figure it out. But our old country vet did figure out, and saved the cat's eye, So I know he does know a few things. If he feels it is necessary to have an ultrasound done, he will let me know, and then OSU would be the ones to do that. Our vet's fees are very reasonable but I have already spent over a thousand on her vet care, over the past few months, and we're getting close to the limit....

 

[chicknmania]

You and your vet have covered your bases. Nothing you can do will make her immortal. No need to continue to indulge in stressful tests. Follow your best instinct and give her nurturing care to maximize her comfort in her decline.

Consider if there's a level of small frequent meals that don't trigger her vomitting. Conversely, several hours of water only fasting might be healing. Try variants on your water. Distilled? Spring? A little ACV or baking soda added? These have all been known to add comfort to some. Mixing warm water in her food ("mouse-body warm") might settle it better. I've had luck with that in several situations.

The milk thistle sounds promising. I hope you hear from the vet on it. It sounds safe to me.
Let her guide you. Cats tend to be more sensible about end of life and palliative care than we are.

Thank you. I have tried smaller meals and also warming her food in the microwave for a couple of seconds, just enough to take the chill off. And a "slow feeder" a little tray designed to make her eat slower. I will try that with the water and maybe the fasting if she starts vomiting again. I thought about bone broth too...another thing that is supposed to be very healing for these types of issues and which I used for my own gall bladder problem back then. I will ask the vet about that too. I decided to go ahead and try sprinkling half a capsule of Mllk Thistle on her food, which I did this morning. It can do amazing things, as I said, and I think it is quite safe.

 

[chicknmania]

I talked to the vet this morning. WE are going to try Ceremia (sp) tabs for her nausea, which started up again today. He also approved using the Milk Thistle. She does not have pancreatitis.