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Dr. Kara
Dr. Kara, Board Certified Veterinarian
Category: Vet
Satisfied Customers: 15899
Experience:  Over 20 years of experience as a veterinarian.
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LIVER PROBLEMS My cat, senior male - maybe 12/13 years old

Customer Question

LIVER PROBLEMS

My cat, senior male - maybe 12/13 years old hasn't eaten for 5 days. Went to vet yesterday and blood test results now received. I didn't take in everything his vet said and didn't like to press too hard for hard facts - I was too upset at the results. Enzymes or something which should be around 60 mark, are 2500 in Monty! He goes in for unltrasound test tomorrow 9AM.
I hope we have got this in time, his normally more-than-healthy appetite was fine 6 days ago. He had a little food for breakfsat last Friday and he's been to the vet twice since then, so I just hope I acted in time.
I guess what I'm asking is, what are his chances?
Submitted: 2 years ago.
Category: Vet
Expert:  Dr. Kara replied 2 years ago.
Hello, my name is***** and I have over 20 years of experience as a veterinarian. I am so sorry to hear about Monty's liver disease and I can understand that it may have been very difficult to process all of the information that you were given.

If he isn't eating on his own then placing a feeding tube is important as it is really impossible to force feed him enough to support his calorie needs. You can also ask your veterinarian for an appetite stimulant, either Mirtazapine or Cyproheptadine.

Do you have a diagnosis as far as what led to Monty's lack of appetite and liver disease? It is important to know what sort of liver disease he has to know if it is treatable and how to treat it. We need to know if this is pri***** *****ver disease or if it developed secondary to him not eating. If it is secondary it is also important to address the underlying problem that led to his lack of an appetite or he will not improve.

The good news is that a liver is an organ that can regenerate itself, depending upon the cause, if given the proper support and treatment. The bad news is that this can take several weeks to months to happen and the healing isn't usually a smooth process, things seem to progress in fits and starts. You do need to be prepared for a long process but if his liver disease is caused by bacterial infection, or primary inflammatory process, he can get better.

The gold standard is a liver biopsy or at least an ultrasound guided aspirate, so I am glad to see that he has an ultrasound scheduled as hopefully that can give you some of the answer that you need.

He may benefit from fluid therapy, vitamin B-12 injections and in some cases supplementing vitamin E and vitamin K, especially if his clotting ability is affected. Ursodiol is a medication used to help with bile sludging, if that is a problem. If a bacterial infection is suspected then antibiotics are recommended.
Denamarin is a nutraceutical that contains silymarin (the active ingredient in milk thistle) and s-adenosylmethionine both of which support liver function and help repair damage to liver cells. I highly recommend it.

Without knowing what type of liver disease he has, or of there is another underlying disease process, it is very difficult to give you a prognosis. I do tell owners however that the more aggressively we treat their pet initially the better chance they have of recovering. If you want to read more about fatty liver disease in cats here is a link to an excellent article about it:
http://www.veterinarypartner.com/Content.plx?A=1455

Please let me know if you have any further questions.
Customer: replied 2 years ago.

This comforts me and if possible, I should like to keep you posted when things transpire?


 


There have been no upsets to his daily routine which would cause stress - we are together all days, as I am retired and he has the best of all worlds! This has come out of the blue.


 


He is here with me now, quite placid though doleful -- we are about to call it a day and sleep peacefully.
Thank you Doctor, I am reassured. He is a treasured companion.


Clive


 

Expert:  Dr. Kara replied 2 years ago.
He does sound like he has a wonderful life with lots of attention. Have a good night's sleep, both of you, you'll both need your energy to get him well.
I would love to hear how things go for him.
You can come back and reply to this page at any time, even after you have rated my response, so please do come back and give me an update, thanks, ***** *****
Dr. Kara, Board Certified Veterinarian
Category: Vet
Satisfied Customers: 15899
Experience: Over 20 years of experience as a veterinarian.
Dr. Kara and 2 other Vet Specialists are ready to help you
Customer: replied 2 years ago.

Just to say the ultrasound revealed no tumour but a bile duct obstruction. He's home again now, and seems contented but still not eating though his vet got some food down him using a syringe this morning. We have medications to administer each morning and he is due back at the vets in 2 days to be monitored. I sure hope he starts eating (he IS drinking water) as otherwsie he will have to be fed intravenously and this will mean his being kept in at the vets for a few days. I'll try some cooked chicken and tuna to tempt him.
He's lost .3 of a kilo over the past week. Otherwise as some sort of consolation, all else about him is fine.


 

Expert:  Dr. Kara replied 2 years ago.
Thank you for the update.
Bile stasis can certainly lead to liver enzyme elevations, jaundice and feeling very poorly. It is not surprising that he doesn't want to eat.
He may need a feeding tube placed, which would allow you to syringe feed him at home.
Did they tell you what is obstructing his bile duct?
It can be related to stones in the bile duct, pancreatitis, liver flukes (rare), an infection or sterile inflammation of the biliary duct system or cystic liver disease. Treatment will depend upon the cause.
I am glad that he is drinking, he needs to stay hydrated.
Please let me know if you have more questions or foe an update after his next veterinary visit, thank you, Dr. Kara.

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