Enlarged liver/jaundice kitty - advice needed

[Monica & Josie]

Dear everyone,

After an ultrasound and blood tests done today the vet told us that Josie has jaundice and a fairly enlarged liver. No sign of tumour.
She can't have steroids as she is diabetic, she can't have the Denamarin tablets as she would not swallow just spits it out or leaves the food we crushed the pill in so we can't get it into her.

For her old age bless her she gets very stressed out and agitated at the vet so we can't have her on fluid treatment there either as it would probably cause her a lot of stress.

We gave her a Convenia antibiotics shot this evening that apparently should last for two weeks,
Vet said it's hard to tell what will happen or how much time she has left, it al depends on how she responds to the antibiotics..

Apart from the lethargy and sitting mostly in a meatloaf position there are no other visible signs of anything, her appetite has actually increased, she's purring and makes eye contact

She's on Prozinc 0.75u twice a day, Meloxidyl in the morning for her pancreatitis and Milk Thistle tincture for liver support..

Vet told us to bring her back in 2 weeks time but be prepared that Josie could have months but maybe only weeks or days left..

Will try to upload her lab results here as well, if anyone has any thoughts or suggestions for us from experience what we should do / could try it would be very much appreciated, thank you!

 

[Noah & me (GA)]

I've been there twice.
From Noah to Josie
We need a head bumps emoji

 

[Monica & Josie]

Lab results..

 

[Jill & Alex (GA)]

She can't have steroids as she is diabetic, she can't have the Denamarin tablets as she would not swallow just spits it out or leaves the food we crushed the pill in so we can't get it into her.

If she needs steroids simply adjust the insulin dose accordingly. Many of our members have had to give steroids. It's a balancing act and not ideal, but can be done if necessary.

Denamarin really shouldn't be crushed and should be given around 2 hours prior to eating. Have you tried a "pill popper/shooter" or "pill gun":

• https://www.amazon.com/Jorgensen-Pet-Piller/dp/B0002ZAG84/ref=sr_1_4?ie=UTF8&qid=1528412704&sr=8-4&keywords=pill popper for cats
• https://www.amazon.com/Butler-Sales-Bullseye-Dispense-Multiple/dp/B000A86YBQ/ref=sr_1_1_sspa?ie=UTF8&qid=1528412704&sr=8-1-spons&keywords=pill popper for cats&psc=1&smid=A1WQSRCWLDHEOL

Not sure if you can find anything like it in the UK. Alternatively, hiding the pill in a a small piece of soft cheese or meat often works.

For her old age bless her she gets very stressed out and agitated at the vet so we can't have her on fluid treatment there either as it would probably cause her a lot of stress.

Alex reacted the same. The vet showed me how to administer fluids at home. Fluids seemed to help a lot:
How to Give Subcutaneous Fluids (Video)

Apart from the lethargy and sitting mostly in a meatloaf position there are no other visible signs of anything, her appetite has actually increased, she's purring and makes eye contact

Awesome! Food is like medicine to the liver. Try to get her normal amount of food into her plus another half of that amount every day. I ended up supplementing Alex's meals by feeding her with a syringe: Syringe/Assisted Feeding (Video and Tips).

...if anyone has any thoughts or suggestions for us from experience what we should do / could try it would be very much appreciated, thank you!

When Alex suffered from severe liver disease and an acute renal crisis (2010 on spreadsheet), I credit getting an ample amount of food into her (whatever she'd eat), fluids, denamarin, and ursodiol (aka actigall) for her recovery. FYI: Her liver values were worse than Josie's. She lived another 4+ years after that... finally succumbing to oral cancer. Although, I'll be honest, her recovery took a lot of at home care... sometimes round the clock.

Hope this helps...

 

[Susan&Felix(GA)]

Wishing Josie and you the very best.

 

[Diana&Tom]

Hi Monica
I don't have knowledge or experience of this situation but I do know that the people here on FDMB are just the best and will give you all the support and advice you need, moral support as well as practical suggestions. So do keep asking questions - there will always be other people who have gone through this.

You did a fantastic job when Josie was dx with FD - you read and researched, took on board all the answers to your questions, and worked out how best to treat her. You can do the same with this, ie do your homework and come up with a plan. There are never any guarantees, of course, but you can do your best to give Josie a fighting chance.

Wish I could make a more solid contribution but know that I have every faith in you to do your very best for your beautiful girl.

Big hugs to you...

Diana

 

[Tuxedo Mom]

Monica

I am so sorry to see that Josie is having such a rough time and I am sure you must be very stressed.

It is good that the U/S has not shown any tumours. The liver has the ability to regenerate itself so using supportive measures is the best approach.

I agree with Jill about using the steroids. Steroid use can be very beneficial with liver issues and you need to treat that first and adjust the insulin to compensate for any increases in glucose. Also the actigall also called ursodiol is a good medication as it helps remove bile acids. Food is very important when dealing with liver disease so keeping Josie eating as much as possible is important. My Tuxie had chronic liver disease because of his Cushing's and his liver enzymes were very high. I used milk thistle daily for him and it helped keep the readings from getting any higher.

Sending you lots of positive and healing energy and prayers

 

[Monica & Josie]

Aaah.. thank you so much lovely people for all your suggestions and well wishes. I just got in from work and will read it all again properly as soon as I get a chance and respond.

Yes it's been pretty tough since we found out but now that I stopped sobbing I am able to focus on getting help to deal with the situation the best way we can and hopefully what is right for all of us.

As always I very much appreciate all your input and for taking the time to advise x

 

[Diana&Tom]

Aaah.. thank you so much lovely people for all your suggestions and well wishes. I just got in from work and will read it all again properly as soon as I get a chance and respond.

Yes it's been pretty tough since we found out but now that I stopped sobbing I am able to focus on getting help to deal with the situation the best way we can and hopefully what is right for all of us.

As always I very much appreciate all your input and for taking the time to advise x

We're all here for you, Monica.

 

[Tracey&Jones (GA)]

I am sorry that Josie is having liver issues.

Jones is one example of a kitty that will be permanently on prednisolone. It is a constant dance but there are times we get into a good BG zone.

Sending vines for Josie.

 

[Monica & Josie]

Update:
Well I spent most of today reading up about treatments, steroids, Ursodiol, Prednisolone, watching Youtube videos of administering Sub-Q fluids at home, ( thank you @Jill & Alex (GA) your video made it look so simple..! ) learning how to outsmart kitty regarding hiding pills and drops...etc.
I ordered Pill Pockets on Amazon, bought the healthiest and most nutritious wet food, also on the vet's recommendation I started Josie on a 'wonder' supplement called Pet Plus which she loves, phew!
On Monday I will talk to the vet about doing fluids at home, although she specifically stated in her e-mail that it cannot be done at home... will also ask her about giving steroids whilst monitoring and increasing her insulin if necessary. Thank you for your opinion that it's a possibility if needed.
On your recommendations I will also ask if we could start Josie on Ursodiol, sounds like a great support.

As for the patient, Josie kitty is looking a lot less yellow, her eyes are brighter, she's happily grooming herself again and still eating for England!
Also this morning as we were walking towards her whilst she was laying on the carpet she rolled over and exposed her fluffy belly which she hasn't done for weeks! It made me and my little boy so happy and I got quite emotional about it..

Thank you so much again everyone for your suggestions and support, with your help I learned so much already about this new chapter in our lives and feel a lot more confident.
I am prepared that anything can happen and Josie might not be with us much longer but things seem a lot brighter than they were a few days ago and thanks to you I'm feeling a lot more positive again.

Wishing you all a very happy Sunday

 

[Jill & Alex (GA)]

Well I spent most of today reading up about treatments, steroids, Ursodiol, Prednisolone, watching Youtube videos of administering Sub-Q fluids at home, ( thank you @Jill & Alex (GA) your video made it look so simple..! )

You're welcome for sharing it, but credit and thanks for the video goes to FDMB member @Marje and Gracie . She and her husband did a marvelous job with it! If everything doesn't go as smoothly, don't despair! Keep trying. It takes a bit for both the caregiver and the cat to establish a routine. If Josie runs off when you start, try administering fluids in a small room where you can shut the door to help keep him in one place.

Some cats will want to eat immediately after receiving sub-q fluids. I had a small dish of food ready for Alex. I gave it to her as soon as we finished fluids. This helps when you're desperately trying to get more calories than usual into the cat.

On your recommendations I will also ask if we could start Josie on Ursodiol, sounds like a great support.

If you end up giving Ursodiol long term, the veterinary community is divided on whether ursodiol depletes taurine in the body. To be on the safe side, I gave Alex 1/8 teaspoon pure Taurine Powder mixed in her food twice a day. Any excess is simply peed out. My vet also had Ursodiol compounded into a chicken flavored suspension for us. It must have tasted good because I didn't have any trouble giving it to Alex.

As for the patient, Josie kitty is looking a lot less yellow, her eyes are brighter, she's happily grooming herself again and still eating for England!
Also this morning as we were walking towards her whilst she was laying on the carpet she rolled over and exposed her fluffy belly which she hasn't done for weeks! It made me and my little boy so happy and I got quite emotional about it..

Awww, this made me smile! What great news!!!

Let me know if I can help. Wishing you and Josie the best!

 

[Diana&Tom]

Respect to you, Monica, you have a great fighting attitude! You might have to convince your vet that steroids are ok as long as you can also manage bg levels - which you can - and also that fluids are doable at home. I don't think many vets are used to such conscientious owners so it may be a matter of working out how to get your vet on your side with these things. If she won't, what else is she suggesting - just the Pet Plus?

I wonder if anyone here has any thoughts on how to discuss treatments with the vet???