High Liver Value In A Diabetic Older Cat

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Jeanne Leslie-Wander

Jeanne Leslie-Wander

Member Since 2018
I have a 17 year old indoor cat who has been diabetic for several years. He gets insulin shots twice a day. Recently at his annual checkup we discovered that he has a thyroid issue and that his liver levels were elevated. The vet put him on thyroid medication (Methimazole 5 mg - 1/2 tablet a day) and told me to come back in a month to have his blood levels checked again. The thyroid condition seems to be under control with this medication but his liver values went up dramatically. It is now at 643. She is suggesting that I take him to an internist for an abdominal ultrasound. He gets very stressed out at the vets and it often causes his glucose levels to go off. I am wondering if I should take him to the internist or not. Because of his multiple health issues and his age I don’t think we would consider surgery and I am wondering if there is anything the ultrasound could find as the reason forthe liver values that would not require surgery or chemotherapy.
 
jayla-n-Drevon said:
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Quite. I am sorry and worried to read this for you and your cat. As you can see , my pusscat is also ancient.

Some threads do seem to get a lot of responses and some not so much so.

I do hope all those people will be coming by very soon. I am in New Zealand so very late for me. I shall tag so you get some support. Nothing worse than feeling on your own.

What insulin are you using please?

@Stacy & Asia
@Marje and Gracie
@Jill & Alex (GA)
@Wendy&Neko
@Janine & Floyd
@Juliet
@bellasmum
@Kris & Teasel
 
I have an old cat too and I understand your concern and hesitation. Briefly looking up Methimazole, one of the complications is worsening serum liver enzyme values. One possilbity is the medication itself. Is there any chance to switch to a different medication to see if that helps before getting an u/s? Why does your vet suspect something else is at play rather than the medication itself?

The awesome and hopeful thing about livers is they can take a lot of abuse and come back from it, other organs don’t readily heal and regain function the way a liver does. :bighug::bighug::bighug:
 
When Olive had their first vet visit after arriving her liver values were elevated. We do not know her age but she is an older cat. Her diabetes had just started treatment so she was running high. Doctor said it could be from the unregulated diabetes and it is unknown how long she went without eating before being found that hepatic lipidosis might have started. She wasn't to concerned at that time and said to repeat in a few months after she has been on insulin and has regular meals. Hopefully next week we will get repeat labs done if it's not to soon. She also gave me some hepa support supplement to start at my discretion. I have not yet, as I want to see if any improvement has occurred with consistent dosing and meals.
 
Max would have a higher ALT with pancreatitis but never that high. My vet said it becomes a concern if more than double the high range. Max never got there. I would get an abdominal ultrasound if my cat.
 
With multiple issues, diabetes, hyoerT and now liver, I agree that it might be time to get an internal medicine vet involved. They are good at balancing multiple conditions.
 
Jeanne Leslie-Wander said:
The thyroid condition seems to be under control with this medication but his liver values went up dramatically. It is now at 643. She is suggesting that I take him to an internist for an abdominal ultrasound. He gets very stressed out at the vets and it often causes his glucose levels to go off. I am wondering if I should take him to the internist or not. Because of his multiple health issues and his age I don’t think we would consider surgery and I am wondering if there is anything the ultrasound could find as the reason forthe liver values that would not require surgery or chemotherapy.
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An ultrasound may give you the information you need as to where to go from here. Alex's values were 594 (ALT) and 153 (AST). An ultrasound helped us make decisions such as treating symptoms rather than biopsy or surgery.

With Alex, treating symptoms meant making she sure ate her normal amount of calories plus half more each day (food is like medicine to the liver), giving her ursodiol (actigall), taurine, denamarin, omega 3s, and B complex vitamins. Our vet had the ursodiol compounded into a chicken flavored liquid for us. Her liver values gradually dropped to normal over a span of around 9 months. Treatment for your cat may vary depending upon the results of the ultrasound.

Bottom line, the liver is a resilient organ. I'm glad we went ahead with the ultrasound. Treating symptoms gave us another 4.5 years with her. Her liver had recovered. It was oral cancer that took her at the end...
 
An ultrasound can tell you a lot. There could be a bile duct blockage which can be detected on the ultrasound and then treated. Many conditions can cause the liver enzymes to increase, including pancreatitis. Pancreatitis can be det cod on an ultrasound as well.
 
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