Need advice for liver failure please

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Lydia & Sid & Jake(GA)

Lydia & Sid & Jake(GA)

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I am cross posting this in both the Lantus and general health forums.
Jake is still the same - but at least not knocking on heaven's door like he was last week. He is still very weak and yellow but showing a tiny bit of energy. Last night he wanted out on the patio so we took a little walk outside and we sat together in the flower garden for awhile. He even tried to nibble a little grass. He will walk all the way down to the basement to lay on the couch down there but he won't walk all the way to the litter box (closer than the basement) and chooses to pee in the dining room so I have to watch him and help him go in the right place!
Does anyone have experience with liver failure? The vet told me that it could take weeks for Jake to get better. I've also been told that once cats are yellow, they don't recover. This is my experience with a previous civvie. Any advice is appreciated. Jake is currently exclusively syringe fed 1 can per day - has been A/D but tonight I'm switching to Evo and/or Eagle Pack Holistic Chicken/Duck. He has been getting 1u of Lantus 2x per day. He is on Baytril for a fever, fluid therapy, and prednisolone. I opted to take him off the ovoban because I didn't feel it was helping and wasn't essential to his recovery.


last condo: viewtopic.php?f=9&t=18860
 
Lydia

It would be really helpful to know more about why he is in liver failure; those of us who aren't on the lantus forum likely have no idea of your history. Could you at least update your profile?

There are a few things you can do to help his liver recover, including SAMe and milk thistle. I've little experience with little issues other than when Squeak was first diagnosed, but I have read many times that the liver has a great capacity for recovery. Obviously getting sufficient food into his system is very important...

Jen
 
I'm not sure why he is in liver failure. He was losing weight but doing ok before now. In early March I began syringe feeding him twice per day and giving him weekly B-12 injections. Other than that, he has not had any real health prob other than the diabetes. He was briefly on Novolasc (amlodipine) for high blood pressure but I took him off that because it affected his appetite so much. He seemed ok until last week Monday when I noticed he would not eat at all and would not even approach the food dish. I took him to the vet and he was severely dehydrated and had lost a lot more weight. The vet said Jake has a slight fever and he suspects that Jake has an infection in his gall bladder or pancreas and/or a blockage somewhere. He is yellow and very weak but has markedly improved since last week. As I said, he is getting syringe fed one can 5.5 oz per day but maybe he needs more than that. Also he is on baytril, prednisolone, and sub Q fluids twice per day.

I've heard about milk thistle too. I will look into that.
 
I'm sorry Lydia. I'm new to this board but I'm assuming that Jake has feline hepatic lipidosis? If so, he needs food, and LOTS of it. That's really the cure for FHL. If the liver disease has another cause, then how to treat really depends on what caused it. My cat Tabriz has liver disease from repeated transfusions (iron overload) and antibodies from epogen, plus likely pancreatitis contributes some. He is taking ursodiol. We had used denamarin but it seemed to increase his nausea. He also takes SAMe which seems to help. If there is a blockage ursodiol isn't recommended, but it can help greatly with gallstones and other liver problems if no blockage exists.

I don't know if this is allowed or not, but if it is FHL I'd suggest joining the Feline Assisted Feeding email list at Yahoogroups. PM me for a link (just in case posting links to other groups isn't allowed on here). The FAF list (along with several others) have helped me keep two cats alive that weren't supposed to make it, plus they have excellent articles on assisted feeding, how many calories are needed, and most importantly, a ton of helpful knowledgeable folks who were able to nurse their own cats through FHL or other types of liver problems (along with other things that cause inappetance).

I can tell you that the FAF list has plenty of people whose cats were yellow as a banana and they DID recover. The key is giving them enough food. Dealing with it and diabetes could be a challenge but you need to get the liver fixed and quickly.

I wish you both the best!

PS: Be careful of using milk thistle. Though it can help for some types of liver disease, it actually raised my cat's ALT levels. Once we stopped using it, his ALT dropped 300 points. It can also increase nausea, so you have to be careful when you use it relative to food. You need to know why the liver disease happened first before trying it.
 
Jen & Squeak said:
Wendy, cross posting of such information is not only allowed, it is encouraged :-D
Click to expand...

Glad I didn't break any rules. If anyone else is interested in the list, go to http://groups.yahoo.com/group/Feline-Assisted-Feeding/. They have absolutely WONDERFUL and helpful documents that explain so much. They really helped save Tabriz's life after an acute renal crash when he stopped eating entirely and had to have a feeding tube inserted. I had ZERO clue how to deal with one or how much to feed. They really helped to hold my hand and walk me through the process, as well as calm jitters. Tabriz and mommy both benefited!
 
Hi Lydia

I'm sorry to hear this. Sounds like your guy needs a feeding tube ASAP, and further diagnostics. It makes all the difference in the world to know if he has a blockage or not, so can you get him an abdominal ultrasound tomorrow? Preferably by an internist or radiologist. Cats can and do recover from liver failure but aggressive medical management is needed. If you have the resources, an internal med specialist may be the best person to get you guys through this.

There are three main types of feeding tubes: one is a soft tube threaded up the nose and down the throat (a naso-gastric tube); a tube placed into the esophagus, coming out of the neck (esophagostomy tube, or e-tube), and there are a few types of tubes that go directly into the stomach or intestine (PEG tube, G-tube, J-tube). The first doesn't require any anesthesia; a few drops of numbing agent are placed on the nostril and the tube is passed quickly. The second requires brief anesthesia, and of the 'direct' tubes, only the PEG tube can be done relatively quickly and is minimally invasive.

How to choose? Well an NG tube is great for those cats who are not eating because of an acute condition, for example DKA. You can only get a liquid diet through these tubes, and they can be uncomfortable in the long term, so they are for temporary use only. The other types are appropriate for cats who have a longer-term or chronic problem such as hepatic lipidosis, cancer, etc. Talk to your vet about all the options, and see how soon you can get one in. Believe me, once you have a tube in you'll wonder why you didn't do it sooner. *Feeding tubes definitely save lives* and my cat would have one in a heartbeat if there was any indication for one.

So to sum up:
-- your kitty needs more diagnostics pronto
-- your kitty will need a feeding tube if you are going to continue to treat his liver failure

I have a lot of experience will liver stuff so please let me know if i can help you any further.
 
I think you are right. I was very hesitant about the feeding tube but I think I will ask the vet to insert one. I am very scared about the anesthetic but I don't think he will survive otherwise. Also, thank you for the great information on the Yahoo group. I am going to check that out now.
 
my cat cleo suffered from hepatic lipidosis. her ALT went to the high mid 500s. biggest part of treatment was getting her to eat. anything. just to eat is the main thing. i also added denamarin. i got the small dog size of denamarin and would cut it in half with a pill splitter and put into two pieces of pill pocket.
every subsequent blood test cleo's ALT would go back down til it was finally back to normal.

a friend contacted nutramax to find out what cutting the pill would do to its effectiveness and was told to expect about a 20% decrease in effectiveness. (part of the reason for the coating is to protect it from heat and sunlight, so cutting it did affect it.) but even with 80% effectiveness i consider it a miracle worker.

some vets prefer denosyl because the ingredients of denamarin have different instrux. one component is to be taken without food, and the other one is to be taken with food. but that contradiction does not affect cats. honestly i recommend it highly.

i stopped it after cleo went back to normal liver values for 3 months but she's had some liver crisis since so i've added the denamarin back to her list of meds. i get it from ebay from a regular seller (pazgroupinc i think) and have been very happy with the price/delivery service. i think she ships it for free.
 
Sounds like you've received great advice already. I can't offer much...my Potter (GA) didn't make it through his liver failure. We tried, with medication (and I sooooo wish I could remember the name, but it was 5 years ago) and syringe feedings for 6 weeks before we helped him over the bridge. My vet was helpful, but I've already learned more from the preceeding posts than I ever did from my vet. I know the medication we used was one used for humans, and the vet said to get as much food as possible into him. The liver can't clean itself out and regenerate without processing food. Had I known then what I know now, we would have gone the feeding tube route, and maybe we'd still have him.

Anyway, just wanted to say I understand your situation, and I hope Jake starts getting better soon!
 
Mindy, I'd guess the human medication was ursodiol. It is a bile salt that helps move things through the liver, so it helps with cholestasis. It is commonly used in humans for liver problems, and works in dogs and cats too for the same reason.
 
I think you're right--ursodiol sounds familiar. It was a yellow pill, about the size of a skittle. I remember the vet telling me to coat it in butter to get it to slide down easier, but that just made it slip out of my fingers easier. ohmygod_smile Potter eventually just got used to me giving it and we didn't have an issue with it going down dry.
 
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