Hi Gill and George!
George is looking great and even better is to hear he is feeling great!
I looked at his labs and the liver issues stand out to me. As I said, it is something we dealt with with Gracie for her entire life but mostly the last 3.5 years. Many diabetic cats have elevated cholesterol and George's is pretty consistent with what I see so I wouldn't worry. I did notice that once I switched Gracie from the usual foods like Wellness and Merrick which have higher fat than protein to Ziwipeak and a homecooked diet, her cholesterol levels dropped. However, my nondiabetic cats who ate Wellness and Merrick did not have elevated cholesterol. Thus I believe the diabetes also plays a role here.
When all the liver enzymes like that are elevated (and the ALT, ALP, and AST are mild elevations) then it is indicative of hepatoctye death more so than other organ issues which might also effect the liver. Anytime you have an elevation in bilirubin, you would also suspect there is a gallbladder or bile duct issue. I bet if they had run GGT, it would have also been elevated. At the time of this test, was George eating really well? I ask because these kinds of elevations can be seen with hepatic lipidosis
if kitty is not eating well.
The other culprit in liver values like this is cholangiohepatitis or triaditis. Every time Gracie's liver values had a simliar mild elevation, we would have an ultrasound done. They were inconclusive. She had no symptoms of anything being wrong until this past July when she didn't want to eat and when I caught her urine to test for ketones, it was dark gold indicating bilirubin in the urine. Initially, with the first elevated liver values, the specialist thought she had a dilated bile duct but after further testing and comparisons to baseline ultrasounds I was able to track down with another radiologist, it seemed congenital.
I'm surprised your vet did not recheck labs within one month to see what his liver values looked like. He/she should have done that. I would definitely be following up on that to see if it has resolved. Cats can have quite high liver values before they actually start showing any illness or George's could have resolved after whatever "insult" to the liver was alleviated. The liver can be quite forgiving.
If George's liver values are elevated on the next set of labs, you might want to discuss with the vet the following treatments:
An antibiotic: metronidazole is usually used but some cats can't take it and Gracie was one so she took clavamox.
A bile acid esp if bilirubin and GGT are elevated: most commonly used is ursodiol (compounded with no sweeteners) but if your vet goes that route, be sure you also supplement with pure Taurine powder as ursodiol can deplete taurine.
Water soluble liquid Vitamin E : After an exhaustive search, the one linked is the only one I could find with no sugar. It really did seem to help.
Denamarin or denosyl: they both provide liver support although denamarin is more commonly used.
If values are really high, and especially if there is bilirubin in the urine, I would ask about giving subq fluids as long as George has no heart or other issues which would preclude it.
The only way to know definitively what is going on with the liver is exploratory surgery with biopsies. This was something we chose not to do and we do not regret that decision as it was not the liver issues that resulted in her crossing. Needle biopsies, even ultrasound guided, can miss the potential problem area. We just chose to treat the numbers and they would resolve....although they would later rise again but as I said, this was a lifelong issue of hers.
Please let me know if you have questions.
amps 106 
90@ +1.5 
