2/18 Buddy AMPS 175(1.25u),has mild hepatitis,labs attached

yesterday viewtopic.php?f=9&t=6636

Buddy seems...idk...better...but still not as hungry and still has mussy poo...

Vet results today...also he puked at +4 last night...

I'm hoping whatever is/was going on is passing through his system...i have a feeling it was the salmon oil...

 

Re: 2/18 Buddy AMPS 175 (1.25u)...has mild hepatitis...

Just got off the phone with the vet...buddy has mild hepatitis...

 

Re: 2/18 Buddy AMPS 175 (1.25u)...has mild hepatitis...

Sommer:

Maybe cross -posting on Health about the hepatitis would be helpful to you. You may want to post the lab results (e.g., Hep test, liver values and other blood work)

 

Re: 2/18 Buddy AMPS 175 (1.25u)...has mild hepatitis...

don't physical labs in my possession yet

 

Re: 2/18 Buddy AMPS 175 (1.25u)...has mild hepatitis...

crappola! sorry to hear this. i agree with cheryl, cross post on health when you have the labs.
let's get more eyes on this...

 

Re: 2/18 Buddy AMPS 175 (1.25u)...has mild hepatitis...

The only definite diagnostic test for HL is biopsy. However, blood work results can give a good indication of HL. The key to getting over HL is food. If the cat is vomiting there are meds to help reduce the likelihood of vomiting. Pepsic AC only helps for nausea caused by excessive stomach acid production, it is not really an anti vomiting (Antiemetic) drug.

 

Re: 2/18 Buddy AMPS 175 (1.25u)...has mild hepatitis...

I'm going to call and have the labs faxed...I just cross posted in health but with no info really to give...

Is this a really bad diagnosis? He just doesn't seem normal...

Also, his appetite is not the same as before...he eats very little which is partially why I'm sure his numbers are lower today, see ss...

So my next question is...suggestions for his dose tonight with the decreased appetite?

 

Re: 2/18 Buddy AMPS 175 (1.25u)...has mild hepatitis...

What do you mean about food being the key to getting over HL? How so?

 

Re: 2/18 Buddy AMPS 175 (1.25u)...has mild hepatitis...

The biopsy will be able to tell you exactly what's going on with the liver. The blood work can tell you only so much. The ALT and AST are good indications of a problem, but if those values are not elevated, you could not tell of the problem. Biopsy is best; look at an actual piece of the liver to know, provided good sample taken.
I don't know the most recent biopsy procedures for felines, but maybe there is a test which is non invasive yet about as good as a biopsy. I am thinking of something like Fibrosure test for humans. I know; don't compare humans to cats, but the test was the first thing that came to mind.
Being old school myself, I am reassured by the invasive biopsy.

I hope you can get some good advice if you post the bloodwork results.

what I found quickly on the food part of it.

Hepatic Lipidosis in Cats:

This disease occurs in cats that will not eat for a variety of health reasons. Cats that are affected were often overweight. These cats may have stopped eating because of a change made in their diets or because of a stressful situation at home such as moving, kenneling or health problems in their owners. Secondary hepatic lipidosis also occurs in cats that suffer from diabetes, intestinal disease, pancreatitis or any other serious systemic disease. No mater what the cause, all cats develop an over-accumulation of triglycerides (fat) within their liver which blocks normal liver activity. Signs of this disease include weight loss, vomiting diarrhea, listlessness, drooling and jaundice. Laboratory tests reveal elevated liver enzymes and anemia. In treating this condition we try to address any underlying disease in order to get the cat to eat. Until this is done, cats need to be tube-feed energy-rich, high caloric foods.

 

Re: 2/18 Buddy AMPS 175 (1.25u)...has mild hepatitis...

the most important thing now is getting buddy to eat. food is like medicine for HL. you need to get as many calories into him as possible... and keep track of the number of calories consumed daily. ask your vet for an idea of how many calories buddy should be getting every day. many kitties have feeding tubes put in if they aren't eating well. cyn/cosmo and lynee/max as well as the vet techs here will be excellent sources of information. PM them for suggestions. i *think* they both used some calorie dense supplements, but for the life of me i can't remember the names... maybe another question to ask on health.

insulin... the trick here is to give buddy as much insulin as we can without having him bottom out. we don't want to invite ketones to the party.


ps --- i have not personally dealt with this health condition. listen to those who have.

 

Re: 2/18 Buddy AMPS 175 (1.25u)...has mild hepatitis...

Leo almost died from hepatitis this summer because he got it from a clogged bile duct. He was dx via bloods and ultrasound where they found the clogged bile duct. Here's how he was treated:

--1 course of baytril (14 days)
--3 courses of flagyl, liquid, triple compounded with tuna flavor http://www.drugs.com/metronidazole.html 14 days x 3
--3 courses of actigall http://www.drugs.com/mtm/actigall.html 14 days x 3
--2 months of denamarin http://www.nutramaxlabs.com/Vet/Products/Denamarin.aspx
--fluids every day for 1.5 weeks, then as-needed (get cardio check first, cats with cardio issues can not handle large amts of fluids) Leo has cardiomyopathy so we had to be very careful

For the first several days, I took him to the vet every morning and dropped him off for a full day of fluids. We were worried about his cardio issues, you may be able to get away with doing the fluids yourself at home. They are an important part of the treatment because a dehydrated cat often does not want to eat.

The important thing is to keep them eating. Diabetes now takes a back seat while you treat this. Your insulin needs may fluctuate wildly and you may find yourself skipping shots, especially if you are using fluids. I found Leo snapped back very quickly once all the meds were going and he was getting fluids regularly.. took less than a week for him to be almost good but he did relapse a couple times. Mild relapses but enough to get me to restart his meds. I did not need to use an appetite stimulant because his appetite improved when fluids were started.

 

Re: 2/18 Buddy AMPS 175 (1.25u)...has mild hepatitis...

Hello! I was tagged to come give support for the hepatic lipidosis....

FOOD is super duper important. He NEEDS to eat to get better. Often, kitties with hepatic lipidosis also have pancreatitis, which i would wonder about given your posts about vomiting.

You might ask vet about giving:

1) some antibiotics? we gave amoxi-drops
2) sam-E or Denosyl (for liver support), which might or might not be the same as milk thistle (which i've also heard to be used in treating HL).
3) pepcid/famotodine
4) carnitine

someone will help with dose of insulin. We don't really care what he wants to eat, so long as he eats. HE NEEDS CALORIES. My Cosmo was in the hospital for 8 days with HL and DKA. The HL took weeks to treat/cure, and was very stressful. Jojo even said he could eat dry food while we were dealing with the HL (just to give you an idea of how important the food is). We had an e-tube esophogeal tube) and we used clinicare (almost 25% carbs!!) until he was eating enough on his own to stop.

please don't hesitate to contact me (PM or email) if you have questions. I try to come every day to the board, but since Cosmo is OTJ (antijinx), it's been harder to make time to come.

 

Re: 2/18 Buddy AMPS 175 (1.25u)...has mild hepatitis...

Sommer,

I have no advice to offer but I'm sending eat Buddy vines your way!
(((Sommer)))

 

Re: 2/18 Buddy AMPS 175 (1.25u)...has mild hepatitis

The labs are attached...

I included this weeks lab work and our last lab work from Sept. 09, didn't know if a comparison was in order...

Thanks for all the help and advice

No puke today (antijinx) and he seems in better spirits tonight...

 

2/18 Buddy PMPS 245 (1.25u)

Buddy seems in better spirits tonight...he ate a full dinner so I gave him his full dose...

fingers and paws crossed he keeps his dinner down...

 

Whoa, this thread is getting confused, I think starting with Larry's post. Hepatitis is not hepatic lipidosis. This kitty does not have hepatic lipidosis, his vet just dx'd mild hepatitis.

Just a comment. I'll look at the labs now ...

EDITED to add:

Ok I'm back. Hepatitis is a diagnosis that is arrived at by biopsy. There are several ways to get a liver biopsy. You can do a "tru-cut" biopsy; that is an ultrasound guided biopsy using a special (huge) needle to cut a sliver of liver. You can do a full exploratory (open 'em up) or you can do a laprascopic biopsy (tiny incision, camera and biopsy instrument are inserted into the stomach). My dog has chronic cholangiohepatitis and I have had two lap. biopsies done on him. The benefit of an actual biopsy, rather than the "tru-cut", is that you can also culture the liver and gall bladder for infection.

Biopsy will diagnose the disease but cannot tell you about liver function. Liver function is assessed by a "bile acids" test. You can ask your vet if that's appropriate.

I am unsure of the context of these tests. I assume your cat is having some issues, so I would make an appt with an internist (if there is one in your area) to have an ultrasound done, and discuss the biopsy options with him or her. Cholangiohepatitis/hepatitis rarely occur in a vacuum in cats so there is often concurrent bowel and pancreatic inflammation. You need to pair up with a vet who can investigate this for you. In the meantime you can ask your vet if Buddy would benefit from a drug called Ursodiol. (Note: this drug can interfere with the bile acids test, so do that test first, or stop the Urso for two days before.)

Hope this helps. I think you need to get some diagnostics done and then attack this. I have a lot of experience with hepatitis in dogs and cats (my late cat Earl had cholangiohep.) so I know a bit about it.

 

Yeah, that is what I thought too but then I was thinking...maybe they are one in the same...mild hepatitis is not as bad as HL right???

 

[quote="sommerbethel"
Yeah, that is what I thought too but then I was thinking...maybe they are one in the same...mild hepatitis is not as bad as HL right???[/quote]


I just edited my last post. Yes, HL is acute liver failure and it is often fatal, so hepatitis is a better "short term" diagnosis. It can progress to cause major problems, so it shouldn't be ignored, but does not need the immediate, aggressive treatment that HL does.

 

I just edited my last post. Yes, HL is acute liver failure and it is often fatal, so hepatitis is a better "short term" diagnosis. It can progress to cause major problems, so it shouldn't be ignored, but does not need the immediate, aggressive treatment that HL does.[/quote]

Thanks Jess...I had a feeling the condo was going in the wrong direction for a minute...my vet didn't seem in urgent concern. We have another appointment set for Saturday if we need it. He seems much better tonight...

Question for you...could the fact that I added Salmon Oil to his diet a few days ago have anything to do with the blood work results? shot in the dark here...I know it is suppose to have some affect on the pancreas and liver...

 

Hi Sommer,
My post is about hepatitis.. Leo did not have HL and I was also confused as to why we were talking about that, but if you have any questions about the treatment of it, please let me know via PM. You can do much at home.

 

Thank you so much I will totally do so

 

cleo had cholangiohepatitis this summer (along with a bunch of other problems).

definitely echo that a big help for a sick liver is getting the cat eating. cleo stopped eating much because of vomiting so my job was to try to find a way to stop the vomiting and get her eating. mirtazapine helped jump start her appetite (some try ciproheptadine instead). i used cerenia for the vomiting.

we gave her denamarin cut in half and slipped into part of a pill pocket every morning. i got a good deal on this thru an eBay store (pazgroupinc is the seller) (via Buy It Now on an auction). i also gave vitamin B and vitamin B complex in injectable form. if you give the denamarin, give right after cutting it, because exposure to air/light lowers its effectiveness. cheryl & winnie contacted nutramax, which makes it, and they estimated about 20% effectiveness lost from breaking it up but it worked so well for cleo i'm very happy with it tho cut in half. don't think she could have handled it uncut (aspirin pill size).

there was some discussion about whether to use denosyl rather than denamarin but i chose to give denamarin based on jess and jojo's advice (seems when vets push denosyl over denamarin it's coz they are thinking denamarin doesn't work as well for dogs but it's different for cats).

cleo's ALT went from something like 546 down to under 100 at checkup last month, so i can't argue with the results. she had cholangiohepatitis and the beginnings of hepatic lipidosis diagnosed via ultrasound and biopsy (actually she had full surgery so the surgeon could actually see and handle the liver).

 

I think that's unlikely. I assume the salmon oil is in capsules, or if it's liquid, it's fresh?