Question for DR. reg liver diseas

Hello,
last wed we noticed that one of our 6 cats was looking thin, and dehydrated...we rushed her in to our vet..the first thing he noticed was that her mouth was yellow..she is an 8 year old spayed female, who was not overweight..He did a blood test and her ALKP was 779, ALT 363 TBILE 4.5 g
everything else was normal...we dont have much money, and have alot of animals, so we had him give her fluids, and hoped for best case scenario..being hepatitis, and sent her home with antibiotics...she will not eat or drink a thing, so the next day we opted to give sub q fluids at home and and syrynge feed AD, mixed with some potatoe..He didnt feel that she could have hepatic lipidosis, because she is not an obese cat..we are still hanging on to the hope that she does, and maybe will recover..I have been playing around with different food doses, 3cc every 2 hours seemed stressfull, so I tried 6 cc every 4, she always seems to feel worse after i feed her, which is why he had me mix potatoe in thinking the protein was to much for her in the AD..yesterday was a week, she just sits on the bed, when i pet her she purs, and sometimes rubs all over me, she uses the cat box to pee out the fluids, we are giving her...We live pretty far out from the vet, an hour...and he would have to send us to a big city 3 hours a way to do a biopsy, which we cant afford, we are already almost 400 into this...do you think a cat who is not obeses could have hepatic lipidosis...waht food  schedule would you suggest...what is the minimum she needs in a 24 hr period, 36cc? She is not getting worse, but she is not getting better....but she does not appear to be suffering...we are doing 200 cc of fluid two times a day...all the info on line is for hepatic liver...how long if it was hepatic lipidosis would the mouth stay yellow...
please help me if you can...this is so hard, and I would like to know what i can try within reason...
Sincerely, Chrisitne
Oregon

[Aleda M Cheng, D.V.M., C.V.A]

Any cat can get hepatic lipidosis if they don't eat for a while.  I think that the amount of food you are syringing is OK.  Any more than that would be too stressful.  200 cc's of fluid once per day is more than enough.  Twice per day could increase her stress level and cause her to urinate constantly.  Whatever the cause of your cat's jaundice it is imperative to get her to eat on her own.  Try baby food meats (for human babies) in all flavors to help entice her.  You can warm them very slightly to increase the smell.  Also ask your vet if you could try an appetite stimulant such as Periactin or Remeron, for your cat.  If your vet does not have them in stock he could give you a prescription.  Request the generic version if you get them at a human pharmacy since it would be less expensive.  

Additionally, some cats aren't interested in eating because they feel a little bit nauseous, in that case a very low dose of Pepcid (OTC), or Reglan (prescription) would help.  I would kindly ask your vet about these also.

[chrisitne1229]

Thank you for your reply..We were thinking the same thing about the fluids..I recently switched to the KD, and was wondering what you thought about that..I started giving her 12 cc every 4 hours, Do you think thats to much?The KD has only 6.5 % protein, and w/o knowing if it is Hepatic lipidosis, Im not sure to be giving her high protein or low..I also bought some good EVO canned food, but noticed she seemed to get more yellow..Would like to know whats a safe protein percent if I dont know what im dealing with...how long does it take for the yellow to clear out? I am also working with a herbalist giving her a milk thistle/dandelion root complex, also probiotics to compensate for antibiotics, and a tad of slippery elm..The problem with her, and tempting her to eat/drink on her own, is that she would NEVER eat anything other then dry cat food...she has never shown any intrest in anything else, except for crackers!!!
So its hard w/o knowing whats going on with the liver, im not sure how to go about feeding her...
Thank you so much for your advice and time, I can not ell you how much I value anything you have to offer..We are on 11 days now since blood work, and vet said she wouldnt make it past three days..she purs, and rubs on us, and doesnt seem to be on her deathbed..

[Aleda M Cheng, D.V.M., C.V.A]

Does your cat also have kidney disease?  If not,  than I don't know why you were given K/D.  Any how it does not matter what she eats right now, whether canned or dry, crummy cat food or expensive cat food, even crackers, she just has to eat!  Was she given slippery elm because she also gets constipated?  Optimally she should have a diet without grains of any kind and it should be 50 or more percent protein, if she does not have kidney disease.  Get her on one of the appetite stimulants I have listed above.

[chrisitne1229]

[chrisitne1229]

I switched to KD because it is only 6.5% protein, where the AD was 8.5...my vet says he doessnt think she has hepatic lipidosis because she was not obese..he said cats that do not have HL and have liver problem need a low protien diet...I had bought her some good quality canned food, but the protein was 9% and she seemed to get more yellow..how long will it take to get the yellow out? to me all her symptoms seem to be the same as HL, but Im not a vet..the herbalist I am working with suggested probiotics, and slippery elm, mixed in with her food, slippery elm helps detoxify the liver..
She does not have Kidney disease...I called today about an appetite stimulant, and he said no...Maybe i should seek a new oppinion?

[Aleda M Cheng, D.V.M., C.V.A]

Other herbals and supplements for liver disease include: alpha lipoic acid, choline, inositol, DHA, EPA, dandelion root, burdock root and most importantly: Silimarin (Milk Thistle).  I would seek another opinion.

[chrisitne1229]

Oh yes, i forgot, she is on a milk thistle complex as well...
I took her into to a different vet, for a second oppinion..good thing I did..He did a more complete blood screen, including a cbc, and feels certaion that she has cholangiohepatitis...although her alkp levels dropped from 798 to 346, and her alt that was 343, is now 65...her Bilt, was 4.5 g and is now 15.6...He suggested to reduce IV  fluids from 200 cc twice a day to 100cc once a day...he has her on a strong Clavamax, an appetite stimulant, pretazone, and urtisol...or something to thin bile...he gave me a liquid formula called clinicare to give her one can daily, but at $7 a can, i just cant...I promised to try and get 1 can of AD down her a day, mixed with the clinicare...her white blood cells, were extremely high...of course there is no promise of his diagnosis without a biopsy, but he believes based on her blood work, this is what we are dealing with..I am so glad i seeked another oppinion, even if hes wrong, I feel like Im actually doing something proactive for her now...I am still using probiotics,milk thistle/dandelion root, complex, it has alot of other stuff as well, slippery elm to comfort digestive tract and absorb toxins...I am hopefull that fianlly we are helping her...what do you say? what do you know about cholangiohepatitis...where in the world could she have picked it up from?
Thank you,
Chrisitne

[chrisitne1229]

My Kitty ate on hewr own for the first time in two weeks today...goes to show how important a second oppinion can be!!! Hooray!!!

[Aleda M Cheng, D.V.M., C.V.A]

Ya Hoo!