Chronic diarrhea, elevated liver enzymes, what is causing this?

[isykitty]

My cat has been having chronic diarrhea everyday every time.  Her stool is loose and nothing looks digested.  It comes out exactly the way it goes in.  Her abdomen sounds louder than it should and it sounds like there is liquid in there when you listen.

Her blood work shows elevated liver enzymes and everything appears normal.

She was negative for hyperthyroidism.  

She is drinking a lot of water ( a cup a day) and pees a regular amount.  She has loose stools maybe 4 times a day.  

Today she threw up a huge amount of undigested looking food.  She really dislikes eating the dry special intestinal diet food and usually throws up when she eats it.  I try to mix it with her wet food but I guess it still gets to her and makes her tummy upset (I can tell it's upset cause she sits by her litter box when it is).  

Metrinidazole did help for a bit but doesn't seem to help anymore.  K-pectin also helped but like everything else seems transient.  

She is somewhat more lethargic (may be due to age) but she is usually a very happy kitty.  She wakes me up with purrs and loves to talk to whoever wants to talk to her.

What is going on??? I have tried a lot of things.  Special diet venison/duck meat does not seem to be making any difference.  The only thing that has helped is lithothamnium.  I guess it dries out everything and her stool slightly resembles what normal stool looks like for a moment.  I've also been giving her anti-inflammatory and anti-spasmodic herbal medicines (scutelleria and venus fly trap extract).  

What should I do??? I was thinking of getting a pancreatic test for her and perhaps a intestinal biopsy.  I feel like she has major problems with digestion.  Everything she eats comes out and she is so thin.  I'm so sad :-(  It makes my heart ache when I see her in such discomfort.

[mich683]

My cat also has had loose stools since we got her at about 12 weeks old,she has had Amphipen,Metronizadol like yours and also steroids,she is ok when she's on the steroids and Amphipen as soon as the steroids are taken off she's back to square one.It's been like that for 4 years.My vet said she has IBS,You could ask your vet about steroids ?She is only fed on Royal Canin sensitivity dry food or cooked chicken,and thats all.I know how awful it is for you and the cat,i have had to clean all my carpets and it's costing me a fortune in cat litter. She has been taken off steroids for the last few weeks to see how she goes,just had to ring the vets as she's getting the runs today.
Regards
Mich

[zodiacqueen]

Hi, remember I'm not a vet.  I've got a lot of experience in dealing with cats-had them my whole life-I'm 35 yrs old.  What usually happens when I go to the vet, they ALWAYS do a standard x-ray first.  I'm sure people would back me up on that.  Then if that is inconclusive, they will do an ultrasound(shows liver, pancreas, and gall bladder).  Why isn't your own vet telling/suggesting you anything??  God knows, we pay enough money!!

What I would do, personally, write down a list of some of the tests that I mentioned and go get a face-to-face consult with the vet.  Usually, they don't charge you for that-I've done it.  I wouldn't do it over the phone because you'll get the receptionist who'll possibly screw up the msg.  This is too important for her to be screwing this up!!!

Keep checking to make sure that she's not dehydrated.  

I hope that other forum members will help me to answer this-In case I forgot to mention anything!!

PLEASE-keep us posted!!  Take care of yourself, too  :)

[isykitty]

She's been much more lethargic today.  Her belly looks so distended (is it supposed to be hard or supposed to be soft and squishy?).  She has had a stool sample done and nothing has come up.  I had fed her raw chicken awhile back (which I think may have caused this whole situation...I feel so bad I thought it was a good thing).  Are there any parasites associated with that?  The vet didn't seem to think much of it when I told her.

Which is better, xray or ultrasound?  

[zodiacqueen]

I know it s-u-c-k-s but usually you need more than one test.  No, you don't need to get cats sedated for x-rays, unless you have a kitty that's completely obnoxious and evil at the vets.  The x-ray could give you some info, but you need a few tests to REALLY see the whole pic.  I would most definitely get the stool sample done, too.  I'd have them look for more than the standard hookworm, roundworm, tapeworm.  Maybe, your cat's got an unusual parasite/worm.  Well, you obviously had blood work done, because you knew the liver enzymes were elevated.  Were the other values normal?

I don't think there will be any other way around getting more than one test.  I think those are the best, that I mentioned to start with, since they aren't invasive.  Ultrasound is non-invasive, too.  They'll be able to get a good view of the liver with that test.  Ask your vet about some of the tests, see which ones he reccommends.

Glad your kitty's not dehydrated.  That's a great sign.  Keep your eye on it though!!

[isykitty]

Thanks zodiacqueen for your suggestions!  when cat's undergo x-rays do they need to be sedated?  There are many tests that I can do but I want to do the one that would give the most definitive (if that's even possible) diagnosis.  Don't want her to be sedated so many times.

She seems well hydrated.  The scruff of her neck seems normal.  She has...not really diarrhea but loose stools.  She preferentially eats wet food so it really comes out how it goes in...I'm going to try to give her some dry food that is not the prescribed food only because I feel like the prescribed food hasn't really helped her at all.  She's gotten thinner probably because most of the prescribed food is just moisture.  

[zodiacqueen]

Hi, I am sorry you're going through such a rough time.  Instead of doing something invasive like a biopsy, have you had ultrasound done yet?  There's also MRI and Cat Scans for cats too.    Have you gotten a stool sample from her yet?  What about x-rays?  The x-ray won't show the liver or pancreas, but you could possibly see something else going on.  Also, is she indoor or outdoor??  She could also be diabetic.  Just a couple of ideas!!  Hope they help.

Also, are you making sure that your kitty is drinking enough water, because if her diarrhea is that bad then there's the danger of dehydration.  If you have a syringe- you can get it from your vet, I'd give her some every hour.  Squirt a little bit at a time so she doesn't choke.   This is how to check for dehydration-lift the scruff of the neck up(where the momma cat holds the kittens), if it stays up and doesn't snap right back, then the cat's dehydrated.

Well, please keep us updated.

Hang in there!!