Very high ALT results

[Karen3w]

Hello

My cat had a pre-op blood test on Tuesday before being neutered on Wednesday 6th May 2009. The ALT results were high, but no other results were elevated, so they repeated the test, with the same results.  They then sent the blood away to an external lab for testing, with the same extremely elevated results (over 600!).

The cat appears fine, although he coughs sometimes, he has intermittent diarrhoea and the vet has told me on our last two visits he appears bloated which could be due to worms.

I have requested another blood test, which will be extensive and they will take the blood next Tuesday, they have also requested a faeces sample.

They don't seem to know what could be causing this, as they have repeatedly told me that the other liver tests should have elevated results too.

What could this be and how can I treat it? What food should he have? Thank you.

[Karen3w]

Thank you very much for your help.  I am taking a sample of his faeces to the vet on Monday for testing and on Tuesday they are taking a further blood sample to test.  

What could liver damage mean in the long term? Is he going to die? Or can the liver repair itself?

I will print out a copy of your reply to take to the vets to request a liver biopsy etc.

I have been treating Max with Milbemax, will this not kill lung worms? Or is it a different kind of lung parasite that could cause the coughing and diarrhoea?

He is being fed Burns dry food, a mix of kitten and adult cat food.  he was previously on Hills Kitten pouches.  I am loathe to change his food again unless absolutely necessary as I am worried that may be causing the diarrhoea in the first place, although I did mix the Burns food in gradually with the Hills.

I will get hold of probiotics and the other things you mentioned - can they be mixed in with his food or water?

Thanks again.

Karen

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

Sorry, the last part of the answer got cut off.

Since cats are obligate carnivores, the best diet for cats is a grain-free, high protein, very low carbohydrate, canned, or wet diet.

There are many good commercial brands.  Evo/Innova, Merricks, Spots Stew Brand, California Naturals, Natures Variety, Wellness, Orijin, and many more.  Look for brands that have human grade food, no by products.

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

ALT could be elevated due to hepatocellular (liver cell) damage.  It is recommended that a serum bile acid test, and an ultrasound of the liver with a possible liver biopsy be performed.

Lung parasites can cause cough as well as diarrhoea.  Please have your cat's faeces checked ASAP, and subsequently treated.  

There are uncommon parasites that can affect the liver, such as liver flukes  liver parasites can cause liver damage, and thus elevate the ALT.  

Whether or not the cause of the elevated ALT enzyme can be determined it may be a good idea to place  your cat on a good probiotic, Silymarin (milk thistle), Choline and Inositol, Alpha-lipoic acid, and SAM-E supplements,  to help lower the elevated liver enzyme and provide liver support.

The prescription diet L/D can help with liver disease. The best long term diet for cat's is one that is

[Karen3w]

I just wanted to add that he is also very windy and they smell awful!