Hello, I live in Japan, with my wife and 3 cats. One of our cats, the youngest had a blood test yesterday, and there are two areas that came up abnormal. The vets English, and my Japanese are not sufficient to communicate what is happening. Please offer any assistance you can.
Max is 2 1/2 years old.
GOT 177 (normal 18-53)
GPT 470 (normal 29-84)
We have been told that he will need an IV everyday for 10 days - 2 weeks then another test will be done.
Sincerely,
Jim on behalf of Max
Liver Problems - Please help
Re: Liver Problems - Please help
sounds like liver disease...im sorry to hear about this.
you should really call the vet back and ask for someone there to explain the details so you can understand.
both levels you mentioned indicate very high levels of a liver enzyme. could be cronic renal failure, iron overload or hyperthyroidism...however, i believe the high GOT indicates a liver desease.
some links that may be of some help : again, call your vet asap and have the details explained so you can understand...you need to act quickly with this as liver disease can degrade extremely fast and be difficult to remedy.
you should really call the vet back and ask for someone there to explain the details so you can understand.
both levels you mentioned indicate very high levels of a liver enzyme. could be cronic renal failure, iron overload or hyperthyroidism...however, i believe the high GOT indicates a liver desease.
some links that may be of some help : again, call your vet asap and have the details explained so you can understand...you need to act quickly with this as liver disease can degrade extremely fast and be difficult to remedy.
Re: Liver Problems - Please help
Thank you Jason, much appreciated. I live in the country side of Japan, finding a vet with Enlish ability is out of the question. I could travel to Tokyo, costs would be huge.
If Max passes away, my wife will be profoundly sad, but we are not a rich family.
I guess it is hard for you to diagnose a cat without inspecting it yourself. The links you gave me seem to cover a wide range of possibilities. If you would be willing to, please answer these question with as much straight-forwardness as you feel willing to provide.
1. Based on the numbers I provided, how confident are you that this is liver disease?
2. Is liver disease terminal? Will it become painful for Max later on?
3. What can we do for Max here at home. He is only 2 1/2 years old. Diet?
I promise I won't be emailing you everyday! We just received the news yesterday, and so far you are my only link to information. We really appreciate this website and particularly you. Thank you.
If Max passes away, my wife will be profoundly sad, but we are not a rich family.
I guess it is hard for you to diagnose a cat without inspecting it yourself. The links you gave me seem to cover a wide range of possibilities. If you would be willing to, please answer these question with as much straight-forwardness as you feel willing to provide.
1. Based on the numbers I provided, how confident are you that this is liver disease?
2. Is liver disease terminal? Will it become painful for Max later on?
3. What can we do for Max here at home. He is only 2 1/2 years old. Diet?
I promise I won't be emailing you everyday! We just received the news yesterday, and so far you are my only link to information. We really appreciate this website and particularly you. Thank you.
-
Guest
Re: Liver Problems - Please help
P.S. would it be helpful for me to post the entire list of results from the blood work?
Re: Liver Problems - Please help
Jim, I can try to help if you have additional lab values to post.
The SGOT is what we refer to as AST, it is useful to detect liver, heart or skeletal muscle, but it should not be a test used specifically to diagnose, it should be used in combination with other enzymes, and in this case, you'd want to look at the other liver enzymes, CK (creatine kinase) or LDH (lactate dehydrogenase).
The SGPT is another term for the ALT, which is the primary hepatic enzyme. This enzyme can be elevated during times of stress, or due to a hepatic disease of any type (too numerous to mention without other notes from you). As with the AST, you want to take into account all liver enzyme levels in order to wage a guess on liver disease. Other tests that would help include ALKP, GLU, CHOL, Total Protein, TBil, and sometimes BUN. Since there are different types of liver disease to consider, you must also consider the primary symptoms or health complaint, degree of dehydration upon exam, x-rays to view size and shape of the liver, and health history prior to this exam.
Was your kitty vomiting? Did he suffer anorexia prior to these tests? Is there a possibility he ingested a toxic drug or substance? Were x-rays taken? Did your vet prescribe antibiotics? When you said IV fluids, do you mean your kitty is currently being hospitalized or did you take him home and are giving him sub-q fluids? (under the skin) What are you currently feeding him? Is he anorexic or eating/drinking on his own or are you force feeding him?
Another possibility, IF your kitty has no symptoms, is not seriously dehydrated or has no other indication of liver disease could be misinterpretation of the results due to hemolysis of the blood sample or mishandling, or that the blood analyzer was not correct (not calibrated properly).
I would strongly advise getting an interpreter and finding out what your vet's suspicion is regarding these lab results. They may or not be significant at this point in time (again, impossible to diagnose here, impossible to advise without knowing kitty's prior health history, symptoms presented, what other diagnostics were done, what vet's current treatment approach is and based on what findings other than these two enzyme results alone). On the other hand, if your vet suspected a serious liver problem, then the correct treatment approach would be to treat aggressively, that is with fluids, antibiotics, possibly corticosteroids, lowfat/low-protein diet fed agressively. Additional diagnostics might include an x-ray, and more advanced might include an ultrasound or bile acids assay test with a fine-needle biopsy to confirm any type of serious liver disease. While most types of liver disease can fast progress without appropriate and agressive treatment, you truly need to know what your vet was telling you, and what his suspicions are regarding the liver, so you know best how to proceed.
The SGOT is what we refer to as AST, it is useful to detect liver, heart or skeletal muscle, but it should not be a test used specifically to diagnose, it should be used in combination with other enzymes, and in this case, you'd want to look at the other liver enzymes, CK (creatine kinase) or LDH (lactate dehydrogenase).
The SGPT is another term for the ALT, which is the primary hepatic enzyme. This enzyme can be elevated during times of stress, or due to a hepatic disease of any type (too numerous to mention without other notes from you). As with the AST, you want to take into account all liver enzyme levels in order to wage a guess on liver disease. Other tests that would help include ALKP, GLU, CHOL, Total Protein, TBil, and sometimes BUN. Since there are different types of liver disease to consider, you must also consider the primary symptoms or health complaint, degree of dehydration upon exam, x-rays to view size and shape of the liver, and health history prior to this exam.
Was your kitty vomiting? Did he suffer anorexia prior to these tests? Is there a possibility he ingested a toxic drug or substance? Were x-rays taken? Did your vet prescribe antibiotics? When you said IV fluids, do you mean your kitty is currently being hospitalized or did you take him home and are giving him sub-q fluids? (under the skin) What are you currently feeding him? Is he anorexic or eating/drinking on his own or are you force feeding him?
Another possibility, IF your kitty has no symptoms, is not seriously dehydrated or has no other indication of liver disease could be misinterpretation of the results due to hemolysis of the blood sample or mishandling, or that the blood analyzer was not correct (not calibrated properly).
I would strongly advise getting an interpreter and finding out what your vet's suspicion is regarding these lab results. They may or not be significant at this point in time (again, impossible to diagnose here, impossible to advise without knowing kitty's prior health history, symptoms presented, what other diagnostics were done, what vet's current treatment approach is and based on what findings other than these two enzyme results alone). On the other hand, if your vet suspected a serious liver problem, then the correct treatment approach would be to treat aggressively, that is with fluids, antibiotics, possibly corticosteroids, lowfat/low-protein diet fed agressively. Additional diagnostics might include an x-ray, and more advanced might include an ultrasound or bile acids assay test with a fine-needle biopsy to confirm any type of serious liver disease. While most types of liver disease can fast progress without appropriate and agressive treatment, you truly need to know what your vet was telling you, and what his suspicions are regarding the liver, so you know best how to proceed.
..........Traci
Re: Liver Problems - Please help
Again, WOW. Thank you for this information CatHelp-Online. Here are the blook work results we were given:
RBC: 10520000
WBC 8400
PCV: 61.6
Hb: 16.4
TP: 6.6
ALB: 3.1
GOT: 177
GPT: 470
ALP: 107
BUN: 26.3
Cre: 1.2
TCHO: 291
TG: 127
GLU: 109
Na: 152
K: 4.6
Cl: 115
In addtion to the GTO and GPT, the vet was also concerned about the TG. He has given us a IV bag which we took home, and we are giving it to Max ourselves, under the back of his neck. We where given a bad of some kind of generic IV solution, with an additional small pack to add it. I will try and translate the contents. It is in Japanese so the English will come out strange. I hope you can recocnize what I am saying. Please ignore spelling as I am sure it is way off: Neomi (some type of liver booster), lestionin C (a vitamin?). We are giving 70 cc's everyday. At this point the vet has not started Max on any antibiotics.
His medical history is one major car accident in which he broke his hip (requiring corrective surgery). No known illnesses to date.
He was (and still is) not vomiting. We are feeding him Hill's Prescription Diet l/d.
If after you read the info above, you do not have any addition information from the extremely generous email you have already written, I understand. Again, thank you so much for what you have done.
Jim on behalf of Max.
RBC: 10520000
WBC 8400
PCV: 61.6
Hb: 16.4
TP: 6.6
ALB: 3.1
GOT: 177
GPT: 470
ALP: 107
BUN: 26.3
Cre: 1.2
TCHO: 291
TG: 127
GLU: 109
Na: 152
K: 4.6
Cl: 115
In addtion to the GTO and GPT, the vet was also concerned about the TG. He has given us a IV bag which we took home, and we are giving it to Max ourselves, under the back of his neck. We where given a bad of some kind of generic IV solution, with an additional small pack to add it. I will try and translate the contents. It is in Japanese so the English will come out strange. I hope you can recocnize what I am saying. Please ignore spelling as I am sure it is way off: Neomi (some type of liver booster), lestionin C (a vitamin?). We are giving 70 cc's everyday. At this point the vet has not started Max on any antibiotics.
His medical history is one major car accident in which he broke his hip (requiring corrective surgery). No known illnesses to date.
He was (and still is) not vomiting. We are feeding him Hill's Prescription Diet l/d.
If after you read the info above, you do not have any addition information from the extremely generous email you have already written, I understand. Again, thank you so much for what you have done.
Jim on behalf of Max.
Re: Liver Problems - Please help
Assuming the TG is triglycerides, they are above normal but I'm not sure if it is significant at this point, (retesting these enzymes might show remarkable differences)....a high level of triglycerides could be anything from a pancreatic attack, to dehydration, to a biliary obstruction to a high fat meal fed prior to the blood testing. Since it is higher than normal in combination to the other liver enzymes, you might want to ask your vet to rule out hepatic lipidosis or biliary obstruction (bile sludge from the liver)....an amonia enzyme test might be useful here as well as a bile acids essay test.
If your kitty has recently lost a significant amount of weight, was severely dehydrated upon exam, was at any time anorexic, and was jaundiced (yellowing of the skin and mucous membranes), then hepatic lipidosis (fatty liver disease) or biliary stasis/obstruction should be ruled out. The above mentioned tests should help your vet in concluding a diagnosis. Last case scenario might be an ultrasound, but I would test amonia and bile acids first. Might also ask your vet if pancreatic enzymes were included in this blood profile, I didn't see them listed. Since the pancreas is closely related in function to the liver, this would be another rule-out if the amylase, lipase, cholesterol were elevated as well.
In the absense of symptoms, this is somewhat a strange case, I would think vomiting and anorexia would have been the first primary health complaints, followed by weight loss, lethargy, jaundice, severe dehydration. Are you absolutely certain kitty did not ingest a toxic substance (a human medication maybe?) Otherwise, it could be that he was anorexic and you didn't notice right away, or notice sudden weight loss? Was there an extremely stressful event in his environment of late?
In any event, it sounds like a liver degeneration problem,....this could be anything from a liver infection, to hepatic lipidosis to biliary obstruction. Sounds like your vet is treating appropriately, but I would ask about why he didn't include antibiotics in the treatment, and ask about the amonia enzyme test, bile acids test, and pancreatic enzymes.
In the immediate sense, watch your kitty closely, make sure dehydration does not set in again, ensure he is eating a sufficient amount of food daily (if he is anorexic at all, don't hesitate to contact your vet immediately for further instruction.....nutritional support is the most critical part of treatment in most primary liver diseases, as well as proper hydration). If he develops lethargy, withdrawal or depression, take him back to your vet immediately for more aggressive treatment. If jaundice is not evident right now, but develops at any time, get kitty back to your vet immediately. Same with vomiting, diarrhea, lethargy, fever, any signs you are alerted to that kitty is ill or uncomfortable.
I would restest the liver enzymes within 10 days from the first test, providing kitty does not develop further or worsening symptoms, in which case you want to retest sooner and opt for more agressive treatment.
If your kitty has recently lost a significant amount of weight, was severely dehydrated upon exam, was at any time anorexic, and was jaundiced (yellowing of the skin and mucous membranes), then hepatic lipidosis (fatty liver disease) or biliary stasis/obstruction should be ruled out. The above mentioned tests should help your vet in concluding a diagnosis. Last case scenario might be an ultrasound, but I would test amonia and bile acids first. Might also ask your vet if pancreatic enzymes were included in this blood profile, I didn't see them listed. Since the pancreas is closely related in function to the liver, this would be another rule-out if the amylase, lipase, cholesterol were elevated as well.
In the absense of symptoms, this is somewhat a strange case, I would think vomiting and anorexia would have been the first primary health complaints, followed by weight loss, lethargy, jaundice, severe dehydration. Are you absolutely certain kitty did not ingest a toxic substance (a human medication maybe?) Otherwise, it could be that he was anorexic and you didn't notice right away, or notice sudden weight loss? Was there an extremely stressful event in his environment of late?
In any event, it sounds like a liver degeneration problem,....this could be anything from a liver infection, to hepatic lipidosis to biliary obstruction. Sounds like your vet is treating appropriately, but I would ask about why he didn't include antibiotics in the treatment, and ask about the amonia enzyme test, bile acids test, and pancreatic enzymes.
In the immediate sense, watch your kitty closely, make sure dehydration does not set in again, ensure he is eating a sufficient amount of food daily (if he is anorexic at all, don't hesitate to contact your vet immediately for further instruction.....nutritional support is the most critical part of treatment in most primary liver diseases, as well as proper hydration). If he develops lethargy, withdrawal or depression, take him back to your vet immediately for more aggressive treatment. If jaundice is not evident right now, but develops at any time, get kitty back to your vet immediately. Same with vomiting, diarrhea, lethargy, fever, any signs you are alerted to that kitty is ill or uncomfortable.
I would restest the liver enzymes within 10 days from the first test, providing kitty does not develop further or worsening symptoms, in which case you want to retest sooner and opt for more agressive treatment.
..........Traci
Re: Liver Problems - Please help
My wife and I are shocked at your generousity. Thank you so much. We are taking the steps you are suggesting. I will let you know how things turn out. Again, thank you, thank you, thank you and thank you!
We are ruled by our 3 masters, Fin and Moshi Moshi are sisters, and Max, the youngest is our little lion in cats clothing.
Re: Liver Problems - Please help
I just wanted to thank you both, and give you an update. We took Max to the vet for a follow up, and his numbers are down back to almost normal levels now. The veterinarian believes it was some type of poison that Max ate. We will be continuing the IV for another week, and go for another followup to be sure.
Again, thank you so much.
Suggestion: set up a paypal account for people to send money to your favorite charity. I am not rich, but would gladly send $20 as I am sure many people would. Every bit helps right? And your help is far too good to be completely free.
Again, thank you so much.
Suggestion: set up a paypal account for people to send money to your favorite charity. I am not rich, but would gladly send $20 as I am sure many people would. Every bit helps right? And your help is far too good to be completely free.
We are ruled by our 3 masters, Fin and Moshi Moshi are sisters, and Max, the youngest is our little lion in cats clothing.
Re: Liver Problems - Please help
wonderful news!rogersjb wrote:We took Max to the vet for a follow up, and his numbers are down back to almost normal levels now. The veterinarian believes it was some type of poison that Max ate. We will be continuing the IV for another week, and go for another followup to be sure.
thanks for the suggestion. similar request.rogersjb wrote:Suggestion: set up a paypal account for people to send money to your favorite charity.