liver enzymes/hepatic lipidosis
liver enzymes/hepatic lipidosis
i have a very specific question and i dont know if someone can answer it or not but i need to try. i need to know what is the most successful treatment/supplement/medicine to bring down the ALKP enzyme to normal levels in the case of diagnosed hepatic lipidosis. Kitty's bilirubin or whatever has gone down from 4.29 to 0.10 but his ALKP has gone up from 450 to 606 and i am scared to death. he is less jaundice now than he was and is eating on his own again but not hard foods or much water. Kitty origanally lost about 10 pounds but has gained back only 8 ounces. his fur is shinier now and he still get subQ fluids. attitude is great. hes on 6 different meds. but that ALKP bugs the hell outta me and i need something to bring it down. please anyones ideas are greatly appreciated. some of u know i lost one cat (Weezal) already to this and will not lose this one. he is 12 years old and not one bit ready to give up. he has been fighting this since Weezal died in december and has survived so far, i need more ammunition though. any homeopathic or supplemental suggestions are welcome as well as less popular medical treatments; possibly. i just need ideas. Thank u soo much anyone who can help..
Ask your vet about using Denosyl for cats, but let him guide you on this because it needs to be dosed specifically and according to weight (also should be given at least an hour prior to a meal for better absorption).
More importantly however, is taking a good look at the other liver enzymes at this point. If the GGT is also significantly higher than normal range, your vet should be looking into potential biliary obstruction....to help aid him in diagnosis, he can test ammonia, total bilirubin, glucose levels and bile acids...an ultrasound can also help confirm.
Please be aware that the hepatic lipidosis could be secondary to another problem, such as biliary obstruction, whether this be gall bladder or bile ducts, it needs to be ruled out. Or, the biliary obstruction possibility could be secondary to hepatic lipidosis, with lipidosis as the primary disease.
Lastly, ask your vet to make sure hyperadrenocorticism, hyperthyroid are also ruled out as secondary factors that may require treatment as well.
On another note, any corticosteroid use (i.e., prednisone) and anticonvulsant meds, as well as severe dehydration and electrolyte losses can affect the ALKP......while prednisone is probably necessary at this point in time, if the ALKP and GGT are persistently higher than normal range, the abovementioned testing should be done to rule out other complications of hepatic lipidosis.
Consult your vet again and ask about tips you can do to keep him rehydrated on a daily basis, he needs more natural water consumption as well as the proper amounts of sub-q fluids administration on a daily basis until at least the crisis has resolved.
More importantly however, is taking a good look at the other liver enzymes at this point. If the GGT is also significantly higher than normal range, your vet should be looking into potential biliary obstruction....to help aid him in diagnosis, he can test ammonia, total bilirubin, glucose levels and bile acids...an ultrasound can also help confirm.
Please be aware that the hepatic lipidosis could be secondary to another problem, such as biliary obstruction, whether this be gall bladder or bile ducts, it needs to be ruled out. Or, the biliary obstruction possibility could be secondary to hepatic lipidosis, with lipidosis as the primary disease.
Lastly, ask your vet to make sure hyperadrenocorticism, hyperthyroid are also ruled out as secondary factors that may require treatment as well.
On another note, any corticosteroid use (i.e., prednisone) and anticonvulsant meds, as well as severe dehydration and electrolyte losses can affect the ALKP......while prednisone is probably necessary at this point in time, if the ALKP and GGT are persistently higher than normal range, the abovementioned testing should be done to rule out other complications of hepatic lipidosis.
Consult your vet again and ask about tips you can do to keep him rehydrated on a daily basis, he needs more natural water consumption as well as the proper amounts of sub-q fluids administration on a daily basis until at least the crisis has resolved.
..........Traci
Re: liver enzymes/hepatic lipidosis
ok thats a lot of info and i loooove you for it! i will ask the vet tomorrow when Kitty goes for his next liver panel. if it helps, here is what Kitty is taking now.....twice daily: amoxi drops, lactulose (2cc's), cyproheptadine 2 mg(appetite stimulant), metronidazole 1/4 of 250mg tablet, and once daily: vitamin E 100 i. u. and l-carnitine 250mg... as well as 200 cc's sub Q fluids every other day and daily 4 tubes(12 cc's) of water and prescription diet a/d food.. he does eat lots of soft food on his own and quite often..he pees regularly but the other is still rare.. and his yellow is fading but still faint. his attitude is 100% better but the blockage theory scares me and the ALKP is steadily increasing. the ALT went from 172 to 209 but the TBIL is the only good thing going from 4.29 to 0.10. does that help any? i will take your info to the vet, u have been a great help to me. if u think of anything else let me know. i think the ultrasound sounds like an excellent idea at this point. I will do anything for my Kitty. Thanx again! You ROCK!!
Re: liver enzymes/hepatic lipidosis
GOOD NEWS!!!! Kitty is recovering and almost out of the woods!!! I didnt think it was possible but the vet is very pleased. No more jaundice and his alkp is down to 124!! YAY!!! he also gained 1 pound and 3 oz over the last week alone. Vet says i can start weaning him off of everything slowly. He is gonna make it!! I am so happy I cried! Thank you so much for all your help! I will keep you updated!!!
Re: liver enzymes/hepatic lipidosis
Great News about Kitty....I know you were worried sick... I'm so happy for you and Kitty that he is on the path to recovery. It's so hard when our furbabies aren't well.
Take care and saying prayers that Kitty co ntiniues to do well.
Take care and saying prayers that Kitty co ntiniues to do well.
Lisa, Angel Smokey and little Caz
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Re: liver enzymes/hepatic lipidosis
Baby got very sick the end of Aug. He was immediately put on Prednisolone and Standard Process Feline Hepatic. When the rest of the tests got back after Labor Day he went on Actigall. The important part in addition to all this is food. You have to get the food in him if he isn't eating or he will need a feeding tube. Luckily we got Baby to eat after only a coupe of force feedings. He was checked again this week and his liver is perfect! He gained back the 4 lbs he lost. I am still giving him the supplements. Don't despair, this is treatable when caught in time. I lost Boots to it in 1995. He had just turned 8. I got the vet to be found guilty of 13 counts of malpractice!
Lynda