Bob is a 7 year old cat of uncertain parentage who has always

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Bob is a 7 year old cat of uncertain parentage who has always been healthy. His only problem has been occasional vomiting, usually of bile. A month ago, he stopped eating & drinking. After 2 days of this I took him to my vet. By that time, he had become jaundiced. We've had blood work done twice (high white cell count, low clotting factor, high liver enzyme levels),had him xrayed (nothing found),done 2 courses of both Baytril & CEFA, and did an exploratory liver biopsy. The biopsy results were inconclusive, but fatty liver disease was ruled out. I've been told this could be anything from pancreatitis to liver cancer (there was abnormal cell growth in the liver samples). The next step would be an ultrasound & exploratory surgery at a vet school that's several hours away. The lab didn't really give us much hope of being able to find the cause of Bob's problem, calling it "nonspecific liver disease". We don't want Bob to go thru anymore surgery, and the car trip just isn't feasible, either. I have been force-feeding & IVing him for 3 1/2 weeks, and he hasn't lost any weight during that time. However, in the past week or so, excess salivation has become a major issue. When I feed him, no matter what I feed him, the saliva flows like a river. I just started giving him something for nausea, and something for stomach acid yesterday(both recommended by the vet). I'm also giving him milk thistle in small doses, and begun chamomile tea, hoping to sooth his stomach as well. I'd like your input as to what could be going on with Bob, but more importantly, is there anything I can do about the excess saliva? It's almost impossible to feed him sometimes. I've had the vet check his mouth & throat twice for anything that could be causing the saliva, and she's found nothing out of the ordinary. I desperately need advice. If I'm going to be nursing Bob until the end, I need to be able to feed him. (we've ruled out a feeding tube, as we have 3 other cats & don't think we could keep it either clean or in place)I also wonder if Bob is just getting so upset at the force-feedings that he's making himself sick. I can get whipped cream into him sometimes by just smearing it on his mouth, and he doesn't drool at all. However, when I swaddle him, it's like a gusher. Optional Information: Age: 7; Male; Breed: ? Already Tried: everything

Edited by Customer (name blocked for privacy) on January 27 2006 at 12:12 PM

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The vet has me giving Bob 1/4 of a 10mg. Pepcid tablet; do you consider that safe for him? I haven't noticed abdominal swelling yet, and I don't think he is in pain. In fact, if it weren't for the fact that his skin & mouth are totally yellow, you wouldn't notice much of a change in him. I've asked the vet for an anti-depressant several times, as I think that's a big cause of Bob's anorexia. We brought a new kitten into the house last June; Bob's "best friend" Belle died of CRF in November. He just seems sad, if that makes any sense.
Since the lab says this isn't FHL, could you give my any ideas as to what could have caused the blockage in Bob's bile ducts and is there anything else I can try? Also, when the lab says they found "abnormal cell growth" what does that say to you?
Thank you for understanding that we don't want to make Bob go thru anymore than he has to. I've felt so guilty that I'm not going ahead with invasive procedures on him, but there comes a point when you say "enough is enough". Lastly, can you give me any idea as to the progression of this disease--what to expect in the weeks/months to come, expected life-span, etc?
Thanks so much.

Sorry to take so long to get back to you. It took me a little while to try to get an idea of what might be causing Bob's liver problems, and I think I might have a possible cause.

First, Pepcid is perfectly safe to use for a cat's stomach. That tends to be the newer medication used, so that is a good choice.

Cat's can definitely suffer from depression, just like people can, and one of the causes is losing a family member, such as another cat. Most vets feel cats should be treated with an appropriate antidepressant or anti-anxiety drug to help them get over their depression. And now, with Bob so sick, he's got to be even more depressed. I think an antidepressant would definitely be appropriate to help with Bob's depression, and the difficulties he has with his feedings. You'll want to consult with his vet about the best choice, but Buspar might be a good one for him. Prozac takes 1-4 weeks to work, and can cause similar side effects that Bob already has such as jaundice, vomiting, and persistent lack of appetite. Elavil is also a good choice.

As for what could have blocked Bob's bile ducts, I think he has Feline Infectious Peritonitis (FIP). The four most common causes of liver failure in cats are:

-     Hepatic Lipidosis (fatty liver disease)
-     Cholangiohepatitis (inflamation of the liver and bile ducts)
-     Lymphoma (a type of cancer)
-     Feline Infectious Peritonitis

The first two have the best outcome.

-     Feline Hepatic Lipidosis:

FHL, also known as feline fatty liver syndrome, is the most common form of liver disease of cats in North America. It is unique to cats. The most common form of the disease is idiopathic. The condition is triggered when a cat stops eating due to stress or any other reason. After a few days without food, the cat's body will begin to use fat for energy. Since cats do not metabolize fet well, the fat cells build up in the liver and eventually prevent it from fuctioning normally.

-     Cholangiohepatitis:

Inflamation of the liver and bile ducts by a bacterial infection. There are several forms, and it caused by bacteria caried from the intestinal tract or the bloodstream.

-     Lymphoma:

Lymphoma is a cancer of lymphoid tissue. It can appear in any organ in the body. It is treated with chemotherapy and it's outcome is pore.

-     Feline Infectious Peritonitis (FIP):

Feline infectious peritonitis (FIP) is a disease caused by a coronavirus infection. There are many different strains of coronavirus, but most do not produce serious disease. FIP-producing strains are distinguished by their ability to invade and grow in certain white blood cells. The infected cells transport the virus throughout the cat's body. An intense inflammatory reaction occurs in the tissues where these virus-infected cells locate.

There are two forms of FIP:

     - effusive (wet) - The most characteristic sign of effusive FIP is the accumulation of fluid within the
       abdomen and/or chest. When fluid accumulation becomes excessive, it may become difficult for
       the cat to breathe normally.

     - noneffusive (dry) - The onset of noneffusive FIP is usually slower. Fluid accumulation is minimal,
       although weight loss, depression, anemia, and fever are almost always present.

In noneffusive FIP, liver failure is common, as is lack of appetite, vomiting, diarrhea, and a combination of other symptoms that make it difficult to diagnose.

The following article explains FIP:
http://www.vet.cornell.edu/fhc/resources/brochure/fip.html

If FIP is in fact what Bob has, than his prognosis is for several weeks to up to a year. They recommend doing everything you can to keep him comfortable, which is what you're doing.

You can ask your vet if he thinks this might be a likely cause of Bob's liver failure, and if so he can recommend anything else for Bob.

No matter what the cause, I think you should be persistent with the vet about antidepressants for Bob; I think they will help.

I hope I've answered all your questions, and if you think of any others, feel free to ask. I'd like to help in any way I can.

See:
http://www.cah.com/dr_library/liver.html
http://www.sniksnak.com/cathealth/liver.html
http://www.thepetprofessor.com/articles/article.aspx?id=358
http://www.vetinfo.com/catliver.html#Feline%20Liver%20Disease%20-%20prognosis%20and%20treatment
http://www.uihealthcare.com/topics/cancer/canc3012.html

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Ideopathic liver disease & excess salivation

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