Nate,
I don't have any real advice to offer you but I do feel for you.  Sounds
like you have tried and are trying to do everything thing you can for TB.
I'm hoping someone else in this group can offer you some real suggestions.

I hope you can get TB's condition under control and he gets better soon.

Sue

Hey there, here's my experience FYI:
Last year around memorial day, my cat Fritz wouldn't eat either and wa
vomiting foam. Rushed him to the vet, the result, hepatitis.
He was put on amoxicillan, then a few weeks later prednisolone an
metronidazole.
He only got marginally better, and had an ultrasound, needle biopsy
few months later. I was scared I would lose him because he was 18 year
old at the time.
He got through the surgery just fine, albeit with funny looking bal
droopy stomach, and the results showed no enlargement of the liver an
generally inconclusive. Chronic Mild Inflammation. We are working unde
the assumption that he has cholagial hepatitis. I did get his teet
cleaned up in October in case all the mouth bactieria was contributing
I was scared again he would just die when knocked out but again he mad
it through just fine.
He was vomiting liquids every morning like clockwork around 5:30 am.
was thinking for a long time this was old age, or the result of live
inflammation, but turns out it was stomach acid. This has since bee
almost completely eliminated by slippery elm powder and small sliver
of Pepcid AC (never Pepcid complete, has harmful stuff)
Well, to make a long story short, it has to be managed til he dies. Al
the vets have not been optimistic that he can go into remission. Not a
his age.
He still gets Prednisolone, 5 mg every other day to keep th
inflammation down, and the Metronidazole and Amoxidrops keep bacteri
at bay. When I tried to wean him off those meds the result was a
opportunistic infection that messed up his voice and ruined hi
appetite until a week of clavamox and reintroduction of the meds fixe
him up, but it took weeks. This was in March of this year.
He is now anemic from lowered kidney function (i've been giving hi
sub-q's at home for a few months now) and chronic inflammation, so soo
we will be trying Epogen to see if that helps him. His Hematocrit ha
dropped to 20, should be 29-38 or so. He's gotten a bit wobbly an
lowered energy.
His kidney values continue to be high (around the 500's) but his BU
Creat have almost normalized since hydrating him.
The vet says his condition is part of a common triad syndrome tha
usually goes along with Irriitable Bowel Syndrome (which he did hav
around age 9 but which we thought was gone, good diet made symptom
disappear)
The vet says the immune system MUST be suppressed with the Pred to kee
his liver from being destroyed. She thinks the inflammation is th
result of a faulty immune system.
He has lost weight, used to be a 9 or 10 lb cat, but in the last fe
years got down to 7.3 at time of diagnosis, then over the last year i
down to 5lbs.
It's very heartbreaking, I've been depressed, sleepless and found
counselor.
The weight loss is the hardest, he is so bony. They think at this poin
he only has a few more months, but is a trooper. He's not tha
jaundiced, only slightly pale yellow, not in pain, and not nauseaus.

Things I have learned in managing his disease:

Higher doses of Pred have helped his appetite emmensely

Actigall or Urisidiol very good for keeping the bile flowing & bil
ducts cleaned out. Protects against bacteria all jammed up in there
Ask your vet about that one.

Denosyl can make him nauseaus & inappetance, so I use sparingly
Denosyl MUST be given with a little syringed water to wash it down o
it sticks in the throat & irritates it.

I give the metronidazole at night since it's bitter & can mak
nauseaus, so why not let him sleep through that.

Combining all pills in a gelcap is VERY helpful, we've got the routin
down to 2 gelcaps a day, morning & night. I give with syringed foo
since that washes down the pill.

A really good small shooter syringe works best for feeding. Not th
dropper kinds. The nozzle can be snipped off to suck the food u
better. I have a 3cc shooter, it takes about 10-15 syringes to feed
decent size meal. Syringes must be thrown out often to preven
bacteria. I go slow while I'm doing other things, a syringe every fe
minutes snuck in the side of his mouth. He doesn't even dribble i
anymore, and doesn't hide or dread being fed. Patience and getting into
a routine are a must. I can even feed him on my bed or futon & don't
even have to trap him in the bathroom anymore.

One pinch slippery elm powder added to each meal keeps digestion moving
along (works on constipation as well as diahrrea)
A constipated cat is NOT happy.

I must add Lixotinic & liquid B vit to each meal or anemia worsens. I
hear Pettinic also good.

Blood pressure in old cats MUST be monitored. His was 280 in Feb so
he's on Norvasc & Benezapril. Had we not caught that, he could have
gone BLIND from retinal detachment. I knew nothing about this til it
came up.
Lowered kidney function can cause high BP.
Fritz was howling in the mornings & very hypertensive til BP under
control, now he doesn't howl & is much calmer.

Websites like FelineCRF have been very helpful in helping me figure out
how to handle all the symptoms & manage the disease. Very helpful people
on the forums there.

It has been very hard & depressing, I've had him 19 years 7 months so
every week is a gift. He is very thin & tired but still gets lots of
enjoyment out of life, loves his yogurt treat & the occasional bite of
salmon. He eats some on his own, his appetite has been better since
upping the pred. He loves Pet Guard food, I always give wet since dry
makes him barf. Overall his life quality is very good but he is on the
decline & it's so hard. I expect to have him a few more months, maybe
even til the end of the year, but I do cherish every moment. It has
helped me to accept the condition instead of trying to cure him, for a
long time I was doing so much research & trying everything on him, but
at this point, it's just being managed & he is comfortable. But
everything I've researched indicates keeping on the Pred, Metron, and
Amox VERY important.

My heart goes out to you, maybe your cat is young enough for a
remission. With careful diet maybe that's possible. Please continue to
research & try different diets & supplements, and by all means watch
out for Anemia & Blood pressure! Also diabetes if his Pancreas is
affected.

Purrs, hugs & best of luck:
madsongstress

NateB323 Wrote:

<snip>

Hi Nate,
I'm so sorry you and TB are going through this.  I don't have any advice on
the medical end of it, I haven't experienced anything similar.
As far as whether or not to do the surgery, that's a tough one.  Try to
think of it without the cost as a factor to start with.  If you decide you
would do it, then get creative about how to pay for it.  Borrow money if you
have to, talk to the vet's office about a payment plan.  This is just my
opinion, but it's to try then constantly wonder 'what if'.  Talk to the vet
about all the risks of surgery.  Is TB a good candidate?  If they do find
something, what are his chances of a full recovery?

Good luck, and keep us posted.

-Kelly

I have some shortened experience with this. Maynard was 2 weeks shy of
his 19th birthday when I discovered his yellow ears. By then it was
really too late for him. We tried treatment for 4 days, but it was
really too late. I should have done bloodwork earlier in the year and
caught it sooner.

It does sound like you caught it earlier, so I will tell you what I
learned, and hopefully it will help you out.

There are 3 supplements you can add to his diet that will help the
live and also with bile removal. One is Milk Thistle. You can get that
with the regular vitamins. Ursodial is another one. I'll have to look
up the other one.

Another thing to consider is fluids. Sounds like you had him at the
vet for fluids. How has he been overall? Does he get dehydrated
easily? You can do fluids at home if you need to. The vet gave me a
lesson on this, and it wasn't hard at all. Just took about 5 minutes a
day. Much cheaper, and you can give it to him as needed, rather than
waiting for vet visits. And there's not much stress since there is no
vet visit. Just put him on your lap and pet him to keep him from
moving around.

Eating is obviously a big issue. I'm sure somebody else will reply
with the appetite starters. My vet didn't mention those. But, from
this list, it sounds like they work really well.

You may also want to get an antacid. If he's nauseus, that may be why
he's not eating.

Dear Nate;

It's a tough decision.  We put our beloved 13 year-old-cat Stinky to sleep
today due to liver disease.  Vet thought she had cholangiohepatitis secondary
to possible cancer or lippidosis (we did not want to put her through the
trauma of biopsy or exploratory surgery as further diagnosis especially at
her age).  She was hospitalized for two days with fluids and antibiotics and
was eating a little.  We brought her home and were administering antiobiotics,
prednisolone, metronidazole, appetite stimulant, and a pain/sedative med.
She did not respond.  She wouldn't eat and refused water.  She drooled out
the liquid meds we gave her.  We took her for recheck Mon.  The vet gave her
subcutaneous fluid therapy to help with dehydration.  We switched all of her
meds to pill form.  We would administer the sedative first hoping she would
tolerate the pills better.  She did not tolerate us forcing the meds down
very well.  We got them down her for a couple of days with much effort.  I
hated traumatizing her like that but we wanted her to recover.  No such luck,
she got progressively worse and we didn't want her to suffer anymore.

The important thing  is TB responds well to the syringe feeding.  If he does
not eat for a few days he can develop hepatic lippidosis ( Our vet thought
Stinky may have had this) which requires insertion of a feeding tube.  This
treatment is high maintenance and there are no guarrantees.  We decided it
was best to relieve Stinky of her discomfort. I sensed that she was ready to
go.   We lost our cat Star last March to liver disease.  She was 13 also.

It's devastating to see a beloved pet suffer.  We will miss our baby
tremendously.  I have been in tears everyday for the past ten days.   Today
was the hardest.  But at least she is at peace now.  I wish you luck in
whatever decision you make.  Hope my post helps.