Tolly has liver damage

[lovetimesfour]

Tolly has bee taking phenobarbital for almost 8 years, and the inevitable has now come to pass, his liver enzymes have shot off the charts.

My vet has started him on denosyl (Sam-e) which helps the liver make new cells to replace the damaged ones. I don't have much info or answers to my questions yet, as we spoke only a short time on the phone, after his routine annual blood work. I am making a list of questions to go over with the vet at Tolly's next check up and blood work in two weeks. The blood work of course is to see if the denosyl is doing it's job.

The vet has also had me cut back his phenobarbital dose by 3.75 mg daily. This is very scary to me, and if the seizures come back I will put him right back on the higher dose. Quality of life is more important that quantity, I cannot have him going through those terrible seizures again, ever.

[mutt]

Hi Smith. I am sorry about the trouble you are having with Tolly. Are you expecting to lose him, or do you think he can recover? Let us know when you have more news.

[lovetimesfour]

Hi Greg, thanks for your reply. Tolly is doing well, and has shown no symptoms yet. The damage was discovered in his routine blood work. The liver is regenerative, so I am not expecting to lose him any time soon.

He has an appointment next Tuesday, Jan. 26, for more blood work, to see how the denosyl is working. So far there have been no seizures, since cutting back a little on his phenobarbital.

I have a long list of questions for my vet on the next visit. I will be sure to post what I learn here, it may help someone else down the road.

Here is Tolly, telling me "No More Computer Until You Feed Us"

[JanKing]

Aww..I'm so sorry to hear about Tolly's problems..the good news is that you and the vet seem to have a handle on everything and he is getting excellent care!! Keep it up and he will be fine in no time..also keep us informed, ok?

[lovetimesfour]

Thanks Jan. Tolly's appointment for his next blood work is tomorrow and I have a page full of questions for my vet.

I have successfully changed his food from the Wellness pouches to two flavors of the canned Innova, and his Petite Cuisine chicken (he likes a three flavor rotation). He has had no seizure activity since cutting back on his meds, it has been 16 days.

I won't hear about the blood results until Friday, but I will be sure and keep you updated.

here is Tolly hiding in a Sunbeam

[lovetimesfour]

This past Tuesday, 17 days after starting the Denosyl, and reducing the phenobarbital, Tolly had blood work again. This time the blood work shows great improvement in his liver values! This is because of the Denosyl and the reduction in the phenobarbital.

His ALT, which had shot up to 538, (it was 97 eight months ago, 1-100 being normal range) is down to 116.

But then last night he had a seizure. Yesterday was exactly 3 weeks since reducing the dose. It was very short. Even though it was a small one, there isn't a doubt in my mind about what I saw, I know I wasn't just "looking for it".

It was on my list of questions to ask my vet, "if I was going to see break-through seizures how long would it take," but I decided not to ask, or even search on-line, because if I had an idea of a time frame, I would be watching, perhaps too intently, and maybe see signs that aren't really there.

I found one of Tolly's pills under a chair when cleaning this morning. I've found them before, over the years, so I know he's missed a dose now and then, but it never caused any problems. Perhaps on the lowered dose, a missed dose is a more serious issue.

Of course I have no way of knowing when that missed dose was, as I am not the most meticulous housekeeper in the world any more.

Then tonight at the same time as last night, 5:30 pm, Tolly had another seizure. Again very small, this one in fact was even smaller than the one last night. I had company today, so my friend witnessed it, too.

So, because of finding that missed dose, I will give it a few more days, to see if things straighten out, unfortunately if they are going to come around 5:30, I am hardly ever home at that time so won't know if he's having them or not, unless they increase to the point that they come when I am home.

If that happens, I will put him back on the higher dose. I'll be talking to my vet tomorrow I hope, the news about his improved numbers was left as a message on my machine.

Here he is, on my lap.

[mutt]

I'm glad to hear that Tolly's liver is better. I hope the seizures aren't getting too bad. I'm sure that's difficult to deal with.

[LadyTalisman]

WOW

Sound like you've both been through the mill a bit.

I hoep things improve for you both.

[CatzEyez]

I cannot imagine what it must be like to watch your pet go through something like that. I can only hope for u and Tolly that things improve for him. He is so very lucky to have someone like u to watch over and take care of him.

[lovetimesfour]

Thanks everyone Tolly is doing well right now. His next bloodwork will be at the end of March, to see how his liver is holding up. There have been no more breakthrough seizures. yay!

[lovetimesfour]

Tolly has suddenly gotten very thin. I mean, in the past few days. Tolly has always been a skinny cat, and does not have a lot of interest in food. It was the advent of Mazy (see Mazy's Gotcha Day thread) that caused him to beef up, he developed a lot of muscle learning to hold his own against the rough play of our Mazy cat.

Over the past few years I've managed to get him to the point where he even has a little fat pad on his ribs, and I so delight in stroking that little pad of fat, plus I use it as a gauge to determine how he's maintaining his weight.

Suddenly, that pad is gone. Practically over night it seems. Yesterday I took them out in the yard to get some fresh air as the sun came out after our (3 feet!) blizzard and it was 40 F. I took some pictures, and when I looked at them, was shocked to see how thin he really is.

He is very active these days, so now I'm beginning to wonder if he is TOO active. He plays and plays and plays! Weight loss and extra activity = hyperthyroid. He has an appointment on March 30 for new blood work, but I called this morning and made an appointment to bring him in this coming Tuesday.

here are the pictures that shocked me.

[mutt]

Sorry to hear about you having more trouble with Tolly. Sometimes it seems like when one thing goes wrong, everything goes wrong. How is Tolly now? Any better?

[LadyTalisman]

It does sound like a over active thyroid.

Our neighbours cat Bumble has that problem, one day he was a little porky then suddenly looked like a bag of bones.

He's doing real well with his meds so hopefully it will be the same for Tolly

Please let us know how Tolly gets on and if it is an over active thyroid. . . . . SWAPS PLEASE (i'm underactive). LOL

GOOD LUCK

Hugs.gif (35.69 KiB) Viewed 91 times

[lovetimesfour]

Thank you Gail and Greg. Tolly has not lost anymore weight, I was very surprised to see. My vet checked him over thoroughly and thinks we should wait for the blood work until the next scheduled one. (March30) His thyroid in January was on the low side of normal, and if he is developing a problem, it is likely to show up better if we wait a couple more weeks.

Vet is of the opinion that Tolly's increased activity is the result of the reduced phenobarbital, and she may be right. But I worry so, and as I advise other people: "when you see a change in behavior the first step should be the vet", so I do also.

I appreciate your concern, and will keep you updated!

Below, see Tolly enjoying some early sprouts of catnip in the Rock Garden yesterday, it was a nice sunny day and they stayed out a half hour before they got tired of wet feet!~

[lovetimesfour]

Tolly's ALT number is creeping back up. Not the scary 538 it was in January, but up from the 116 six weeks ago. 175 now. Vet is puzzled and has decided to put him on a two week course of antibiotic (baytril) in case he's got some infection going.

His white blood is low, not quite below normal, but on the cusp. Vet says this could indicate a possible cancer, but she doesn't think it likely. She has admitted frankly that she is at a loss.

Thyroid numbers are below normal, but she said that is not uncommon with phenobarbital patients..

She may decide to send us to Cornell for a liver biopsy. They do it there with a laparoscope. She could do it here to save me money, but it would involve major surgery. I will definitely take him to Cornell, if it comes to that point.

I was hoping for better news.

Here is Tolly this afternoon enjoying the warm spring day in our yard.