Acute fatty liver? Cholangeohepatitis? Liver cancer?
I've written in the past about our male orange tabby, Hedgie. He had become lethargic and lost a great deal of weight, so we took him to the vet for extensive testing. The vet found he was very jaundiced, so at first suspected hepatitis. All the testing done was inconclusive, so there is my subject line.
Our vet thinks Hedgie has all the symptoms of acute fatty liver, except that he eats a lot, and he eats well. In the past, he had issues with irritable bowel syndrome, but with careful control of what he eats that can be controlled fairly easily. He also has the symptoms of cholangeohepatitis, except the hepatitis panel in his blood came back in the normal range. So the liver cancer would be the last possible thought.
We spent nearly $1,000 for the testing and a diagnostic ultrasound with an internal medicine specialist-veterinarian, but were questioning whether to do more. The internal medicine doc said that if we agreed to a liver biopsy (another $600+), and it came up positive for liver cancer, would we REALLY want to subject Hedgie to rounds of chemotherapy (starting at $3,000)? But if the biopsy came back negative, we would be at square one again.
So we have elected to do all the comfort measures instead, and of course as any cat lover would do, we are questioning if this is the right decision.
The vet did have us start giving him Prednisone twice daily, which seems to help. He isn't lethergic, but he hasn't gained weight either. And he still eats well. (By the way, the vet knows how difficult it is to give a cat a pill. He recommended Pill Pockets. Ohmygosh, what a lifesaver! Hedgie thinks these are the best treat EVER!) I'm an RN, and I know the potentially bad side effects of long term use of Prednisone, but if it makes him feel better, and makes his life BETTER for the potentially short time he has left, why not?
Sorry I'm rambling about all this.....I just hope we are doing the right thing with no further testing, needle pokes, biopsies, invasive procedures.
Any thoughts, fellow cat lovers?