Liver Enzyme ALT of 6000?? And Lymphoma - Cat Forum : Cat Discussion Forums
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post #1 of 5 (permalink) Old 11-20-2018, 01:14 PM Thread Starter
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Liver Enzyme ALT of 6000?? And Lymphoma

My 13yo cat had been vomiting every few days for about a month, but otherwise acting normal. I brought him to the vet.. exam and blood work were unremarkable. The vet told me to keep monitoring him and if things didn't improve, bring him back in a month..

The occasional vomiting continued, so back he went. This time he felt something in his lower abdomen, so he had an ultrasound that day. And another round of bloodwork..

The ultrasound came back with bad news.. a discreet mass in the intestine, and what he assumes is a very swollen and aggravated lymph node in the abdomen. He said in all likelihood this is lymphoma, and said I should consult an oncologist asap. Unfortunately the closest is about an hour away, and has a 3 week waiting list.

A couple days later he called with new blood work results.. all normal again, except for the ALT, which was an unbelievable 6000! Has anyone ever seen a level like that before? Normally this value should be 27-158, according to the chart. In his previous bloodwork, this value was a nominal 47.

Apparently this means that the liver is now under major attack by the lymphoma, and is rupturing cells, thus the enzymes entering the blood stream. The other liver results are still normal, so he says this means the liver is still managing to function.

Coincidentally, the day that the vet tells me this is the first day he actually started acting sick. He's clearly getting weaker, tho still eating and drinking..

My vet has nothing to offer, really. He wants the oncologist to biopsy and assess chemo treatment. Not sure if that will still be an option in 3 weeks..

He says palliative treatment such as steroids would render biopsy results useless, so he doesn't want to prescribe unless I'm not going ahead with chemo..

It's a rock and a hard place, and my poor cat is in between...
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post #2 of 5 (permalink) Old 11-20-2018, 03:27 PM
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The ALT scores are pointing to major problems, like liver and heart failure. Liver cancer is possible, too.

If this was a short term problem then another possibility would be poisoning, like maybe he got in to Tylenol or something. But still going on after a month, I'm afraid that's not a good sign.

I really hate to say this, man, but your cat is in pain and suffering, and I don't know if there's much of a chance of a happy ending. And it kills me to say that, because I had to put my Charlie to sleep on November 7, and it broke my heart to do that.

But I had a dog to pass several years ago with congestive heart failure, and I let her pass naturally; a decision that I will regret for the rest of my life. That was such a painful, horrible way to go!! I would do anything to go back in time and have her put to sleep instead.

You just need to be objective here and judge his quality of life. With him still eating and drinking you might have some time left, but once that stops then you'll know.

Last edited by marie73; 11-20-2018 at 03:44 PM.
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post #3 of 5 (permalink) Old 11-28-2018, 02:59 PM
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Hi pokey,

Just wondering if there's any news? Wow, I have to say that I've never seen an ALT anything near that, and it really is a rock and a hard place.

Eating and drinking is a good sign, so if kitty is still stable, it may be worth doing the biopsy. Depending on what kind of lymphoma it is - if that's what it is - it may be treatable. Small cell lymphoma responds very well to treatment.

Last edited by spirite; 11-28-2018 at 03:03 PM.
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post #4 of 5 (permalink) Old 12-01-2018, 12:02 PM Thread Starter
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Hi Spirite, thanks for the reply..

The only news to report since my initial post is that we did manage to get in to see the oncologist. Unfortunately the time spent with him was barely 10 minutes, and basically a waste of time. He said that they could go ahead and try and get a needle biopsy, but the only real point to that would be if I was serious in doing chemo, which he said would be "$5-6,000" for six months of treatment.

Even if the protocol was 100% guaranteed to put him in remission, I simply don't have that kind of money. And I'm not interested in digging a debt hole, either.

So he disappeared to fill an order of steroids, and was never to be seen again. Hardly worth the 2 hours in the car and making Buddy (my cat) a stressed, drooling mess.

He's continuing briskly down the classic cancer path.. losing weight, low energy, isolating himself more. But at least he's still eating and drinking well, no small thing.
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post #5 of 5 (permalink) Old 12-02-2018, 05:39 PM
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Try to have as much quality time with your little old man as you can. Make videos, they can help you after you have to make The Decision. They will hold on way past the point we want them to because they live in the moment. So it is up to us as their stewards to ease the suffering. You will find us all here to help you and share your tears.

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