acute hepatotoxic death in cat

RE: acute hepatotoxic death in cat

ingavdh — Wed, 29 Aug 2018 19:24:26 GMT

[quote user="Robin Grimmer"]

Did you submit any liver for histopathology ingavadh?

[/quote]

No.

Tbh we are thinking along the lines of a toxin ingestion but from responses so far i'm guessing no similar cases experienced.

RE: acute hepatotoxic death in cat

Robin Grimmer — Wed, 29 Aug 2018 08:25:12 GMT

Let's clear up a few myths re steroids and liver disease. Steroids in themselves don't cause liver damage - (but they can lead to iatrogenic hyperadrenocorticism and associated liver changes). Steroids are specifically indicated for certain hepatic conditions eg lymphocytic cholangitis in the cat, chronic active hepatitis in the dog.

However, dogs in particular with liver disease are prone to g/i ulceration so should be given a gastric protectant. I have seen dogs in liver failure given steroids and then haemorrhaged fairly spectacularly usually resulting in euthanasia.

Did you submit any liver for histopathology ingavadh?

RE: acute hepatotoxic death in cat

ingavdh — Wed, 29 Aug 2018 06:56:37 GMT

-sigh-

it's not quite as simple as that. 5 being theoretical dose, actual intake probably 50-75% of that if you inspected the bowl afterwards. and not every day could she be persuaded to eat it.

and as i say, it made a remarkable difference.

and bloods were normal after 7 months.

[quote user="Anthony Todd"]

But "steroid injections (arthritis)" mentioned as well??

[/quote]

only when she wouldn't eat the oral dose for a week at a time and began to stiffen up again. this doesn't mean not eating at all, just refusing tuna/milk/whatever.

RE: acute hepatotoxic death in cat

Anthony Todd — Tue, 28 Aug 2018 22:58:54 GMT

[quote user="ingavdh"]prednisolone, 5mg (max) crushed into tuna or milk or whatever she would eat, once daily, for 7 months.[/quote]

There you go!!

Why do you ever need to give continuous daily pred ever? Mind you that's not a very high dose, and the cat should be able to cope, but I've no evidence to support my opinion.

But "steroid injections (arthritis)" mentioned as well??

I'm sure there are many cats that have coped with continuous pred +- injections for longer aren't there??

There are references in humans though:

https://livertox.nih.gov/Corticosteroids.htm

in which they state the human dose for pred is 5mg od????

with 5 mg daily being considered physiologic doses in adults.

RE: acute hepatotoxic death in cat

ingavdh — Tue, 28 Aug 2018 21:25:57 GMT

[quote user="Martin Atkinson"]

My first thoughts would be acute on chronic pancreatitis/triaditis - can't see the pancreas in the pics [...]

long term use of steroids especially with the GI haemorrhage.

[/quote]

7 months. the oral prednisolone 5mg/day did restore quality of life in this cat.

pancreas grossly normal. recent bloods (past month) were normal. no apparent gi haemorrhage.

RE: acute hepatotoxic death in cat

ingavdh — Tue, 28 Aug 2018 21:22:47 GMT

[quote user="Anthony Todd"]

and as usual no details of drug, dosage or duration are given. [mind you, I don't think we have in this case either....]

[/quote]

prednisolone, 5mg (max) crushed into tuna or milk or whatever she would eat, once daily, for 7 months.

note doses were missed due to inappetance and none was taken during the 1.5 weeks she was missing, or the week prior where she wouldn't eat bar the odd mouthful of dry food.

RE: acute hepatotoxic death in cat

Anthony Todd — Tue, 28 Aug 2018 20:14:06 GMT

[quote user="Martin Atkinson"]I then wonder how much of it may be iatrogenic from the long term use of steroids especially with the GI haemorrhage.[/quote]

Sorry but this is a typical off-hand remark about the use of steroids which is totally contrary to my long experience, but typical of steroidophobes, and not surprising given the poster's long aversion.

I'd be grateful for some evidence please.

I know a search will throw up loads, but typically, and as usual no details of drug, dosage or duration are given. [mind you, I don't think we have in this case either....]

RE: acute hepatotoxic death in cat

Martin Atkinson — Tue, 28 Aug 2018 11:18:58 GMT

My first thoughts would be acute on chronic pancreatitis/triaditis - can't see the pancreas in the pics. I then wonder how much of it may be iatrogenic from the long term use of steroids especially with the GI haemorrhage.

RE: acute hepatotoxic death in cat

Richard Carter — Mon, 27 Aug 2018 11:23:03 GMT

good fat reserves present though with no jaundice of fat so some damage may be post mortem. Smear of liver impression to see if high neuts present to see if triaditis/ hepatitis? May pick up other cell lines such as lymphocytes. Low oxygen situations can also cause pale centri-lobular liver damage so hypertrophic cardiomyopathy, CHF, thrombosis other dds?

RE: acute hepatotoxic death in cat

ingavdh — Sun, 26 Aug 2018 19:47:46 GMT

didn't float, not really pale.

RE: acute hepatotoxic death in cat

Chris Milligan — Sun, 26 Aug 2018 19:44:20 GMT

Lots of potential causes of course - my main concerns would be fulminant liver injury or hepatitis, severe pancreatitis, cholangiohepatitis or other causes of biliary obstructive disease, lipidosis if the cat has been acutely starved of any cause for a few days, FIP, erythrolytic diseases and neoplasia of course

RE: acute hepatotoxic death in cat

Lou Dawson — Sun, 26 Aug 2018 19:42:45 GMT

Hard to see from pic but is the liver a bit pale/tan? Did it float?