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Erik update
Erik saw the vet in late June and had lost weight, gained bilirubin (the jaundice number), and was heading toward anemia. The vet discontinued his hyperthyroid meds (which can aggravate liver problems), started him on daily fluids, and wanted to see him again in three weeks. That visit was last Tuesday.
He had lost more weight (5lb 14oz! ack!), the bilirubin doubled to 3.7 (this is way high), the quasi-anemia hadn't changed, everything else was about where it usually is... and his T4, the hyperthyroid number, was up to 29 (normal for him is about 1). My vet didn't think she'd seen one that high until I reminded her of Embla's record-setting T4 of 70 right before she had the radiation treatment. So we started him back on the meds for that right away.
She speculates that he has a blockage in the gallbladder. Since his surgery ultrasounds in that area are pretty inconclusive, so there's no point in doing that. If it is an obstruction (a stone) then he would need surgery; the other possibility is that things are inflamed. So after she got a second opinion she suggested we start him on Prednizone (the general "itis"-fighting drug), which I picked up tonight.
Two years ago I had to make a "now or never" decision about surgery (he appeared to have smaller stones that might someday cause problems). The surgeon thought there was serious risk of doing harm, so I chose not to do it. I do not regret that decision; however, now I'm seeing the consequences, I guess. Erik is too frail for surgery now unless there's nothing to lose. It sounds like the Prednizone is the last non-surgical option, so now we wait and see what that does. Meanwhile, my vet will talk with the surgeon. If the Prednizone doesn't bring the bilirubin down and the weight up, that seems like the next step.
Erik's quality of life is still good. He eats (not enough); he curls up in my lap; he shows no signs of pain (only old-age slower movement). I really hope the Prednizone helps him. (Apparently it's an appetite stimulant, yay.)
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So, if I may: where's Ask?
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Prednisone could cause him to become temperamental and aggressive, too. Be prepared to give him some personal space. I had a cat on a short run of prednisone for liver issues once; he just wanted to hide out in my room and not be bothered by his siblings for a while. He did beef up on it too, and stayed quite large for the rest of his life.
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