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I live in China and my access to English speaking vets is…

Hello, I live in China...
Hello, I live in China and my access to English speaking vets is limited. I have a 2 year old male neutered cat who has a history of peeing outside the letterbox, particularly when I have been out of town or my schedule changes. The past 3 to 4 days he has been peeing a lot more than usual (both in and out of the litter box), not eating or drinking as much as usual, vomiting clear liquid and refusing to let me near him. He normally loves to be pet and cuddled, but the past few days he's just hiding under the bed or table. I took him to the vet and his ALT level is 520. She said his penis was inflamed and red, maybe if he had been licking it a lot. She gave him an injection of hepagen and maropitant (I’m not sure if these are Chinese brands or if you are familiar with them). He’s on cystaid plus twice a day for four days and hepo tab once a day for a month. I am going back tomorrow and the next day for more injections (I assume the same ones but not sure). I did a bit of research on ALT levels and it appears it is cause for some alarm, but the vet didn't say anything about any further tests like a biopsy or ultrasound. Are elevated ALT levels normal with a lower urinary tract infection?
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Answered in 7 hours by:
3/14/2018
Tom Crippen
Tom Crippen, Cat Veterinarian
Category: Cat Veterinary
Satisfied Customers: 71
Experience: BVSc MRCVS
Verified

Hi, my name is*****'m a vet in the UK and hopefully should be able to help you. So I would say in direct answer to your question no ALT levels aren't raised in my experience with a simple urinary tract infection. In young cats most cystitis signs are not caused by infection, they usually have a sterile cystitis (95%+), this is what we call idiopathic or stress cystitis - is commonly can be linked to a stressful event - you going away could do this. There can be other causes of cystitis - rarely bacteria, sometimes stones/crystals. without urinalysis +- imaging (xrays/ultrasound) it would be difficult to say.

The ALT - so this ALT level is quite high. In cats anything over the normal is generally deemed significant. ALT is a liver enzyme released on damage of the hepatocytes usually. There can be many causes of ALT being high - we classify these as extra hepatic (something happening outside the liver affecting the liver eg some hormonal diseases, heart disease, lots of others) and intrahepatic something happening directly to the liver cells - (hepatitis, toxin).

I would say looking into this for me would be a good idea - this might involve ultrasound of the liver, further bloods to asses clotting function and look for other things going on then possible biopsy/aspirate of the liver.

Liver issues in younger cats are quite common, sometimes they go hand in hand with other issues like IBD and pancreatitis too so we quite often look for these at the same time.

The Hepagen as far as I can find is a liver supplement containing antioxidants, these can really help with liver problems but generally I don't rely on these alone if an owner is willing to get a diagnosis.

The other thing to consider is local diseases that we don't see in the UK where I'm from. Being in China I'm not sure if there are common things they see there that present with this pattern of results so this is important to check with your local vet.

I hope that helps

Any other specific questions get back to me.

If possible can you rate my answer by clicking the stars at the op of the page.

Thanks, Tom

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Customer reply replied 4 months ago
Okay, thank you. So it’s quite likely his cystitis and raised ALT levels are completely unrelated?

I would say yes to that statement. Although I don't think I could say for definite but quite likely unrelated.

Tom Crippen
Tom Crippen, Cat Veterinarian
Category: Cat Veterinary
Satisfied Customers: 71
Experience: BVSc MRCVS
Verified
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If possible could you rate my answer with the star system above. I can still answer further questions if necessary.

Thanks, Tom

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Hi,
I'm just following up on our conversation about Tiger. How is everything going?
Tom Crippen
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