Meet Asher. He's my best friend, and he's a very sick boy.
On May 22nd, Asher started sneezing. His muzzle swelled up, he began pawing aggressively at his face, and then he stopped eating. By the next morning, he couldn't stand. At the hospital, his liver enzymes were found to be extremely elevated -- his ALT was over 3600, 29 times the maximum normal value. He also had damage to multiple other organ systems, the most confounding of which was anterior uveitis affecting both eyes.
His blood work, x-rays, and an ultrasound didn't point to a cause, however. His liver values came down some and he started eating, so he was able to come home a few days later to follow up with the internal medicine specialist he's been seeing since he was diagnosed with inflammatory bowel disease just this past April. I talked to numerous vets from May 22nd through 25th -- his ER vets, internal medicine team, primary vet, and dermatologist -- but none could offer insight into what was going on. And as one of his ER vets put it, "your little guy has a lot going on."
Asher was very much up and down once he got home, but was mostly eating, had intermittent energy, and his eyes were improving. Multiple times, we thought we had figured out a possible cause, but every clue turned out to be a false flag. Last Wednesday he followed up with his internal medicine specialist, and we got the news that his liver values had not improved -- in fact, a new one was high as well. He had a needle biopsy of his liver and spleen, which ruled out cancer of those two organs but could not get large enough samples to diagnose an infection, cirrhosis, or hepatitis.
The next step is advanced imaging, including an MRI of his brain and CT of his other organs, and surgical biopsies of his liver, all under general anesthesia. The estimated cost is $7000. Because one of the false flags last week looked promising, and because Asher's past 6 weeks plus a string of health emergencies for him and our two old man cats last fall had already generated close to $22,000 in vet expenses in the last 9 months, we opted to wait and see if he improved. We scheduled repeat blood work for this Thursday and took him back home. But he didn't make it that long.
Over the past week, Asher has gotten progressively more lethargic. He's gone from needing to be hand fed in order to eat in the mornings to needing hand fed for every meal to no longer eating at all. His breathing has worsened and his eyes are getting cloudier. His muzzle is swollen again. He's gotten so much weaker. Today he started hiding from me and went from increased frequency of urination to significantly decreased, and his internal medicine specialist recommended bringing him in through the ER.
I'm writing this from the vet hospital parking lot as Asher waits to see the vet. He was triaged and is stable, but his heart rate is concerningly low. I hope it's not too late for him to safely undergo anesthesia and surgery, but if he can, we will need help. My late husband's last request of me was to take good care of Asher, and as hard as I've tried -- with all the monitoring symptoms and tracking timelines and making phone calls and hours of research and updating medication white boards and giving shots and eyedrops and reaching out to friends, family, poison centers, and contacts in the veterinary field -- I can't help but feel like I'm failing for still not knowing why my boy is so sick. I know I can't keep him alive forever, and I don't want to extend his life if he's in pain. But I couldn't forgive myself if I gave up before trying everything to figure out what's wrong.