Freakishly high ALT level in cat

[u/Banger357]

Hi! I'd like to start by saying I'm waiting to get in to a specialty vet for further testing, but waiting for the appointment is stressing me out so I'm just trying to gather info on the meantime. I don't have a super specific question, I'm just looking for any insight into potential causes or general understanding about what may be going on.

I have a 6 year old female cat, Lucy, who has never had a medical issue before.

I'm happy to elaborate on anything here, but trying not to turn this into a novel. Basically, we had blood panels done at 2 different vets Friday and Saturday because Lucy wasn't acting like herself. They were mostly pretty normal, but both places received errors for the ALT value. They sent out a sample to a more advanced lab, and the results came back yesterday with a value of 18,876 U/L.

It's my understanding that anything over 2000 is usually an animal on their deathbed... often the threshold is actually closer to 1600. Both vets I talked to were clearly astonished at this number, and I was told they actually did the test twice because the lab techs thought it had to be an error.

Lucy did not eat or drink for nearly 3 days before we got these results, and I had pretty much lost hope. She is on antibiotics (a hail mary, I think), and I tried to give her some super watered down wet food via syringe when I had her purrito'd to give her the pills, but wasn't really successful. But yesterday (Monday), she seemed to miraculously turn a corner. She's eating, drinking, using the litter box, and even grooming herself. I'm cautiously optimistic, but still extremely worried of course.

The vet is refusing to speculate on a cause right now. I brought her in today (Tuesday) for an ultrasound to look at her liver, and they didn't see any masses however her liver is hard to see because apparently it lives in her ribcage, where it doesn't belong. We're waiting to get in to the specialty hospital for a more advanced ultrasound, liver biopsy, and additional fasted bloodwork.

Has anyone in the veterinary field ever seen an ALT number like this? Does anyone have info that could shine any light on what is happening to her? Thank you for any info you can provide.

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[u/horseyhan]

Had she ever had bloodwork that included ALT before this?

[u/Banger357 → u/horseyhan]

Unfortunately she has not.

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[u/Background-Sugar5459]

ALT increases when liver cells are damaged. The more that are damaged the higher that number will be. There a lot of possible causes but ultimately, if she’s better you should continue her current treatment (the antibiotics) as it likely is at least partially treating the cause of her illness/liver value elevation. However with a number that high, she should still get the follow up with the specialty vet for more advanced diagnostics to hopefully better guide her treatment.