High liver enzymes - described as palliative

My cat is an orange 18 year old indoor domestic.   I’m looking for opinions on treatment options for high (1000-2000) liver enzymes that may not have been thought of. He will not take to the liver enzymes and too high risk for ultrasound or biopsy. He is a very happy cat and looks like he’s healthy & young.   Background info: Controlled diabetes 1 unit twice daily insulin for two years and once in remission Liver enzymes began elevating 6 months ago Recent diagnosis of hypothyroidism - starting to reduce slowly (69 to 46) with meds In remission from chronic bronchitis Controlled arthritis with injection monthly Kidneys are good Requires dental surgery but too high risk Small benign polyp on ear around 10 yrs Recent bump under skin on tailbone Focal seizures - entire life Frequent vet visits - annual, blood, urine, sugars etc.   Clinical Info: Low appetite/weight loss No behavioural changes - baseline “spicy” Slightly lethargic No pain indicated Slightly constipated/urinating normal Drinking water normal Halitosis

Hello.  I have a fondness for spicy orange domestic shorthairs and am sorry to hear that yours is ill.  I am also about to be sciency / pinickity, for which I partly apologise.  The problem is that one cannot treat liver enzymes.  Liver enzymes are released by liver cells that are undergoing change - eg death- and because there is a normal rate of turnover of liver cells (liver regenerates) , a certain quantity of liver enzyme in the blood is normal.   I suspect that your result (not sure which enzyme was being measured) suggests a higher than usual rate of liver-cell turnover or damage or inflammation.  However, livers can be damaged for a huge array of different reasons.  There are some vague treatments that are 'good for' livers in general - supportive diets, supplements and the like - but to do any more than that, it helps to know what is 'wrong' with the liver before one treats it.  Or indeed, whether the enzymes are high because the liver is working overtime to fix some other problem eg toxicity, or sometimes simply due to a rate rate of metabolism eg in out of control hyperthyroidism.  However, it sounds as though your vet - who knows the specific enzymes that they're looking at - has detected a concern that makes them want to look at the liver more closely.   By trying to diagnosing the cause of the elevated liver enzymes, they can then talk to you about more specific treatment, should it be necessary.

As a vet, I am generally happy for clients to decline investigatiom providing that a patient can be kept comfortable, and that the owner is aware of the possibility of conditions that, if not found now, could get much worse or even become untreatable.   I dont know enough about your cats' case to comment on this, but it's all about asking your vet questions (what could it be / what is likely / what could you treat if caught early) in order that you understand the situation to the best of your ability.  The supplements/ diets that you suggest ought to be part of this conversation and will be specific to your cats' case.