Liver problems in 8yo dog

Hi everyone. You guys helped me so much last month when my kitty got sick - had an unknown infection and had drastic behavior change. She's doing much better but must keep spraying the pheramone or she starts reverting back to being scared. Not sure if she'll ever recover completely and we'll have to keep spraying, but it's worth it if it makes her feel better.

My dal will be 8 next month. For the past week she has not been eating very much and starting throwing up Monday night. Kept food down for a day, then the next day she would throw up again. I started feeding her boiled hamburger and rice to see if that would help. We had gone out of town for the weekend and she was stressed with the babysitter - thought she just had an upset stomach. When she threw up the hamburger/rice I knew she wasn't doing too well. I took her to the vet yesterday.

Her bloodwork showed elevated liver enzymes or abnormal liver function or ? Not sure exactly what they said but it was serious. This was 5:00 pm yesterday - vet closing - so they sent me to the emergency vet for continued treatment for the weekend. The vet recommended immediate IV of steriods, antibiotics and fluid. At the emergency vet they did an ultrasound. There were no nodules or lumps noticable in the liver, but it was enlarged and darker than it should have been. They also wanted to take a needle biopsy but I said lets wait to see how she responds to treatment. (A long story - our GSD died of liver cancer just a few days after doing a biopsy - kind of scared of the same thing happening again).

I'm not sure what all this means, but the test results were as follows:
ALKP >2000, s/b 23-212; ALT couldn't get reading (2 tests).
Those were the most serious apparently.
They didn't seem as concerned about the following but according to the paper these are also high:
Ca 12.2, s/b 7.9-12.0; Chol >520, s/b 110-320; TBIL 3.9, s/b 0.0-0.9

The emergency vet took another test for the ALKP to get a more accurate reading - stated it was just above 2000. She's been on the IV for 24 hours now and they took another test tonight to see if there's been any change. I called at 7 and their machine isn't working right so I'm supposed to call in another 2 hours. In the meantime my stomach is in a tense knot.

The vet said this could be hepatitis, liver disease, something that is causing her liver to be irritated (acute), etc. The emergency vet was trying to rule out cancer. No lumps looks promising but can't be sure without doing the biopsy. The emergency vet said when she's seen dogs like this it takes awhile to respond and she may not be able to go home even by Monday.

The vet also stated as far as long term she would need to switch to a low protein food.

Questions if anyone has any insight: Are there reasons for the liver enzymes to get elevated like this without it being liver disease or cancer? Do you think this might be an acute illness that she will recover from? Any suggestions on dog food. We've been feeding her Proplan lamb/rice senior formula. I don't care if I have to cook fresh for her every day if that's the best. But obviously hamburger wouldn't be good as that is protein and I assume the Chol test is her cholesterol which is high. Dogs can't become vegetarians can they?

Sorry for the rambling. Any help or advice would be greatly appreciated.

Thank you,
Rachel

First of all: :grouphug: I am so sorry for what you are going through right now.

Now as to the liver, I can't be of much help, but I can tell you thise: My family's dal was diagnosed with liver disease when she was 9, went through some serious hospital stays as you described, and more, and pulled through to live a happy life until 11 (a pretty decent age for dalmations). So don't lose hope.
Liver disease is pretty common in dals, but most seem to overcome it with help.

As per food, if you are worried about metabolizing proteins, then yes you can put your dog on a vegetarian diet. This can be done both by homemade food, or a kibble.
Here is a site on vegie dogs:
http://www.vegetariandogs.com/
Here are some vegie-dog foods:
http://www.naturalbalanceinc.com/dogformulas/Vegetarian.html

Puppyluv,
Thanks for the info. I went to the websites - I'll have to research somewhat. I also went to Hill's prescription diet website. Guess I'll do my homework to see what will be the best.

Just talked w/the emergency vet. One of her enzymes came down, but that is not necessarily good news as the vet says that it could be her body is just running out of the enzyme, not necessarily that it is getting better. What is more troubling to her is that the belirubin (sp?) has gone up. She said this could mean the liver is not processing properly or that the bile is backing up... something or other. I have absolutely no medical background so I appreciate them trying to explain to me but this starts going over my head. So the plan is to continue the iv and test again in 24 hours. She said she may be hospitalized for at least a week.

The vet mentioned again about the biopsy and said we need to seriously consider it. That way they can get more information as to what's going on, whether its an infectious cause or the immune system fighting itself... Our GSD's first symptoms were excessive drinking of water and then excessive urinating even in the house. She was tested for cushing's disease which they said she had and was put on cortizone. This maybe helped a little initially but then she continued to get worse. ***stop reading if you are sensitive*** She became thin everywhere except her belly which was large. She then started to retain water and her ankles were swollen. At this point we had the biopsy done and they confirmed it was cancer. Two nights after this was done she started throwing up blood and then died the next day. I think she started bleeding internally from the needle and it never stopped. In hindsight I don't know why we had the biopsy done if the ultrasound clearly showed the growths.

Our dal is not as severe as our GSD was when she had her test done, but this still concerns me. Just not sure what to do. Cost is not an issue.

Again, any advice is appreciated. Just need to keep my mind busy or I'll develop an ulcer.

I completely understand your worry about your Dalmation. The thought of repeating a test that coincided with your previous dogs passing makes it more scary. I've seen a few needle biopsies done without the same result as the one you had. I think maybe it was just a coincidence that the two occurred one after the other. If you trust the vet and have explained why you are nervous about the test then they should be able to go over it with you and explain what risks if any there are. Everytime I put a Berner under anesthetic I am a basketcase worrying that it will not come back out again as a result of losing one during surgery. It's normal to be very worried and expressing that to the vet really does help and sometimes makes the vet less clinical and more human.

I hope your Dalmation has a long life ahead. :grouphug:

Well I talked w/ DH in depth last night about the biopsy and he called the vet himself. We decided to go ahead and have it done. They said they would do a clotting test first, then do a 2nd ultrasound to make sure there is no bleeding afterwords.

I overslept this morning and the vet who has been treating her goes home at 8am, but I just called right now to check to see how everything went. The vet on duty said they weren't able to do the test as she didn't want to be on her back (which she hates anyway) and she was too stressed to be able to get the sample. They do the procedure with no sedation. The vet this morning said they will try again tonight as they didn't want to stress her too much, but they will give her a light sedation tonight. Hmm, that concerns me. I had her put under to have x-rays done when we were dealing with arthritis and I really didn't like her response to it. When they did the initial ultrasound the first day and they were shaving her she was on her back, 3 people holding her down and she was fighting them the whole time. They had me come in and I held her head and she immediately calmed down. When the treating vet gets on duty tonight I'll see if that would be better - if dh and I were there to hold her and that would be more calming for her.

The vet said she looks better today and ate more food and is keeping it down. Still just a waiting game.

Thank you for all the hugs.

I have a dal too and hope yours gets through this battle. They are the most amazing dogs!!!! My girl is 10 and had a liver problem this summer, to the point where I had an appt to have her put to sleep, but to make a long story short, she got better. She has Cushings disease with the skinny face, limbs, shoulders, and a potbelly and swayback. Anyway, her liver counts were way up and I didn't go through with the scans and biopsies because she was already not feeling well at all and I made a choice not to stress her out any more. The vet really doesn't know why but after about 3 weeks of going downhill, she slowly started to get better. I cooked her rice and added a can of salmon or tuna to it and a bit of salt and of course, she had pepto bismal for the diahrea and vomiting. Please let us know how your dal is and I will be praying that she gets better. -Linda

Hi,
Wondering if anyone has any more advice. I went to visit our dal at the emergency vet Sunday and they had taken her off the iv b/c she was holding down food/water. I said if she's off the iv why can't she go home? So we went home late Sunday afternoon. We tried the needle biopsy Saturday night but she was uncooperative. Stated they would try again Sunday with a light sedative. I took her back Sunday night and the vet that saw her originally didn't want to do the sedative right away - to see how it went. I was at her head while they did the work and everything was okay for the first 3 needle sticks. By the 4th she knew what was coming and would flinch before even being touched. Smart girl. But everything went okay with no sedative, they confirmed she was not bleeding internally, etc. Unfortunately all 5 samples were unsuccessful - no liver cells.

So they sent me home with two antibiotics and an anti-nausea med as I told them I could tell she was nauseous. She is on prescription diet k-d right now, even though l-d sounds like a better fit. She has eaten only about 1/2 can total yesterday. Not sure if its a combination of feeling sick plus the taste of the yucky food (she's pretty finicky). Last night she acted like she was hungry and I put the food out again and she took a few bites and was done. Usually she would have begged for something more until she got what she wanted.

So my original, regular vet called Monday morning and said I see you went to the emergency vet over the weekend. Said they were sorry their phones were down Friday (as I had tried to call about 10 times with either busy signal or no answer, plus I sent them two faxes). So I ended up going to the petsmart vet - walkin. He's the one who sent me to the emergency vet. My original vet wants to keep her on the meds for the next week, possibly two, then see if her bilirubin has gone down, then maybe another week after that to possibly do a more invasive biopsy. Doesn't seem too concerned about the urgency of the matter and this will somehow take care of itself.

What I've been told from the emergency vet is that without a proper dx that they can't treat this more aggressively. That there are other meds that can be used but they might do more damage if the dx isn't right. So I was told I need to get more bloodwork and some type of biopsy Mon. or Tues at the latest. The petsmart vet was closed yesterday so I called first thing this morning. They can't get me in until 4pm.

So I think I'm going to stop using my original vet and see the petsmart vet. He seems to be more aggressive with treatment. So I'll see what happens today. Any insight on what I should push for as far as treatment? Every vet I've talked to seems to have a different emphasis on what treatment she should receive.

Thanks again for all your support.