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2nd opinion re: liver disease

imacouturier
November 4th, 2005, 05:31 PM
Hi,
Can anyone offer a second opinion? Is anyone knowledgeable about liver disease and symptoms/treatment? Thanks in advance for any help!

Last time I posted this is where we were at: Our almost 8yo dal starting having trouble a few weeks ago. She was vomiting bile, took her in, her liver enzymes were high and bilirubin high - referred to the emergency vet - stayed for the weekend with iv fluids and antibiotics - two needle biopsies unsuccessful - sent home with antibiotics and instructions to see regular vet in a few days.

Well she's had good days and bad days - vet has been pleased she is still eating, but barely. We have her on prescription diet low protein - canned - and she hates it. I started putting the juice from canned chicken to make it better - she'll eat at most half a can then be finished. She was eating maybe 1 1/2 cans per day and at 70 pounds her recommended amount is 3 1/2 cans. Needless to say she's lost weight over the past few weeks but more than that muscle tone. We had another followup this last tuesday - vet pleased she is still at least wanting to eat. She has been begging to have "real" food. While we were at the petstore I was looking at the dry prescription diet and she almost ripped open a bag. I got one down with low protein and opened it for her and she started eating before I could get the hole big enough for her head. So since tuesday she's been on dry food and likes it much better. But I didn't want to get the dry at first because it has 12% protein and the canned only 5%. Still low compared to her regular senior food at 26 or 28%.

Wednesday morning I noticed her belly was larger and very hard. Then when we went outside her stool was almost black. So I called the vet even though we had just been there yesterday - and we went back in. I brought a sample of stool. The vet took her cbc - said her platlets were good, not low, her white blood cells have gone up significantly but didn't say it was bad. Originally they were very low the first time and he said it just means her body is trying to fight this infection. And he said some other stuff over my head. But I was specifically asking him if she was bleeding internally and he said no. Her platlets would be very low if that were the case. He didn't seem interested in the black stool. Her large belly was due to aceides (sp?) - some kind of swelling because the liver is not processing like it should.

So we came home wednesday - at about 1 1/2 cups dry food total, same thursday (normal would be 3+ cups). But she was actually wanting to eat.

Friday (this morning) she was not feeling well and shortly after getting up she vomited a small amount. No food from the previous night. It was dark brown with fibrous string-like things in it. Our first thought is that it is blood. That was several hours ago. She has also had several black stools over the past few days, but also normal stools.

I called the vet and he asked how her color was (jaundice) and it is getting slightly better. She was the color of legal pad paper. He asked me to take her temp (which is 100.6) and said that's good. They want me to call back tomorrow but nothing else for today.

Also, she is now on prednisone and antibiotics.

I'm concerned there's bleeding going on internally but the vet says no. Maybe I don't understand how liver disease works but this is a red flag to me. My dad died of liver disease and my mom said he would often vomit blood and have black stools - by the time this started happening he only lived another 6 months.

Should I just wait it out? Call tomorrow and then just go in for her recheck on tuesday when they plan to check her bilirubin? Get a second opinion? Being that it is now friday afternoon that would mean the emergency vet again. My credit card is going to be real scary when it comes this month. We aren't too concerned with the costs and aren't sparing any expense, but want what we do to be needed and helpful - not just a waste.
Thank you for reading - sorry so long. Any help or opinions would be appreciated.

jesse's mommy
November 4th, 2005, 05:36 PM
I would definitely get a second opinion. It sounds like you need it. Good luck and keep us posted.

mycat
November 4th, 2005, 09:53 PM
I agree that you need a second opinion. Not all the vets are the same.

But don't open the phone book. That will be a mistake.

Go around ask your friends, neighbors, co-workers, church-goers, ... if they have pets and know a good vet.

zorrodog
November 6th, 2005, 09:57 AM
:sorry: it is happening to your dog! Our little Jack Russel died last week from exactly same symptoms. Our vet did x-rays and noticed a tumor in his liver. He was less than 5 years old! He lost weight during three previous weeks, and was trembling as if he was very cold, then threw up all over the house, and last he was just being very sad and not wanting to go out or play. The blood test showed a large amount of white cells...They also put him on IV and antibiotics, but it was too late. Did you do an x-ray of your dog?

We have a large field bihind our property that was sprayed with herbicides in summer to kill noxious weeds. He has never been exposed to that stuff before. I would like to hear from anyone who has knowledge of this stuff. Please advice, it it could have been influence of chemicals?
:pawprint:

Invicta
November 6th, 2005, 05:56 PM
If you believe/think you need a second opinion then I would get in the car with your girl and get to the emergency vet (that isn't the one you went to before). Do not wait - just go.

I would suggest starting your dog on a liver cleansing diet and continueing with it indefinately. http://www.canine-epilepsy-guardian-angels.com/liver_diet.htm

Milk Thistle is an herb that helps to cleanse and heal the liver. http://www.canine-epilepsy-guardian-angels.com/milk_thistle.htm

I realize that these are K9 epilepsy resources, however, my girl Guinness died in August of phenobarbitol induced liver disease. She showed the same signs that your girl is showing. A liver cleansing diet and milk thistle isn't just for epi dogs.

My thoughts and prayers are with you and your girl.

imacouturier
November 8th, 2005, 03:02 PM
Zorrodog - so sorry to hear about your puppy. :grouphug: That's just not fair, is it. Only 5 years old. That's how I feel about our dal, even though she is older (8) she should have a few good more years.

They did an ultrasound of her liver, and while it showed it was enlarged, no obvious lumps or tumors, unlike our GSD five years ago who had multiple masses in her liver.

Invicta - I'll look into the diet plan. We have her on prescription low protein diet right now and she isn't liking it very much, but has begun to eat more lately though.

So we had another checkup today with the same office but another vet. They took new bloodwork today and said her T4 (thyroid) was low and could be contributing to her symptoms. Her ALT was 796 - still very high but the previous two times it was tested it was so high they couldn't get a reading - off the chart. Her bilirubin is 4.2 which is lower than the last time we tested almost three weeks ago. Still high though of course. But she seems to have some improvement.

Her bloating is still very bad and I asked at least three different times about a diuretic or draining, etc. They said since she is on predisone it might be hard to find a drug that will be okay to take with that, as well as the pred acts as a diuretic itself with the increased drinking and urinating.

So tomorrow they want to do the bile acid test and see what the results are from that, then possibly a thyroid stimulation test depending on results.

They want to keep her on the prednisone and baytril, plus add another antibiotic.

So except for the swelling I think she is actually improving just slightly. Even though I can tell she can't stand the food she is getting she will go eat some on her own without being prompted. I think she is so hungry now that she is desparate. She has lost 5 pounds so far with almost all of her muscle mass just gone.

Thanks for all the support.

imacouturier
November 10th, 2005, 02:14 PM
Just a quick update on our dal. Well we've been to the vet every day this week. Exhausting! They performed the bile acid test, a urinalysis, thyroid tests, and others. Her thyroid was low so that was a concern. The bile acid tests results were in today and it shows a primary disease of the bile ducts, meaning something with the liver. The vet said it could still actually be something with the pancreas but based on other symptoms and the blood work they think it is primarily an infection of the liver. Her white blood cells were up to 32 on Tuesday and down to 23 today. Also red blood cells are increasing. The vet "poked" (lack of technical term) her abdomen yesterday because of the swelling but did not get any fluid. He was concerned that it was not fluid retention at all and that her organs themselves were swelliing. But overnight her swelling came back down almost to normal, and along with the bloodwork today he said this is a very good sign. So we are now on 2 antibiotics, the predisone, prescription diet with low protein and low fat (didn't know about the low fat before), and making improvement. She could make a full recovery but the vet was cautiously optomistic and said there is still a possibility that she could start relapsing again. But we are all glad with the results we are currently seeing.

So they think this is actually a bacterial infection that is targeting her liver and don't know how she got it. My m-i-l got her some freeze dried beef liver treats that smelled absolutely horrible and would not have been my choice. But we did give a few to her now and then starting about two or three months ago. Does anyone think that she could have gotten this illness from these treats? Makes me wonder. I realize dals are prone to liver problems but why/how would an infection get ahold of the liver?

Thanks for your input and support.