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Mickey has a problem with his liver

Helene4
August 11th, 2009, 09:58 PM
In June, Mickey had his annual bloodwork done. Two liver enzymes were elevated and I was told to retest in 6 weeks so last week, Mickey had another blood test. The 2 liver enzymes went up again :sad:
ALT in June: 252 ALT in August: 526
ALP in June: 345 ALP in August: 411

So yesterday, Mickey had a bile acid test to see if his liver was still doing it's job. I got the results today; his liver is working but there is a slight anomaly, the beginning of something ( sorry I don't have any numbers). The next step is an ultrasound. We can go to a vet clinic 2 hours away but the vet is not a specialist and might not be able to see anything abnormal or we can go to St-Hyacinthe at the vet faculty (7 hours from here) to see a specialist. Then again there are no guarantees, he might not see anything either if the anomaly is very small. I think we will start by going to the nearest clinic and take it from there. Maybe regular blood tests to monitor Mickey's liver? :shrug: Mickey is over 13 years old and I think a long trip and a visit to the vet faculty would be stressful for him. He doesn't have liver disease symptoms, he seems to be in very good shape.

My vet hasn't talked to me about supplements or medication yet but I bought milk thistle today after doing some research on pets.ca ( it's a good thing you guys are here :thumbs up). I also wanted to get some Sam-e but didn't find any. I will keep looking. If I don't find any, is there a site, preferably canadian, where I can order online? What about Denamarin and Denosyl, can I order online or do I have to get it from my vet? I just have this feeling that I should be DOING something other than blood tests and ultrasounds so I started giving Mickey milk thistle. I hope it will do some good. I haven't told my vet about this; I just don't know what she thinks about these supplements.

Thanks for sharing your experiences and your comments.

luckypenny
August 11th, 2009, 10:15 PM
I found Sam-e at a health food store nearby (Tau). Costco is also supposed to carry it. If you still can't find any, pm me and I'll send you some.

Here's an article/recipe I found when researching liver issues. Don't know if it might work for you...Toby refuses to eat fish :shrug:.

:goodvibes: for Mickey.

http://www.wsstc.org/documents/Liver%20Cleansing%20Diet.pdf

Helene4
August 11th, 2009, 10:45 PM
Thanks Luckypenny! I will see if my pharmacy has any as well as my little health food store in town. There is always WalMart in the nearby town and other pharmacies; I will be going there later this week. Too bad we don't have a Costco around here. I got the milk thistle at Loblaws, they have a lot of supplements but I didn't see any Sam-e. Thanks again for the offer, I will keep you posted.

ScottieDog
August 12th, 2009, 12:08 AM
I'm sorry that Mickey is having problems. I have used Denosyl and Denamarin with my Scotties. Denamarin is the more effective of the two. It contains SamE and milk thistle. Tipper took this when she had bacterial hepatitis and her two liver enzymes were in the 1800 to 2000 range. In the 6 weeks that she took it, her levels dropped by half. (Sadly, she succumbed to kidney failure unrelated to the liver problem, so I can't offer any long-term prognosis.)

Both Mac and Tipper took Denosyl to lower the ALP enzyme. Scotties tend to run an abnormally high value and we monitor this. We had decent results lowering the enzyme, but the dramatic changes were seen with the Denamarin. I was given a script and told to order it online--Tipper passed before I needed the refill, however.

http://www.drugs.com/vet/denosyl.html
http://www.drugs.com/vet/denamarin.html

I do remember it was important to give these medications/supplements on an empty stomach. My family vet wanted to test the supplements for 6-8 weeks and then retest the blood. I believe that Mac ended up taking the supplement once for about 6 months. Good luck.

Helene4
August 12th, 2009, 07:32 AM
ScottieDog, first of all I'm sorry to hear Tipper is no longer with you :grouphug: Thank you for sharing; it's good to hear from someone who has used both of these medications.

ScottieDog
August 12th, 2009, 09:58 AM
Helene, thank you for your kind words about my sweet Tipper. This week marks the one year point when she went into kidney failure--she passed in late September. It still hurts so much.

I do want you to know that my little girl didn't pass from the liver problems. She had so many health battles that she bravely fought--spleen removal which "broke" her immune system, multiple severe UTIs, suspected bladder cancer with surgery, the hepatitis. Her health was so fragile that her cancer medication sent her into kidney failure.

One thing I do want to mention is that with the liver compromised, you do really need to be careful with medications. The liver of course is a filter; if it can't properly do its job, then the filtering either isn't done properly, or another organ (like the kidneys) are overly taxed. So please be careful and ask questions about the medications Mickey takes. I still have times when I feel the specialty vet was negligent giving us the cancer medication with my dog's liver compromised, but I also know that she did everything she could to pull my little dog through and I remember her tears the day we said goodbye. I guess it is human nature to want to place blame; I do know that my little dog just had too many things wrong to go on. No one ever did anything to intentionally cause her harm. Sorry I'm rambling, but like I said, this is a hard week.

Helene4
August 15th, 2009, 05:08 PM
Well, I found some Sam-e at Wal Mart. Pretty expensive stuff: $30.47 for 30 tablets! :eek: They are 200 mg, enteric coated. And now my search continues; I have to find out how much I should give Mickey. I know it has to be given on an empty stomach and milk thistle is given with food.

Next step is the ultrasound, the vet clinic should call next week.

ScottieDog, I know how you fell. When Kalou passed I cried for a year and half. It's been 5 years and every year when may 5th comes around, I remember. I can now think of her without getting all teary-eyed. It sounds corny but it's true, time heals all wounds.:candle:

Dr Lee
August 15th, 2009, 10:00 PM
I just thought I would poke my head in and explain the liver supplements a little:)

SAMe verus Denosyl
These are the same. SAMe stands for S-adenosyl-methionine. It is a liver enzyme that is critical for many functions within the liver. Thus with any type of liver disease, supplementing this can help assist function. The big deal about Denosyl is that it comes in a different sizes where SAMe seems to mainly come in a 200mg form. Unfortunately SAMe is a highly unstable and reactive molecule so it is enteric coated because if the tablet is crushed/split/cut, then much of the ingredient will be degraded and rendered ineffective by the stomach. Also it is best given on an empty stomach because giving it with food decreases absorption. Standard dosing (ALWAYS talk to your vet. Do not dose based off of this - just giving it for general knowledge sake): up to 12 lbs 90mg per day; 12-25lbs 90mg twice a day or 225mg once a day; 25-35lbs give 225mg per day; 36-65lbs give 225mg twice daily, 65-90lbs give 225mg three times daily and over 90lbs give 225mg four times a day.

Marin
Marin is a combination of Silibin (the active ingredient in milk thistle), Vitamin E and Zinc. Thus Marin is superior to milk thistle for the additional ingredients which are also liver supportive. Marin is recommended to be given with food because the zinc can cause some stomach upset.

Denamarin
Denamarin is a combination of SAMe (denosyl) and Silibin (milk thistle). Denamarin is recommended to be given WITHOUT food for the reason of enhanced absorption of the SAMe. It also should NOT be cut/crushed/chewed/split.

Note: Even though Denamarin is the combo - ideal liver support usually involves both denamarin and marin together. The reasons are for enhanced silibin dosing as well as the addition of zinc. Many experts believe that pets suffering from hepatic (liver) disease have suboptimal zinc levels.

I hope this is useful information and I wish your pet the best:pawprint:

Helene4
August 16th, 2009, 12:54 PM
Thank you very much Dr Lee. I will talk to my regular vet about these supplements when I get the chance and when Mickey will have his ultrasound in the other clinic I will see what the other vet has to say about all of this. I think my vet is waiting for all of the results before suggesting any kind of medication. In the meantime, I will continue giving Mickey the milk thistle and I will start the Sam-e, it can't hurt and it might help! :fingerscr

Dr Lee
August 16th, 2009, 04:01 PM
..., I will continue giving Mickey the milk thistle and I will start the Sam-e, it can't hurt and it might help! :fingerscr

Whether you use SAMe, Denosyl, Milk Thistle, Marin, or Denamarin - you are right; in general they 'can't hurt and might help'. They are all non-specific liver supportive supplements. Used at recommended doses, they are considered very safe.

I would not supplement zinc and Vitamin E from such a cavalier standpoint though.

Let us know how it goes.:pawprint:

Helene4
August 20th, 2009, 04:20 PM
Well, Mickey had the ultrasound yesterday and the news isn't bad! :thumbs up The vet said Mickey has 3 very small nodules on his liver and a few on his suprarenals (hope it's the right word, had to get my French-English dictionary for that one!). Anyway, in his opinion, it is not cause for worry at this point, it is a consequence of old age. I was sooooo relieved! I asked him loads of questions but when I got out of his office I couldn't remember what he told me :o I just kept thinking "it isn't bad, it isn't bad!"

I will see with my regular vet what should be done; maybe more blood tests in a few months and eventually another ultrasound to monitor the nodules. But as the vet said, if Mickey doesn't show any symptoms, he should be okay.

Mickey was a real good boy, he was calm during the exam so they didn't have to sedate him. And the tech told us he doesn't look like a 13+ year old dog, he looks like a puppy!:cool: We told her at home he doesn't just look like a puppy; he often acts like one :laughing:

I talked to the vet about milk thistle, Sam-e, Marin, Denamarin and Denosyl. The only one he was familiar with was Denosyl :frustrated: so I will send him some of the links. If he can't understand English I'm sure he can find information somewhere in French. I suppose my regular vet doesn't know to much about these products either so I will send her the info as well and ask what is best for Mickey.

I'm happy to share my good news!:goodvibes:

Helene4
August 12th, 2010, 05:10 PM
I thought I should update this thread, I have good news! Mickey had his annual bloodwork done yesterday and I just got the results. His ALT is now 98,last year it was 526, and his ALP is 270, last year it was 411. The results are not in the normal range but the vet is happy with those numbers, the best in these last years! And I'm reallllly happy! :D The vet told me older dogs who have a bit of tartar often have elevated ALT and ALP. In December 2009, I started giving less Sam-e and milk thistle. In April 2010, I stopped the Sam-e but I'm still giving milk thistle 3 times a week, about 125 mg instead of every day.

I'm thankful I had this forum to turn to since my vet had nothing to suggest. After Mickey's ultrasound last year, I did my research, called my vet and said:"" This is what I will be doing..." She wrote down what I was giving Mickey, the dosage, etc, and told me not to buy the supplements online (seems she's seen cases of intoxicated pets that were given meds bought online).

Anyway, I am extremely pleased with his results. Mickey will be 15 years old this fall and he is in great shape! :thumbs up

hazelrunpack
August 12th, 2010, 09:53 PM
What a great update, Helene4!! Yay for Mickey! :goodvibes: