Liver problems in dogs

[sara106]

2 weeks ago my dog became very ill.  Wouldn't eat, was vomiting and was jaundiced.  His billirubin count was 24, I dont' knwo what his ALK, ALT and AST levels were because I was out of town.  His ultrasoudn was normal.  He was put on Amoxicillin, urso diol, baytril, denamarin and IV fluids.  After two days he strted to eat and was able to go home.  Since them he has improved clinically- is eating agin, and acting normal.  He is still on the meds but was taken off the IV today.  His billirubin has droped to 4.5 but his ALK, ALT, and AST continue to rise.  The second set of tests the ALK was 754, now it is 984; ALT was 785, now it is 1231 and the AST was 306 now it is 361. The Vet still seems to think it is an infection but I am very concerned that this is something more than that. Any suggestions as to what it might be, what type of treatment he should be receiving and/or when should his liver enzymes begin to lower?

[Dakota2012]

I am so glad to hear the good news about your baby.
Susan

[Scoobstersmom]

My Scooby had repeat bloodwork and his liver numbers are still very elevated but a little better than a month ago.  His ALKP is still in the 3000's but ALT dropped from 600 to 250.  The ALKP is down by a thousand so maybe we are heading in the right direction but still have no clue why they're elevated in the first place.  Very frustrating. But he is 14, and with the very elevated liver numbers we can't do any invasive testing to figure it out.  

On the positive side, he is doing awesome clinically.  Active, full of energy, eats and drinks and pees and poos normally and acts like a puppy again.  So there is much to be grateful for today.

Diana

[sara106]

I will ask my vet about fungus. Mickey never had a fever that we know of.  Right now clinically he is great.  Plays and is very normal except his apetite isn't what it should be.  I will post aging when I have his new blood work.  The vet mentioned liver biopsy but I don't want to do that.  There is a risk, both the biopsy and the use of anesthesia can be dangerous.  Unless he gets worse I don't want to do anything that's invasive.

[Scoobstersmom]

We considered the possibility of a fungal infection - coccidioidiomycosis - for our dog as it is endemic to our area and he had it in his lungs as a pup.  But the titer was negative.  The vet has riled out what she can through bloodwork and ultrasound, but my dog is 14 and has the high liver enzymes which make him not a good surgical candidate for a biopsy.  He's been doing awesome for over a month now while on antibiotics, so we are just hoping the meds are resolving whatever the issue is.  Also, it was weird but when he was at his sickest, he did not have a fever.  Instead, he had a low body temperature.  It dropped down to 98.4 for a few days then slowly climbed back to 101.  Weird!

Thanks for the ideas though.  Keep them coming!

Diana

[sara106]

Thanks for the referral to the website.  There wasn't anything with exactly his symptoms but it is a very useful site to keep.  He goes in for additional testing on Friday

[Misfits4Me]

Most of these are common, but at the end are new emerging Liver Diseases & causes.....I thought the last one was interesting......Please read this and see if any of it rings a bell w/your dogs.......Karla

http://canineliverdiseasefoundation.org/?p=25

[sara106]

Thanks for the info.  Your dog's situation is very similar to ours- some different symptoms (Mickey never has a painful abdomen or loose stools, but the rest is similar.  It is good to hear that it wasn't the antibiotics that were contributing to the high enzymes.  I know from personal experience that antibiotics can cause problems with the liver.   We also don't want to do anything invasive because it involves the use of anesthesia which can be very dangerous for anyone with a liver problem.  We plan on going in to our vet for more tests later this week.  Please let me know if you get any drop in enzymes and when your vet takes him off antibiotics.  

[Dakota2012]

Sorry Sara...I did not know a liver shunt had been ruled out.

5 lb loss of weight is a lot for a dog. I hope he starts gaining again.

I certainly wish you the best in finding out the cause and getting it treated so your baby is good as new.

Susan

[Scoobstersmom]

Sara, we,ve been going through something similar with our yorkie and the elevated liver enzymes for the past few months.  The only thing he doesn't have is an elevated bilirubin, but the other numbers are elevated and some even higher than your dog's.  He had a very painful abdomen, vomiting, the loose stools and no appetite.  He had IV fluids for one day, and was put on denamarin and amoxicillin.  With the antibiotics his appetite quickly camed back, no more vomiting or loose stools.  He also had an ultrasound which was unremarkable.  We repeated bloodwork after five days and the numbers were already starting to drop.

As soon as he finished the antibiotics 10 days lat, he immediately crashed again.  Two days later his liver enzymes were higher than ever.  Our vet immediately put him back on antibiotics -- Clamavox and Flagyl -- and within a day he made a pretty amazing clinical recovery.  He was eating, playful, and no vomiting or loose stools again and has continued to do well.  He has been on both antibiotics now for a month.  In the beginning of all this his white count was at the high end of normal, but dropped quite a bit after 10'days on the antibiotics, so our vet is also convinced that it's some kind of infection causing his symptoms.  Either an infection in his liver or his intestines.  We are not in a position to do invasive diagnostics due to our dogs age, so we are just hoping the antibiotics work.  We are finally going to repeat his bloodwork later this week, but our vet has said not to expect a miraculous recovery on the blood counts this soon.  That it can take months for them to drop, and that he may need at least another month on the antibiotics before we see real progress.  

Even though he appears to be doing great right now, it is hard to sit and wait and wonder and worry about what's going on inside of him.

Diana

[sara106]

Since Mickey doesn't have a liver shunt I think things are different.  Right now we are trying to put on some weight since he lost 5 pounds and getting him to eat is a trick so I have to include some of his favorites.  

[Dakota2012]

Sara....my pom with the high liver enzymes is on amoxil for the toxins that had been building in his bloodstream so I would definitely say to keep him on the antibiotic if that is what your vet recommended.
I really need to defer to Karla on this but....my pom can only have minimal protein because of the liver shunt. Apparently protein is a big enemy of liver problems. I cannot feed him beef, chicken or any primary source of protein because it won't break down in his bloodstream and creates toxins. I am wondering if the protein your pup is getting is hurting rather than helping.
I hope Karla weighs in on this one but it is just my experience with liver issues recently. My other pom that has chronic pancreas problems has to have minimal protein and minimal fat. After my vet got her on her prescription diet she has not had a flare up in almost 8 months now and that is good for her.
I wish you luck in getting a diagnosis and getting your pup well asap.
Susan

[sara106]

Good suggestion. I will ask to have him checked for tick born diseases and parasites as well.  We have thought about poisoning but can't think of what that could be.  There is nothing in our yard, we checked, and we dont' live in a neighborhood where anyone would throw something over the wall.  He also doesn't take "treats" from strangers.
He is fed food that I cook for him.  It was organic chicken, brown rice and carrots and some organic kibbles.  Right now he won't eat that since he probably associates it with not feeling well so he gets what he will eat (he lost weight so we want him to eat) which again is cooked for him- chicken liver and kibbles in the morning (organic) and rice and pot roast in the evening.  He is eating fine right now and has put back 2 of the pounds he lost.  We are concerned that keeping him on the antibiotics could also cause his enzymes to stay high since antibiotics, particularly amoxicillin, can cause liver problems but we don't want to take him off them yet since it is possibly an infection.

[Misfits4Me]

Naturally, this looks to be an infection......However, I wouldn't stop there! This also still sounds like Poisoning. What do you feed him? And treats? Is this a small or large dog? I personally would want Tick Borne Diseases ruled out.....They can mimic all of this....Has he ever had a Tick test? Just a thought.....Let us know how he's doing......Karla

[Dakota2012]

I also just adopted a pomeranian that I found out has a liver shunt and his liver enzymes were over 1000 and they did a bile acids test on him and found out he has the liver shunt. He is on prescription diet, Enulose and 2 antibiotics to get rid of toxins in his bloodstream. He is perfectly healthy otherwise.
I wish you and your dog the best.
Keep us posted.
Susan

[sara106]

He is 8 years old and otherwise very healthy.  When he was first brought in his white cell count was 13,000 but it is now down to 9,300

[Misfits4Me]

Welcome Sara...How old is your guy? Has poisoning been ruled out? Did the rest of his bloodwork look good other than Liver enzymes? Let us know....Karla