Can Someone Help Me?

I am attempting to look for an underlying cause of liver disease in our 10 year old Scottish Terrior. Two years ago, she became very sick at her stomach after having her teeth cleaned. Coincidentally, this was also the time perimeter of the dog food scare. (The food she was eating was not on any of the lists publicized.) I have been assured by more than one source that if she had experienced an episode from the dental cleaning, the liver would not have continued to deteriorate over this course of time. The blood work found that her liver enzymes were grossly abnormal. Radiography was performed and we were advised to have an ultrasound. The ultrasound found that her gall bladder was enlarged and we were referred to UT Vet Hospital in Knoxville for possible emergency surgery and further diagnosis. UT did not see the urgency with the gall bladder and she was hospitalized and monitered for a couple of days. She was released feeling well.

A couple of months later, her liver enzymes continued to be abnormal. We returned to UT for additional testing . They performed a needle biopsy and found a few abnormal cells in her liver, but nothing (they felt) to go further.

She was placed on Ursidial, Benazapril, Denamarin, and Fish Oil. Her bloodwork continued to be monitored at least once each 3 months and the results varied. The liver enzymes continued to be elevated, but increasingly additional protein was found in her urine. Her diet was changed to a high quality low protein diet. She continues to feel well. However, she had increased water consumption. Currently, her urine is very diluted. Sometimes, large proteins show in the urine and other times smaller proteins show up causing us to believe there is some globular nephritis happening.

This has continued over the last 2 years. Every test that we know of has been run including multiple Cushings tests with no results and continued blood and urine tests. A few weeks ago, she did test positive for atypical Cushings. The vet school at UT is not convinced that the atypical test conclusion is accurate.

Our vet referred us back to UT requesting an ultrasound be performed. It was non-conclusive. They recommended a laparascopic biopsy with additional bile, copper, etc tests. We received the results today and they have no idea what the underlying problem could be. Her liver is fragile and the biopsies broke apart with very little bleeding when extracted. Cancer biopsies have shown to be negative. The copper test was not back but the slides showed no crystals. There is some evidence of regeneration. They feel she may be a first and I feel that there has to be another “baby” out there that has had an evasive diagnosis.

I would very much like any suggestions, ideas, etc that anyone may have had that has experienced a difficult diagnosis. Any suggestions to continuing to preserve the liver and promoting regeneration will be grateful.

I would gratefully appreciate you forwarding this email to anyone has any sources that may be familiar with this type of case or know of anyone with professional interest in liver disease. I feel certain that there are internists that specialize in liver care and disease but I have no way of knowing who they are.

Thanks and love,
Malie

February 13, 2009 by Lisa  
Filed under Blog

Comments

18 Comments on "Can Someone Help Me?"

  1. shannon on Mon, 23rd Feb 2009 4:25 am 

    I read your post during my research to figure out what is up with my 10 year old golden. Her liver enzymes are way high – normal range is 1-130 and hers were over a 1000! Is your dog excessively thirsty? Mine has been and urinating A LOT! This may be coming out of left field but check into liver fluke. My vet contends that it is only found in Asia but i am going to push him to test for it. I have been finding info online and she has some of the symptoms. It wouldn’t be something they would necessarily look for so they may think you are crazy. I will bookmark your site and post when i find out what is going on with my dog.

  2. Lisa on Mon, 23rd Feb 2009 3:14 pm 

    Shannon,

    Thanks for the post. Can you send me any information you have on the liver fluke disease and I will post it to the blog and in the news section for people to see. I appreciate you trying to help out a fellow liver disase parent.

    Lisa Smith
    Founder, The Canine Liver Disease Foundation

  3. shannon on Sun, 1st Mar 2009 3:39 am 

    I am going to see my homeopathic vet on Tues. I will let you know if liver fluke is confirmed and what she puts the dog on. Right now she has her on 400mg of milk thistle twice a day and Denosyl once a day until she sees her – there is a website on the Denosyl.

  4. shannon on Mon, 9th Mar 2009 7:03 pm 

    Sorry I didn’t post sooner. My vet agreed that it could very well be liver fluke. She said she treated a dog from Florida recently for liver fluke. What we are doing first is trying to get my dogs liver enzymes down some before we treat for flukes because the meds are processed in the liver and it is better to have a healthier liver to start with. Right now she is still on 450mg of milk thistle 2x a day and Denosyl once a day. We are also giving her parsley water – here is a link if you want to see how to make it. http://www.shirleys-wellness-cafe.com/parasites.htm#pets
    It will help cleanse her kidneys. we are rechecking the liver enzyme levels next week and will start her on either Droncit or the method described in the above link for de-worming. An alopathic vet won’t look for flukes…and our dogs sound like they have the same symptoms. I will post more as i know more. see if there is a homeopathic vet in your area. Good Luck!

  5. Carol D. on Tue, 17th Mar 2009 12:04 am 

    Lisa,

    I am running into a very similar situation with my 11.5 yr. schipperke. I shared your story with the internist (at Cornell University) we’re working with. We’re both curious at to which enzymes are elevated with your Scottish Terrier. Buka’s results of her liver biopsy won’t be available until 1 or 2 days.

    Thank you and God bless,
    Carol and Bu

  6. Belinda on Tue, 24th Mar 2009 7:29 pm 

    I have a pommeranian who is almost 13 and was diagnosed with mitral valve regurgitation. Soon after she was put on enalapril, her liver enzymes went through the roof–ALT and ALP.
    She was hospitalized for 10 days and during that time she was off the enalapril. Since then she has been back on it and even upped the dosage. We just came fro the vet because she hasn’t eaten in two days Her enzymes are escalating again. Clinically, so far, she looks great. Has anyone had an experience with this drug enelapril? They want to do a liver biopsy but I said no—I have already spent more than you could imagine and it seems to me like her problems all start when she is put on this medication.

  7. shannon on Mon, 30th Mar 2009 2:59 am 

    we had my dog on denosyl and milk thistle for a month and her liver enzymes were NORMAL when re-tested. I am going to start the de-worming to rid her of parasites this week. The de-worming instructions are on this website. http://www.shirleys-wellness-cafe.com/parasites.htm#pets

  8. Lou Ann on Thu, 2nd Apr 2009 12:33 am 

    To begin with, I would like to appologize that I have offered no responses to all of your comments. I am new to blogging, and for some reason scrolled way down tonight and ‘voila’ found these comments. I have communicated with Shannon and Carol and would like an update on Shannon’s liver flukes when you have something. Obviously Carol, I want to know how Bu is doing.

    Belinda, I am not familiar with your situation, but if you might get your Pom into a university sponsored (or even an internist) vet, they might be able to offer another option. One tends to think that when a new med is introduced and problems occur, it may be the meds. But, there is always the thought in the back of one’s mind that it could be the underlying health issue.

    With our Scottie, she was placed on flax lignans for her atypical cushings after UT Knoxville didn’t find an underlying cause for her liver deterioration. She did fine at first, then we upped the dosage. She started having intermittent diareah. We lowered the dosage for several days and the diareah ceased.

    After a couple of weeks, it was back. We have decreased the fish oil and ceased the flax lignans and still have episodes a couple of times a week. She is now on an antibiotic and a whipworm flush and so far so good. The doc is very concerned it is her liver causing this problem.

    So, I guess my point is these meds can exasperate the problem or have nothing to do with them. Unfortunately, my story is of no help.

    I wish all of you all the luck in the world with identifying and treating your babes. Malie really has us worried so I ask that you think positive thoughts for her.

    I wish there was something I could do to help. Just know I’m thinking of all of you.

    Lou Ann

  9. Cindy on Sat, 23rd Jan 2010 9:00 am 

    We have an 11 yr old American Pit Zeus that has been diagnosed with cirrhosis of the liver. Zeus was hospitalized twice in November and IV’s were used to push fluids. Zeus became increasinly weaker, to the point he couldn’t walk up steps, couldn’t get on the couch and layed around most of the time. We took him back to the vet Monday 1/18/10 more blood work was done and a ultrasound, that is when he gave us the diagnosis of cirrhosis. He has put Zeus on Denamarin (which he says Zeus will have to stay on the rest of his life) and Ursodiol for 30 days. Zeus seems to be in alot of discomfort at times and has trouble walking and standing. His diet has consisted of Senior Pedigree slightly moistened and rice cooked in chicken broth. I have found conflicting information on exactly what his diet should be. Can anyone share information? thanks so much!

  10. Nance on Sun, 17th Oct 2010 6:06 pm 

    I have an 11 1/2 year old Chinese Crested that quit eating and drinking. Took her to the vet and her liver enzymes are elevated. After one round of antibiotics and no further help and she still wasn’t eating/drinking went for a second consult. Once again elevated enzymes and x-ray showing enlarged liver. She has been on Metrodinazole for three days now and her appetite has returned and she is drinking water once more – seems perkier but sure lost weight and this little dog was only 7# to begin with. I’ve been searching for info on a diet that will help her liver to recover if possible. She is on a very bland diet per vet orders at the present – baby food, rice, boiled chicken, etc. I don’t think this a long term diet, Any help and experience with this I’d sure appreciate. Thank you!

  11. Charlie B on Thu, 3rd Mar 2011 9:02 pm 

    I have a 10 year old Schipperke (turbo) who is having similar problems we are in the diagnostic faze. He had a ultra sound and it shows spots on his liver. he is acting very strange. almost like he is slowly dieing and my vet wont give me a definite answer because I cant pay 2000.00 for a biopsy. I see Carol d has the same problem I was hoping you are still on here or anyone here could help me. It is devastating our whole family to watch. My email is c_biancheri at yahoo dot com to reach me or on here. Thank you
    PLEASE HELP!

  12. Allison Henneberry on Tue, 8th Mar 2011 1:14 pm 

    I have a yellow lab that is just under two years old and also started acting strange. Her appetite really diminished however I had thought it was in relation to the ear infections she gets, took her to the vet, obtained some new ear drops and thought it had helped, although her appetite never returned to normal but the vet just said it may be due to her getting older and her metabolism slowing down. Then one day on our walk she began to make this weird gagging noise so I took her home and by the next day she had vomitted in the morning and began to pace steadily, hardly sleeping and staring at the wall for minutes on end. I took her to the vet and they began an IV and indicated she had eaten something toxic, possibly mold. Her enzyme levels were elevated and bile acids way up. She stayed for two days and the vet tested the levels again, stating they had not come down but that I should take her home anyhow as it was probably just due to the enzymes leveling off. I picked her up in the evening, got her home and her hind legs gave out, she couldn’t even walk in the house. I took her right back to the vet and again they tried to tell me to go home with her and they would check her on Monday. I insisted something be done and I was not leaving. The vet told me they were stumped due to the array of symptoms she was showing…she also began to drift off into a type of commatosed state. They told me my only options were to put her down or take her out of province to an animal hospital which is well known and had the apparatus to diagnose her…that night we took her to the hospital and she was admitted to ICU right away. They performed a series of very expensive tests and determined my girl had a suspect ARTERIOVENUS FISTULA within her liver which caused heptic encepalopathy. Apparantly the likelihood of repairing this if they performed surgery was slim so I opted to take her home and treat it with lactulose and antibiotics and a special diet…in addition to other short term meds as her red blood cells were down. We are on day 3 of medical treatment and she is getting better every day. I don’t know how long we will get with her but we cherish everyday. Roxy will turn two on April 21, just over one month from now.
    Moral of this story is, you know your dog. Vets are professionals but ultimately no one knows your dog like you…be persistent. In this case it would have meant my Roxy’s life if I hadn’t have been.
    Would like to see more information on this condition on the internet or hear from anyone who may have some. I find the information in relation to this very vague and hard to research.
    Loving my furry best friend,
    Alli

  13. Sharlene Black on Thu, 25th Aug 2011 8:50 pm 

    This is to Malie. We also have a Scottish Terrier and he is 13 years old with the same problem. No definative answer. We have choosen to let him live his life out as normal as he can. We don’t want to put him thru pain and suffering. We will continue his liver assist and anti-biotics as needed. I wish you well with your dog. They are family aren’t they. Regards, Sharlene, Maine

  14. Dan Weeks on Sun, 1st Jan 2012 4:24 pm 

    heavy water intake and lots of urination in an older dog, check for CUSHINGS DISEASE!!! may also have a pot bellied appearance and losing hair and lack of vigor.

  15. Valerie on Sat, 1st Jun 2013 1:57 am 

    We have 2 boxers, one whose enzymes are over 1000 other is 173. Both caused by eating Sago Palm. Very toxic plant! We are trying a month of pills and liver diet. Did the hospitalization for first 48 hours.

  16. Laurie on Wed, 15th Jan 2014 2:12 am 

    This blog was very helpful. Bella’s story started while I was hospitalized for two weeks and she stayed with my cousins. When she came home it was apparent she had lost weight. (I attributed it to her increase in exercise while she was with them because they are runners and walkers and gave her the full treatment while she was there.) Then in December, she started throwing up bile in the middle of the night for about 3 nights. I started feeding her smaller meal more frequently meals hoping that would help…it did not. Then the increase in thirst and frequent requests to go out. She’s always had a pink toned groin area…assumed it was allergy to wheat, but noticed it was now red. I took her to VET. She did have a raging bladder infection, which they treated her with Anti-Antibiotics. She was NEG for heartworm. BUT her liver numbers were over 1,000 (with 100 being the baseline). The VET was certain she had Cushings. Started her on Chinese herbs, and a human diet of fresh meat and veggies. The vomiting ceased. VET ran Cushing test came back Negative. VET was so certain Bella had Cushings that, at her cost, she re-ran the test. Still negative. At the same time as her second test (maybe a month after starting Chinese herbs) Bella’s liver numbers came down almost half but they were still at 600. As Bella was tolerating the Chinese herbs and they appeared to be helping with her liver numbers, we kept her on the Chinese herbs and she said she would re-check her in a few weeks. Well, this week, I noticed that Bella appears to have LOST MORE weight. I made the call to go back to a “high end” Commercial dog food free of grains. Her demeanor is otherwise the same. I decided to start searching the “net” for any other’s who have undiagnosed symptoms. Your blog is the closest thing I’ve come across. I haven’t done quite as many procedures as you because, I’ve been unemployed for 14 months, unemployment $$ has ended and all of Bella’s VET bills were covered by her Facebook friends who started a “chip-in” fund for her VET bills. I’ve spent $900+ so far, and I simply don’t have the $$ to do an ultrasound which will be close to $400. But based on your comments, it seems one more procedure won’t get us any closer to a diagnosis in the traditional sense. I go the beach OFTEN with Bella, especially from May to October. When the tied is out you can’t walk an inch without stepping on a snail. I’m asking FB friends with water dogs if they’ve heard of this Liver Fluke and will let you know if I receive any response to my inquiry. I realize it’s “rare”, but with all the contaminants in our waters, I think if the VET can’t come with an explanation, then it’s time to take other things into consideration. I will keep you posted.

  17. Laurie on Wed, 15th Jan 2014 2:13 am 

    I forgot to mention Bella is 11.5

  18. David on Sun, 8th Jan 2017 7:24 am 

    Malie,

    Did you ever find out anything definitive on this? I have an 8.5 year old Scottie and we are facing the same thing. Thanks in advance

    David

Tell us what you're thinking...
and oh, if you want a pic to show with your comment, go get a gravatar!