Elevated Liver Enzymes + Lack Of Appetite

[Guest alyssap99]

I thought I'd post this in case anyone has some insights. About a month ago my 12 year old Greta woke up in the morning shivering and trembling; I took her outside and she immediately threw up. The rest of the day she was really lethargic but mostly back to normal by the end of the day.

 

Since then, though, she hasn't quite bounced back. The major problem is her lack of appetite. She eats most meals but lately she's been wanting less of her regular food. She's still got an appetite for treats and bread, that kind of thing, but when I put regular food down she just kind of sniffs it and then walks away. She's lost about five pounds since early fall, which is I'm sure due to her picky eating.

 

I took her to the vet last week and upon exam everything seemed normal (no lumps or bumps, no swollen belly, normal temp, normal gum color). They did bloodwork and everything came back normal (blood counts and lyme) except for her liver enzymes. Two of the numbers were borderline high and two were significantly elevated. I wish I had written everything down but I know that one that is usually 150 was 1000 or so.

 

She was back at the vet today for the more intensive test (bile test, I think), and then they want to do an ultrasound depending on those results. I'm trying to prepare myself for the worst (i.e. cancer) and hoping we get some answers soon, but does anyone have experience with a similar situation?

 

I should add that she's not acting *sick* per se; for instance, we went on a rigorous two mile walk yesterday and she was fine, and actually running for some of the time. I don't think she's in any pain which is good. Any advice or questions would be welcome! Having an older dog is so hard!

[CaliforniaGreys]

Hopefully Ducky will see this and chime in as she's been through this.

Sounds like the bile test is in order, but try not to think the worst, there's a good chance this can be controlled with diet and meds.

I've been through with one of mine and had she not had other complications, she would have done fine.And trust me, it's not only the older dogs

Wishing you the best!

[Guest alyssap99]

Hopefully Ducky will see this and chime in as she's been through this.

Sounds like the bile test is in order, but try not to think the worst, there's a good chance this can be controlled with diet and meds.

I've been through with one of mine and had she not had other complications, she would have done fine.And trust me, it's not only the older dogs

Wishing you the best!

 

Thanks! If it is cancer, I can't imagine it would be very aggressive or else she'd seem like a much sicker girl now. But I guess it's good to at least consider all possibilities and then hope for the best. I am just anxious to find out what's going on at this point so we can deal with it.

[greysmom]

You might ask your vet if you can give her an stomach acid reducer prior to her meals (like Pepcid). If she's feeling a bit off and wanting to eat some things but not her food, I might see if that will help her appetite.

[macoduck]

My thread about Niña's liver problem is here.

 

Is your Greta throwing up whole meals or just a little bit of mucous? Niña was wanting to run outside after waking in the morning and eat grass. The Pepcid helped with that.

 

The bottom line from our visit to the specialist was that she probably has a congenital gall bladder problem(possibly non-functioning), a very small liver and a widened hepatic aorta (which might be related to her slight murmur/cardiac issue). I am very glad that I had the ultrasound done even though we really had no easy explanation for the very high liver values.

 

Her only food now is Nature's Recipe canned food that is grain-free and soy-free.

[Guest alyssap99]

My thread about Niña's liver problem is here.

 

Is your Greta throwing up whole meals or just a little bit of mucous? Niña was wanting to run outside after waking in the morning and eat grass. The Pepcid helped with that.

 

The bottom line from our visit to the specialist was that she probably has a congenital gall bladder problem(possibly non-functioning), a very small liver and a widened hepatic aorta (which might be related to her slight murmur/cardiac issue). I am very glad that I had the ultrasound done even though we really had no easy explanation for the very high liver values.

 

Her only food now is Nature's Recipe canned food that is grain-free and soy-free.

 

Thanks--I will read through the thread! She's not throwing up at all, actually; just that one time at the beginning of this whole episode, about a month ago.

 

Her digestive system is functioning perfectly normally, other than the fact that she is resistant to eating!

 

With regard to the Pepcid advice, how much should I give her? I can definitely try this.

 

I'm also going to steel myself for a day or so and just go back to putting out her old food. I think I'm contributing a bit to the problem by filling her up with bread and peanut butter. Of course if it turns out we are dealing with something serious, I'll have to revisit this strategy.

[Guest alyssap99]

I'm still waiting for the results of the bile acid test, but in the meantime am trying to figure out reasons why Greta still isn't eating. It's so perplexing because she has no other signs of gastro distress, no vomiting, nothing. She's still on the usual walk schedule and has good energy outside (though she's definitely more lethargic at home). Is it the lack of food that's causing the lethargy? So hard to know. She's still very interested in bread, her favorite food in the world, but turns away most other things.

 

Anyway, I'm wondering if arthritis pain could be contributing to her lack of appetite at all. Are there any pain control options for dogs that could be taken on a daily basis? She has been on Rimadyl but it made her really restless and plus I know that wouldn't help her liver issues. I'm just thinking of asking my vet if we could put her on something for a week or so to see if her appetite improves.

 

As always, thanks for the input and advice!

[CaliforniaGreys]

It's such a frustrating problem when they won't eat, and if she does have issues with her liver, no Rimadyl. When I've been in a situation where I couldn't use an anti inflammatory I used Tramadol.

 

Her elevated liver enzymes could be the contributing factor for her lack of appetite, could also be a pain issue.

 

The bile acid test will tell the story on her liver and hopefully that can be controlled by diet.

 

When my little Misty was having problems, she stopped eating but before she stopped totally, she would only eat ice cream and then that stopped.

Someone had said to me the only reason she would only eat ice cream is because I spoiled her.

Then my vet reminded me that she's eating what she knows her stomach can handle. That made sense to me.

So maybe that's why only the bread.

 

Please let us know how the bile acid comes out

[greysmom]

I give Cash one regular (not 24 hour or complete) Pepcid tablet about an hour before breakfast. She doesn't seem to need one before dinner but I don't know if it's a holdover effect from early morning or that she just doesn't need it.

 

Good luck and keep us posted about your girl!

[CaliforniaGreys]

I give Cash one regular (not 24 hour or complete) Pepcid tablet about an hour before breakfast. She doesn't seem to need one before dinner but I don't know if it's a holdover effect from early morning or that she just doesn't need it.

 

Good luck and keep us posted about your girl!

 

Wanted to add another vote for Pepcid, it really helped Misty

[Guest alyssap99]

The vet called with Greta's test results. The bile acid results were normal which is good news. The vet still suggested doing an ultrasound to figure out why the enzyme levels were so high, but we agreed to first try antibiotics for two weeks. If there is any sort of infection, the antibiotics should clear it up and then we'll retest the liver enzymes at the end of the course of drugs.

 

I'm just hoping her appetite starts to come back. She did eat some kibble last night, so that's good news.

[CaliforniaGreys]

The vet called with Greta's test results. The bile acid results were normal which is good news. The vet still suggested doing an ultrasound to figure out why the enzyme levels were so high, but we agreed to first try antibiotics for two weeks. If there is any sort of infection, the antibiotics should clear it up and then we'll retest the liver enzymes at the end of the course of drugs.

 

I'm just hoping her appetite starts to come back. She did eat some kibble last night, so that's good news.

 

Good news on the bile acid test. What are you feeding?

[greysmom]

If she's going on antibiotics I would *definitely* give her a Pepcid before both meals. They can really upset their stomach and your girl doesn't need any help not eating!

 

BTW, I keep saying Pepcid but generic famotidine is the drug I mean. It's quite a bit less expensive and just as effective.

[Guest alyssap99]

 

Good news on the bile acid test. What are you feeding?

 

I had her on Eagle Pack food (combo of wet and dry) until she stopped eating it; before that she LOVED it. Lately she's been refusing all wet food but has been eating a bit of Fromm Duck and Sweet Potato kibble. I am getting so frustrated--she's super eager to eat any kind of treats but she just turns her nose up at regular dog food. I am happy to spoil her if there is something serious and terminal going on here, but it feels at least partially psychological to me. It would seem more clear cut if she was having any other gastro issues but she has no vomiting and no diarrhea...

 

I just hope we can break this cycle! I am so eager to get food in her that I have been bringing her little bits of things throughout the day. Now every time I walk in the room she perks up, wondering what I have for her. Sigh.

[CaliforniaGreys]

Ya know, I never thought I would be saying this but if it were one of mine, at 12yrs old and they didn't want to eat dog food, I would start cooking for them.

Some may think that's crazy and have the attitude if they get hungry enough they'll eat, but not with a senior.

I would bake/boil chicken, a clean white fish, and anything else they like.

[Guest alyssap99]

Ya know, I never thought I would be saying this but if it were one of mine, at 12yrs old and they didn't want to eat dog food, I would start cooking for them.

Some may think that's crazy and have the attitude if they get hungry enough they'll eat, but not with a senior.

I would bake/boil chicken, a clean white fish, and anything else they like.

 

I did cook some chicken for her this morning which she ate happily.

I just wish I had a definitive answer for why she has such little appetite.

[CaliforniaGreys]

Ya know, I never thought I would be saying this but if it were one of mine, at 12yrs old and they didn't want to eat dog food, I would start cooking for them.

Some may think that's crazy and have the attitude if they get hungry enough they'll eat, but not with a senior.

I would bake/boil chicken, a clean white fish, and anything else they like.

 

I did cook some chicken for her this morning which she ate happily.

I just wish I had a definitive answer for why she has such little appetite.

 

I really appreciate how you feel. If her liver enzymes are elevated, that could be it.

I guess a lot of things could be the reason, but while you're waiting to hear that reason, at least you'll have her eating.

And just stick to the foods that will be easy on her liver/kidneys etc just in case that's the issue.

 

Give her a hug from us here in the desert

[Burpdog]

Try EVO weight management (what a mislabel that is) and canned EVO. Instinct is anothr when they won't eat. Boiled ground me, rotisserre chicken.

[Guest Swifthounds]

Whatever is causing the elevated liver enzymes is likely also causing the decreased appetite - it's one of the first notable symptoms of elevated enzymes. Figuring out what is causing the elevation can be trickier - anything from an infection, to a growth on or near the organ itself, to liver failure (primary or secondary to something else).

 

I would check with the vet about famotidine (Pepcid), especially if she's going to be on antibiotics for a while - those alone almost always cause tummy upset. Also, have you asked about an appetite stimulant? Short term, that might help.

 

I find with my old or sick dogs that once they start to go off food, it snowballs from there. They start out not eating because something is upsetting them or their tummy and end up not eating because they're not eating.

 

You might also want to try slippery elm bark for the tummy troubles.

[Guest alyssap99]

Thanks once again for all the advice. I'm definitely going to try Pepcid, though my intuition is telling me she's not nauseous; she's just not hungry.

I think it's definitely a snowball-effect problem. After that weird morning when she had the shivers and vomited a month ago, she's just not had her normal appetite.

 

We had a nice long walk today and she was romping around with another dog, so I don't think she's in any pain. I'll just try to get her to eat as much as possible, see if the antibiotics make a difference, and then do the ultrasound (currently scheduled for 2/3 but hoping we can get in earlier). I'm striving to be a little more zen, though it's hard!

[Guest alyssap99]

I was able to get Greta's ultrasound appointment moved up to Tuesday. She hasn't eaten anything today other than two biscuits and she seems quieter and more lethargic. It really feels as if she's withdrawing from life. I hope we can get some answers on Tuesday.

[Guest plineback]

I thought I'd post this in case anyone has some insights. About a month ago my 12 year old Greta woke up in the morning shivering and trembling; I took her outside and she immediately threw up. The rest of the day she was really lethargic but mostly back to normal by the end of the day.

 

Since then, though, she hasn't quite bounced back. The major problem is her lack of appetite. She eats most meals but lately she's been wanting less of her regular food. She's still got an appetite for treats and bread, that kind of thing, but when I put regular food down she just kind of sniffs it and then walks away. She's lost about five pounds since early fall, which is I'm sure due to her picky eating.

 

I took her to the vet last week and upon exam everything seemed normal (no lumps or bumps, no swollen belly, normal temp, normal gum color). They did bloodwork and everything came back normal (blood counts and lyme) except for her liver enzymes. Two of the numbers were borderline high and two were significantly elevated. I wish I had written everything down but I know that one that is usually 150 was 1000 or so.

 

She was back at the vet today for the more intensive test (bile test, I think), and then they want to do an ultrasound depending on those results. I'm trying to prepare myself for the worst (i.e. cancer) and hoping we get some answers soon, but does anyone have experience with a similar situation?

 

I should add that she's not acting *sick* per se; for instance, we went on a rigorous two mile walk yesterday and she was fine, and actually running for some of the time. I don't think she's in any pain which is good. Any advice or questions would be welcome! Having an older dog is so hard!

 

I'm experiencing exactly the same thing with my 11 yr old. I'm going to talk to the vet tomorrow about step #2, the bile test, but with him not eating, I'm not sure if they can even do it. Maybe straight to ultrasound. I'll keep both mine and yours in my prayers.

[Guest alyssap99]

 

I'm experiencing exactly the same thing with my 11 yr old. I'm going to talk to the vet tomorrow about step #2, the bile test, but with him not eating, I'm not sure if they can even do it. Maybe straight to ultrasound. I'll keep both mine and yours in my prayers.

 

I'm sorry that you're dealing with this, too. It's so stressful, isn't it? It sounds like going straight to ultrasound might not be a bad idea; even with the normal bile acid test result, my vet still wanted to do an ultrasound. Is your dog eating anything at all?

 

I'll report back after we get the US results on Tuesday. I'm nervous about worst-case scenarios, but in the long run I'll be relieved if we can get some definitive answers.

[macoduck]

I thought I'd post this in case anyone has some insights. About a month ago my 12 year old Greta woke up in the morning shivering and trembling; I took her outside and she immediately threw up. The rest of the day she was really lethargic but mostly back to normal by the end of the day.

 

Since then, though, she hasn't quite bounced back. The major problem is her lack of appetite. She eats most meals but lately she's been wanting less of her regular food. She's still got an appetite for treats and bread, that kind of thing, but when I put regular food down she just kind of sniffs it and then walks away. She's lost about five pounds since early fall, which is I'm sure due to her picky eating.

 

I took her to the vet last week and upon exam everything seemed normal (no lumps or bumps, no swollen belly, normal temp, normal gum color). They did bloodwork and everything came back normal (blood counts and lyme) except for her liver enzymes. Two of the numbers were borderline high and two were significantly elevated. I wish I had written everything down but I know that one that is usually 150 was 1000 or so.

 

She was back at the vet today for the more intensive test (bile test, I think), and then they want to do an ultrasound depending on those results. I'm trying to prepare myself for the worst (i.e. cancer) and hoping we get some answers soon, but does anyone have experience with a similar situation?

 

I should add that she's not acting *sick* per se; for instance, we went on a rigorous two mile walk yesterday and she was fine, and actually running for some of the time. I don't think she's in any pain which is good. Any advice or questions would be welcome! Having an older dog is so hard!

 

I'm experiencing exactly the same thing with my 11 yr old. I'm going to talk to the vet tomorrow about step #2, the bile test, but with him not eating, I'm not sure if they can even do it. Maybe straight to ultrasound. I'll keep both mine and yours in my prayers.

The bile acid test is begun with the dog fasting, a blood draw, then the dog is fed and another blood draw is done. Niña did NOT want the dog food at the vet's office so they gave her cat food. They still had to force her to eat it. Her bile acid test results came in a few days later and were elevated but not horribly so. All along her appetite had been pretty good, just picky sometimes.

My vet gave us the option of repeating the liver test in a few weeks (didn't have to do the bile test again) or doing the ultrasound. My fellow GTers with experience, along with Dr Dodds and Dr Couto said not to rush into an ultrasound-guided biopsy. Because we had recently lost Thane to kidney cancer (with no symptoms except peeing blood his last 2 days), and because Niña's health care had been neglected for several years by her previous owner, I wanted the US done sooner rather than later.

My vet doesn't have US so we were referred to a specialty clinic several hours away. No lesions or cancers were found on the liver. She had some possible congenital abnormalities with her bile duct and gall bladder and aorta. I was already of the mindset that IF cancerous growths were found I would not do biopsies just to satisfy my curiosity. Had they found cancer, well, I might have changed my mind again.

[Guest alyssap99]

Bad, bad news. The ultrasound was today and it's cancer, likely hemangiosarcoma, all through her liver and spleen.

We're going to let her go tonight.

 

I was kind of prepared for this news, and am grateful we're facing such a clear-cut decision. But this is nonetheless devastating.