Liver Enzymes Too High To Read At Vet's

[seeh2o]

It's not Bowie, but my friend's 7 year old greyhound. Listless, skin on belly was slightly yellow, didn't want to eat. They took her to the vet today and her liver enzymes were too high to read, so they did a few extra tests and sent her to an animal ER. RBC normal for a grey, WBC slightly elevated. On-duty vet at ER is FIXATED on the dog's raw diet, but other thoughts from regular vet are lepto, salmonella, e-coli, cancer, hepatitis.

 

So I'm here asking those with lots of experience - thoughts?

Edited June 19, 2018 by seeh2o

[NeylasMom]

I'm really no expert, but my mom's dog has had liver issues so I've done some research. I'm curious what the vet thinks her raw diet would have to do with it? So many possible reasons for elevated liver values. Was this an acute onset or had she been having even vague symptoms or seemed "off" leading up to this? If the former, and given the elevated WBC count it being something like a toxin or infection makes sense. I'd test for lepto and other relevant bacteria and possibly treat prophylactically while waiting for results, and do an ultrasound to look for tumors. I'd also get her on milk thistle and Sam-E asap. There are also things like Cushing's, pancreatitis, etc to consider. But if it were me, first thing I'd be doing is switching to a vet who isn't looking at diet to the exclusion of other things at my first opportunity.

Edited June 19, 2018 by NeylasMom

[racindog]

I'm really no expert, but my mom's dog has had liver issues so I've done some research. I'm curious what the vet thinks her raw diet would have to do with it? So many possible reasons for elevated liver values. Was this an acute onset or had she been having even vague symptoms or seemed "off" leading up to this? If the former, and given the elevated WBC count it being something like a toxin or infection makes sense. I'd test for lepto and other relevant bacteria and possibly treat prophylactically while waiting for results, and do an ultrasound to look for tumors. I'd also get her on milk thistle and Sam-E asap. There are also things like Cushing's, pancreatitis, etc to consider. But if it were me, first thing I'd be doing is switching to a vet who isn't looking at diet to the exclusion of other things at my first opportunity.

Ditto this. Look for a more knowledgeable, and less opinionated, vet. ER vets don't have the best rep to begin with. And good luck. Depending on your location it can be exceedingly difficult to locate a competent and caring vet. BTW there is no way I would suddenly switch her to dry. Her system is set up-customized if you will- with the high acid etc to digest her wonderful raw diet. To suddenly switch would induce a great amount of stress on her and the last thing she needs is more stress and challenges for her digestive system. JMO. Definitely would be getting her on some milk thistle phytosome. If this illness is the result of a toxin that alone could possibly repair her liver! They even use it as an anecdote in people for some toxins.

Edited June 19, 2018 by racindog

[MP_the4pack]

My Topaz dies of liver disease. She was 5. I don't know what kind of liver disease it was.

[XTRAWLD]

It sounds like this happened suddenly (acute) so if the dog has been fed raw for some time, the diet IMO wouldn't be to blame however, could have been one bad batch meaning potentially some bacterial issue. (I'm a raw feeder - can she contact the supplier to ask if they have been informed of any other dogs have been affected?) Very easy and relatively inexpensive tests can be done to rule a lot of these in/out with blood work, urine and stool: snap tests, lepto, ecoli, pancreatitis etc. Do all those first. Unfortunately though, you just might not get an answer or a false result. But the second vet suggesting lepto et al, etc is bang on. Immediate round of antibiotics is necessary to try to get to the problem. Because of the yellowing of the skin, there has likely been severe damage to the liver/kidneys so even if the antibiotics help, the pup will be faced with long term effects and something that can potentially no longer be managed. If the dog is already lethargic and not eating, it has been my experience that SAMe or milk thistle will reduce appetite further, which is unfortunate because of the apparent benefits it has. (Every dog is different so certainly worth trying) If the dog already doesn't want to eat raw, you have nothing to lose by switching them to a renal kibble/canned wet. A U/S under sedation can be helpful however the only sure way to know what is going on is a biopsy, which of course carries its own risks. The liver is remarkable at repairing itself, but dead cells are dead cells. Antibiotics stat after all the blood is taken for testing.

Edited June 19, 2018 by XTRAWLD

[seeh2o]

Thanks for this, everyone. She had a few syymptoms leading up to this for a day or two, that's it. I haven't had a morning update yet, I'm sure she's still in the ER.

 

Last night they decided to check for Valley Fever, too, as it can raise liver enzymes. There is a lot of it in the are where she lives, it's also not unknown in Mexico where her girl raced.

[seeh2o]

Ultrasound done, nothing about the liver is normal and there is lymph node involvement. They are thinking cancer or hepatitis. Checking with their regular vet. It's sounding very very bad.

 

Sorry for the ignorant question, but how does a dog develop hepatitis? I know the various ways humans can typically get it, but not dogs.

[seeh2o]

There is a lot of it in the are where she lives, it's also not unknown in Mexico where her girl raced.

My mistake, she raced in Tucson, they have VF there, too.

[NeylasMom]

Sorry the news isn't better.

[seeh2o]

She had a bit of a rally today. Ate a bit, got up to go out and do her biz for the hospital staff. They are taking her to another location tomorrow for exploratory surgery, they don't feel like they can make an informed decision at this point. I think they want to know if it's cancer or not before they make any sort of big decision. If you can spare a prayer, please tuck her into them.

[macoduck]

Hoping for some encouraging news today.

[EllenEveBaz]

Keeping all paws crossed for this girl.

[XTRAWLD]

Sorry for the ignorant question, but how does a dog develop hepatitis? I know the various ways humans can typically get it, but not dogs.

My understanding regarding how a dog develops hepatitis is that it is the result of damage to the liver. If lepto was the cause for example, it is very likely that hepatitis has now developed. I believe the initial cause would have to be a toxin, like lepto, or Lyme Disease from a tick, etc. In humans, it is similar - a contaminated ice cube melts in a cocktail at a resort and when ingested hurts the liver. But if the cause is unknown, it's difficult to know what kind of specific hepatitis it is....to be honest, I'm still learning about it but that's my basic understanding.

 

I'm thinking about them and hope they get the answers they are seeking. It's much easier to treat or make a decision when you know what it is exactly you are dealing with. It's very unfortunate that the liver did not appear normal, but the sounds of the severity you mentioned it is not surprising. Did any other blood results come back yet to try to help determine the cause?

[seeh2o]

Thanks for that, slightly elevated WBC is all I know of at this point.

[XTRAWLD]

How is she recovering from surgery yesterday?

[MaryJane]

My understanding regarding how a dog develops hepatitis is that it is the result of damage to the liver. If lepto was the cause for example, it is very likely that hepatitis has now developed. I believe the initial cause would have to be a toxin, like lepto, or Lyme Disease from a tick, etc. In humans, it is similar - a contaminated ice cube melts in a cocktail at a resort and when ingested hurts the liver. But if the cause is unknown, it's difficult to know what kind of specific hepatitis it is....to be honest, I'm still learning about it but that's my basic understanding.

 

 

 

 

The statement is a bit confusing so, to clarify - hepatitis is a virus and it damages the liver. A toxin like poison mushrooms would be another cause of liver damage. Another cause would be bacterial type infections like Lyme and Lepto. The link provides good information,

 

https://www.petmd.com/dog/conditions/digestive/liver-disease-dogs

[seeh2o]

They did another ultrasound, the vet preferred to do an FNA rather than survey because of weight loss and hey condition. They found a highly mineralized spot in the liver, so did the FNA there. Hoping for pathology report by noon today to guide their decision.

[seeh2o]

It's liver cancer. They are taking her home to let her go. She's only 7. This is so heartbreaking. They just lost their other girl to osteo about 2 months ago.

[macoduck]

[ramonaghan]

Oh no. I'm so sorry.

[Remolacha]

that is so sad

[GreyTzu]

I'm so sorry.