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Old 01-19-2010, 03:46 PM   #1 (permalink)
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Katoba's Fire Roller "Drago's" Health

Well I've got some good news and so not so good news. First of all, Drago's annual 24-hour holter ECG read last month by Dr. Kathryn Meurs, WSU vet cardiologist Veterinary Cardiac Genetics Laboratory of the College of Veterinary Medicine), was totally normal. Unfortunately when I took him in for his annual wellness exam this week, he had some significantly elevated liver enzymes. The vet has prescribed some amoxicillin and denamarin (Denamarin® for Dogs & Cats | Nutramax Laboratories, Inc.) for his hepatitis. He has a recheck in 3 weeks to see if the liver enzymes are responding to treatment. I will keep you all posted.

Other than the elevated alkaline phosphatase and ALT, he shows no clinical signs of liver failure (physical exam normal) right now so I'm hopeful that this will be an acute episode only. Drago is doing just fine so no worries at this point. He is his usual happy and loving self. A full thyroid panel through Michigan State University has also been drawn and I will post the results real soon.

I also plan to update his eye exam (CERF) as well this coming weekend at the Portland shows. I missed the clinic in Fall 2008 because of my neck surgery and I haven't been to a show with one since then.

Take care everyone, Tracy.
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Old 01-19-2010, 10:14 PM   #2 (permalink)
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Vader is going to the health clinic at the specialty in march. Glad to hear Drago is doing well. Hope the liver values get back to normal quickly.
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Old 01-19-2010, 10:32 PM   #3 (permalink)
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Unfortunately when I took him in for his annual wellness exam this week, he had some significantly elevated liver enzymes. The vet has prescribed some amoxicillin and denamarin (Denamarin® for Dogs & Cats | Nutramax Laboratories, Inc.) for his hepatitis. He has a recheck in 3 weeks to see if the liver enzymes are responding to treatment. I will keep you all posted.

Other than the elevated alkaline phosphatase and ALT, he shows no clinical signs of liver failure (physical exam normal) right now so I'm hopeful that this will be an acute episode only. Drago is doing just fine so no worries at this point. He is his usual happy and loving self.
Take care everyone, Tracy.
I am SO GLAD you took him for bloodwork for a wellness exam.
The above you are saying (Amox and liver support supplement) was very similar to the course the normal vet took with my boy who had CAH. He looked completely healthy and normal, just had some evaluated values.
I hate to say this, but need to get right to the point: Drago may not have any outward signs on the physical exam, but I would not rely on that by any means with CAH. My male had been seen less than 2 months before he was diagnosed [with CAH] by Specialists for his heart/cardio echo check and they did see anything on the physical exams that was a cause for concern as far as his liver. Also, I had taken him in to my normal vet less than 2 months before also for a fatty lipoma to be aspirated.
My male was big, strong, looked very healthy as far as his coat and outward physical appearance was great, could and wanted to still run laps around the yard and never got tired, still wanted to go on walks, play, be goofy and happy, eat tons, etc. and yet he died within a few months, even with aggressive treatment and around the clock care. His only outward sign was drinking some more water than usual.

My boy declined very fast with CAH, way too fast, so fast. It presented just like you say Drago's did with the blood test panel. Please have him take a bile acid test. I would also do an ultrasound. I would be aggressive with this Tracy. Those two tests are not invasive and can help him live a longer and healthier life, in the case this isn't just a fluke or infection. I wouldn't mess around or wait based on what I saw happen with my personal soulmate dog.
I miss him so bad. I hope for Drago's sake his bile acid test comes back good and so does the ultrasound. Will be thinking of you guys. I know he is your special guy!
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Old 01-19-2010, 10:41 PM   #4 (permalink)
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Quote:
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I am SO GLAD you took him for bloodwork for a wellness exam.
The above you are saying (Amox and liver support supplement) was very similar to the course the normal vet took with my boy who had CAH. He looked completely healthy and normal, just had some evaluated values.
I hate to say this, but need to get right to the point: Drago may not have any outward signs on the physical exam, but I would not rely on that by any means with CAH. My male had been seen less than 2 months before he was diagnosed [with CAH] by Specialists for his heart/cardio echo check and they did see anything on the physical exams that was a cause for concern as far as his liver.
My male was big, strong, looked very healthy as far as his coat and outward physical appearance was great, could and wanted to still run laps around the yard and never got tired, still wanted to go on walks, play, be goofy and happy, eat tons, etc. and yet he died within a few months, even with aggressive treatment. His only outward sign was drinking some more water than usual.

My boy declined very fast with CAH, way too fast, so fast. It presented just like you say Drago's did with the blood test value. Please have him take a bile acid test. I would also do an ultrasound. I would be aggressive with this Tracy. Those tests are not evasive and can help him live a longer and healthier life, in the case this isn't just a fluke or infection. I wouldn't mess around or wait based on what I saw happen with my personal soulmate dog.
I miss him so bad. I hope for Drago's sake his bile acid test comes back good and so does the ultrasound. Will be thinking of you guys. I know he is your special guy!
I agree. Drago has a recheck scheduled in 3 weeks which will include an ultrasound and bile acid testing if the lab values do not change.

Thanks.
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Old 01-19-2010, 10:55 PM   #5 (permalink)
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I agree. Drago has a recheck scheduled in 3 weeks which will include an ultrasound and bile acid testing if the lab values do not change.

Thanks.
That's a good plan, and a pretty standard way to approach things. Cause for concern? Yes. Time to panic? Not yet, and maybe never.
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Old 01-19-2010, 11:03 PM   #6 (permalink)
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That's a good plan, and a pretty standard way to approach things. Cause for concern? Yes. Time to panic? Not yet, and maybe never.
You are on the one's who told me to start getting more serious when my vet did that course of action. And I followed your advice. And now I know the why's of your own recommendation, as I sit here without him and a huge hole in my heart.
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Old 01-19-2010, 11:07 PM   #7 (permalink)
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I said what I had to say and this is way too personal to me obviously as I am still suffering very badly from my loss, so I am out. Best of luck to you and Drago, I have followed your adventures for a long time and will also follow this one too.
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Old 01-19-2010, 11:14 PM   #8 (permalink)
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You are on the one's who told me to start getting more serious when my vet did that course of action. And I followed your advice. And now I know the why's of your own recommendation, as I sit here without him and a huge hole in my heart.
Cash was symptomatic-he was drinking a lot of water. That's such a common symptom of liver problems that combined with elevated liver values, there's cause to rush through the testing process.

There's not quite that much urgency when the dog is showing no symptoms whatsoever. It's pretty standard to give it 2-3 weeks to see what happens on re-check before moving onto bile acid tests, etc.

In a lot of cases, the liver enzymes will be normal on re-check, with or without putting the dog on antibiotics. Could be the dog was exposed to some toxin, causing a short term spike in liver enzymes, which resolves itself. Could be some bacterial issue, which the abx will take care of.

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Old 01-19-2010, 11:46 PM   #9 (permalink)
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Hey.. I really appreciate the concern and support for Drago and I here at DT. His values are elevated but not real high at this point. So sorry to hear about your boy dobesanddragons; hopefully we will not be going down that road as well.

Tracy.
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Old 01-21-2010, 09:24 PM   #10 (permalink)
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Thyroid results

Well the vet called tonight and we just got the MSU thyroid results. Everything is normal except the free T3 and T3 which are reduced. The interpretation is that the thyroid gland is fine but the reduced T3 levels indicate some other illness process going on however which would connect with his elevated liver function tests.

More when I hear... Tracy
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Old 02-09-2010, 02:04 PM   #11 (permalink)
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2/9/10

Well the repeat of Drago's liver enzymes today remained unchanged from 3 weeks ago. A bile acid baseline test is being submitted this morning and the results will be in tomorrow. Next steps are most likely abdominal ultrasound and x-rays.

Drago has lost 2.5 more pounds and is now down 7 pounds off of his normal weight of 87 pounds. He still remains upbeat and playful with Mariah and does not seem to be in any significant distress at this point.

I will keep you all posted on his progress.

Tracy.
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Old 02-09-2010, 02:13 PM   #12 (permalink)
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I'm glad he's still himself. I hope you get this all sorted out soon.
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Old 02-09-2010, 11:37 PM   #13 (permalink)
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Old 02-09-2010, 11:49 PM   #14 (permalink)
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With elevated ALT you might want to think about doing a bile acids test to rule out liver shunts.
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Old 02-09-2010, 11:50 PM   #15 (permalink)
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2/9/10

Well the repeat of Drago's liver enzymes today remained unchanged from 3 weeks ago. A bile acid baseline test is being submitted this morning and the results will be in tomorrow. Next steps are most likely abdominal ultrasound and x-rays.

Drago has lost 2.5 more pounds and is now down 7 pounds off of his normal weight of 87 pounds. He still remains upbeat and playful with Mariah and does not seem to be in any significant distress at this point.

I will keep you all posted on his progress.

Tracy.
Oops just noticed after I posted the above that you were already in the process of doing a bile acids test. Good luck.
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Old 02-10-2010, 02:59 PM   #16 (permalink)
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Yes I should get the baseline bile acid results later today and then will go from there. I'm anticipating an abdominal ultrasound and x-rays at this point as well masses, foreign bodies (although Drago is not a dog to eat things), etc. Liver biopsy is also still on the table of diagnostic screening if answers to his illness do not become readily apparent.

I am very concerned that this is not going to be a simple acute injury and am bracing for a more chronic serious illness to be discovered since Drago is well vaccinated for potential viral causes and on heartworm medication. Thus, parasites are eliminated from the equation at this point as well.

So when I know more I'll let everyone know. A special thank you to those who have stopped by and left words of encouragement for us. More support is always appreciated and welcome.

Thank you, Tracy.
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Old 02-11-2010, 08:57 AM   #17 (permalink)
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Hoping you find what is wrong with Drago. Keeping you both in my thoughts.
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Old 02-11-2010, 09:13 AM   #18 (permalink)
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Sending everything postive for Drago

Sending special prayers and positive vibes your way. Thanks for keeping us updated.

Quote:
Originally Posted by dragonman View Post
Yes I should get the baseline bile acid results later today and then will go from there. I'm anticipating an abdominal ultrasound and x-rays at this point as well masses, foreign bodies (although Drago is not a dog to eat things), etc. Liver biopsy is also still on the table of diagnostic screening if answers to his illness do not become readily apparent.

I am very concerned that this is not going to be a simple acute injury and am bracing for a more chronic serious illness to be discovered since Drago is well vaccinated for potential viral causes and on heartworm medication. Thus, parasites are eliminated from the equation at this point as well.

So when I know more I'll let everyone know. A special thank you to those who have stopped by and left words of encouragement for us. More support is always appreciated and welcome.

Thank you, Tracy.
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Old 02-11-2010, 01:41 PM   #19 (permalink)
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Exclamation Fasting Bile Acid elevated! :(

Well I just heard from the vet and Drago's fasting bile acid test is elevated two times normal without even a food challenge. This is not good news. In any event we are scheduled for a abdominal ultrasound though Washington State University's Veterinary Teaching Hospital on Tuesday, February 16th. This will be used to visualize a liver shunt. If there is no shunt seen then a ultrasound guided biopsy will be performed to determine if what type of liver disease is present, lost likely chronic active hepatitis (CAH) which is not good.

Drago does not have the classic signs of a liver shunt which include small statue, poor muscle development, behavioral changes (circling, disorientation, staring into space, etc) so I doubt that this is his problem. CAH is more likely in his case given his breed and age of onset. Anyway I will let you know what we find out next week.

I am saddened beyond belief right now. Drago is a wonderful doberman and great role model and ambassador to the breed.

Tracy.
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Old 02-11-2010, 01:59 PM   #20 (permalink)
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So sorry to read this. Sending good vibes your way.
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Old 02-11-2010, 02:40 PM   #21 (permalink)
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Sorry to hear this, Tracy. Here's hoping there's some other explanation other than CAH.

That being said, Razzle was diagnosed with CAH in Oct. 2008. She's doing great, still completely asymptomatic. She had her quarterly checkup just a couple of weeks ago-the docs are thrilled with how well she's doing.

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Old 02-11-2010, 02:45 PM   #22 (permalink)
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sorry to hear this news. Hope the right meds buy him a good quality of life for some time to come.
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Old 02-11-2010, 02:51 PM   #23 (permalink)
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Old 02-11-2010, 02:59 PM   #24 (permalink)
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Quote:
Originally Posted by Murreydobe View Post
Sorry to hear this, Tracy. Here's hoping there's some other explanation other than CAH.

That being said, Razzle was diagnosed with CAH in Oct. 2008. She's doing great, still completely asymptomatic.
Thanks Cheryl, this is encouraging what is Razzle taking? I have Drago on the Denamarin (SAMe and Milk thistle) right now.

Thanks, Tracy
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Old 02-11-2010, 03:04 PM   #25 (permalink)
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Tracy....

A great big hug to you and Drago!!
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