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Discussion Starter · #1 ·
Well I'm extremely upset. Just got the call from the vet with the results of Chevy's blood test. She has lost about 20lbs recently and we did all kinds of parasite tests and stuff then I just got her blood panel back. Here are the results (normal range listed first):

bilirubin: should be <.8 hers is 1.4

Alkaline Phosphatase should be <140, hers is 1300

alt should be <110, hers is 1200

ast should be <45, hers is 255

ggt should be <13, hers is 50

Her cholesterol and triglycerides are good (actually the triglycerides are at the low end of normal). Her red blood cells are in a normal range but are larger than normal. (which could mean she was bleeding somewhere).
 

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So sorry to read this. Are you doing an ultrasound or biopsy? Hopefully your vet started her on a good liver regimen that will help!
 

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Hugs and doberkisses to Chevy from me and Mabel! I'm so happy you finally figured out what was wrong with her, and now she can be treated appropriately.
There are several members here who have and are dealing with liver issues that I'm sure will show up and be able to help and offer their advice from experience.
Good Luck!
 

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Sorry to hear this!

Probably the scariest one of those results is bilirubin. Elevated bilirubin causes jaundice. I've always been told by the specialists I've used for my liver dogs (I've had two) that when this value is elevated, liver disease is pretty advanced, you're probably close to the end stages. I don't mean to scare you, but that was definitely true with my first liver dog-he lived about a month after his bilirubin started to rise.


Are you going to do any other kind of diagnostics? What kind of treatment plan does your doc suggest?
 

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so sorry.

but at least you now know what is wrong.

i remember Australdi mentioned the possibility of a liver issue.

i hope it can be managed.

Hugz to Chevy.
 

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I know there are some supplements you can try. Vetri-Science makes one specifically for the liver and Doc's old vet would sometimes prescribe Milk Thistle (not for him but for other patients with liver issues)... though I can't remember the dose. The liver is a pretty incredible organ. I know it is very upsetting though and I am so sorry to hear the news. Sending good vibes and ease.
 

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Discussion Starter · #7 ·
The vet wants to send her to a specialist that can do a biopsy with an ultrasound guided needle because my vet would have to cut her open to biopsy. With her weight issue and age he doesnt believe she would be able to heal from a surgery incision. That also means they would probably not be able to do surgery to fix whatever is wrong.

I just talked to the vet on the phone today and he didnt say anything about a liver regimen. Any suggestions on that and what I should include? The vet is supposed to get me a price quote from the specialist and call me back monday. I can ask him more about it then.
 

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I am so sorry to hear this. I know there are members who have been through this and I hope they have some help/suggestions for you and your best friend.
 

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Sea Hag
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The vet wants to send her to a specialist that can do a biopsy with an ultrasound guided needle because my vet would have to cut her open to biopsy. With her weight issue and age he doesnt believe she would be able to heal from a surgery incision. That also means they would probably not be able to do surgery to fix whatever is wrong.

I just talked to the vet on the phone today and he didnt say anything about a liver regimen. Any suggestions on that and what I should include? The vet is supposed to get me a price quote from the specialist and call me back monday. I can ask him more about it then.
Unless she has a tumour, it would be unlikely that surgery would fix whatever is wrong. Some liver disease is bacterial in origin-sometimes treatment will cure that.

Sometimes liver disease is genetic-there is no cure for that kind, and unfortunately this kind of liver disease (chronic active hepatitis) is very common in this breed. Most treatment for liver disease surrounds slowing down the rate of inflammation in the liver. You can slow down the progression of the disease, but you can't stop it.

Has she had a dna test for vWD? The reason I ask is vWD and liver disease are a really bad combination in terms of blood clotting ability. Liver biopsies are high risk at the best of times, that risk is even higher with a vWD affected dog. I did a liver biopsy once on a vWD affected dog and would never think about doing it again.

I'd order some Denamarin online. Or you can order Marin online and pick up Sam-E at a health food store or drugstore. Marin and SamE is the same as Denamarin. Both are good for liver support.

I have a dog with CAH right now. Besides Marin and SamE, she takes Ursodiol (prescription), Prednisone (prescription) Flagyl (prescription), fish oil.

If a dog with CAH is storing copper, then they can be put on drugs to deal with that. But these drugs are very, very expensive and I sure wouldn't give them until/unless biopsy results indicated the dog needed them. The only way to find out if the dog is storing copper is via biopsy.
 

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Echoing everyone else thoughts....I'm really sorry you're having to deal with this :(

As Murrydobe said, it's now all about support and quality of life.

The measurement you've given for billirubin is different to the way ours is measured....ie: Zil's was 16 when it should have been 4. That can be brought back down using Ursodiol (bile salts) which although expensive, seem to work pretty quickly. Also by starting a liver support diet, and prednisone/prednisolone. I only used the ursodiol when Zil's billirubin count was up (and dropped it from the regime when the count was in normal range)...he managed about 11 months from diagnosis....but it was a rollercoaster of an epic battle when he was in the acute stages and the progression of this disease seems to be quite an individual thing...although long term prognosis isn't good. :( The exception seems to be if it's caught and controlled early...

If your dog is up to, it a biopsy really is the only way to conclusively know what's going on...but as Murraydobe said...it's a very high risk procedure, complicated by clotting and healing issues due to the compromised liver function. Be guided by the specialist's recommendation but make sure they advise you of the risks and a carefully considered opinion as to whether it is appropriate for your dog's individual case.

Regular blood tests are going to be a way of life for some time until you see a stabilised pattern. Also request fasting bile acid and protein screens to the full blood analysis ...it will give you some valuable fine tuning information.

In addition to the denmarin, Ursodiol and prednisolone, ranitidine (to prevent ulcers forming) and in later stages spironolactone if ascites forms, a liver support diet is going to be your main form of 'control'.
This involves switching to forms of protein that are easily digested and produce less ammonia as a byproduct of digestion. ie: no red meats. small amounts of chicken, turkey, and fish become the major sources of protein, in addition to cottage cheese and tofu. (I also tried amaranth with Zil, but he didn't appear to want to eat it). The inclusion of oatmeal is also extremely helpful as it absorbs excess ammonia and regulates motility/absorbtion rates through the intestine (which is also critical for avoiding excess ammonia). High ammonia levels can lead to HE (Hepatic encephalopaty....head tremors) and neurological complications.

The goal through medication and diet, is to simulate the function of the liver as a balancing/regulating organ. It's not easy to do and takes some time to find the right balance for each individual...which can also change on a daily basis initially...but hang in there and keep working on it, as it can be achieved to a certain extent.

As Chevy is already over 8 years old, this might not be the typical genetic form of CAH...or it might be a copper storage form...so the benefits of a biopsy could outweigh the risks...as you might have a chance of beating the odds. However I'm not a vet...so the specialist is really the only one who can advise you on this. Hopefully they will do x-rays and ultrasounds first to check for tumours, shunts and surface scarring of the liver.

I wouldn't wait until the specialist appointment to begin the ursodiol, prednisolone and denmarin...or the change in diet either. Get started on them straight away...especially the ursodiol.

Good luck, and we're all here as a moral support team. unfortunately this is an emotional rollercoaster of a condition and there's no easy or simple ways through it. :(
There are other little tweeks (herbal and diet) that can be tried as specific issues crop up and once you have a better picture of what the situation is from the specialist.
please keep us informed how chevy's going as we'll be praying for her.
 

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So sorry to hear this. I'm glad you are getting a referral to a specialist.
 

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So sorry. have a liver dieses dog too. Its hard but once of a good liver regimine its becomes easier. Blades rubin has been as high as 2.9, he was severlly jaundice. This was two years ago, and still has quality of life just has to be closely moniterd
 

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So sorry, sending good vibes for Chevy.
 

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Denamarin brought my Vizslas's ALT down from 1500 to 150 even on pred. She did NOT have liver disease so it may not be as helpful in your case, but I swear by it!
 

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Discussion Starter · #16 ·
I'm definitely geting some of the danamarin
 

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How is Chevy going? Has she been to the specialist yet?
I would place the Ursodiol, the switch to a white meat/cottage cheese/oatmeal diet and prednisolone as a prority over the denmarin. The denmarin is a support and repair supplement...but the other two are specific treatments for the acute issues and need to happen straight away.
 

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Discussion Starter · #18 ·
Yeah, its copper storage, was just informed that it was, havent had a chance to pick op her meds from the vet, will be doing that after work.
 
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Im really sorry to read this. Diesel and I are sending and the best cyber mojo we can muster up.

Dober hugs and kisses to you both.
 
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Very sorry to hear of her diagnosis. :(
 
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