Delilah is a Chocolate Lab. She went for her annual checkup in June. At that time she was about 8 1/2 years old. At her appointment I asked to have her thyroid checked as she appeared (to me) to be drinking a lot. (**Note, she does take thyroid medication twice a day.)
What do you mean my liver levels are elevated?
I was floored when the vet called and said her thyroid was normal but her ALT (Alanine Transaminase) liver levels were slightly elevated. By slightly I mean, the range for ALT is 18 – 121) Delilah’s were right around 200.
First it’s important to know exactly what the liver does. According to Pet Education “The liver is an extremely important organ in the body. It is responsible for protein, fat, and carbohydrate metabolism; vitamin and mineral storage; digestion of food and detoxification of wastes.”
Since the liver’s job is to detoxify wastes, we started out with a double dose of antibiotics and a hard dose of Denamarin, thinking perhaps her liver was just feeling sluggish or something she’d eaten or been exposed to had made it angry. Denamarin is a combination of SAMe (Sah-me) and Milk Thistle. Milk Thistle is a natural herb used for liver problems. SAMe is a reaction between amino acids and molecules that carry energy. It is also used to treat liver problems as well as bile flows.
Delilah was on the antibiotics for three weeks and the Denamarin for a month. As the treatment wore down we had her tested again and the liver levels had once again risen slightly. Our vet recommended a change in supplements and suggested an ultrasound of Delilah’s liver.
The ultrasound showed the liver to be the right shape and size with no masses detected. We were advised the next step was a biopsy of the liver.
We stopped the Denamarin and added in Hepagen-C from THORNE Research. I also called our holistic vet who was not surprised that the levels had risen slightly after a course of antibiotics. He liked the Hepagen-C but wanted to add another liver support as well, so we started her on Canine Hepatic Support from Standard Process. He and I were in agreement that a biopsy wasn’t warranted at this stage. Our regular vet agreed we had time before the biopsy was necessary and I also discussed it with another vet in the practice and we all agreed no biopsy at this point.
Delilah has now been on the new protocol for about two months. Since she’s having her dental cleaning this morning, we had her blood work done last Friday and the vet called with her results Saturday afternoon. Her levels have gone up again. Her ALT is now at 236. Additionally her TBIL (Bilirubin) is right on the borderline of normal/high and her A/G Ratio (Albumin to Globulin Ratio) is creeping up to the high end of normal.
I won’t lie and tell you I’m not concerned because I am. But having researched this topic for a number of months, I feel like there could be outside factors contributing to the elevations. Since the liver’s job is to remove toxins, is there something Delilah is exposed to that isn’t agreeing with her liver?
My initial thoughts:
- Something she eats. This dog eats EVERYTHING. Stuff she finds in the yard, stuff she finds in the woods or the road, stuff that’s bad for her, like Chocolate.
- Coffee/Alcohol. I admit to liberally lacing my coffee with whiskey on the weekends. If I’m not diligent with my cup, she WILL help herself.
- Flea and tick spray. I use a natural Flea and tick spray. When I first showed it to my vet she mentioned some dogs have a problem with one of the oils. I googled it this weekend and the spray I’m using has 1% cinnamon oil which can be toxic to dogs.
- An environmental toxin. While I try and use natural cleaning products, there is no telling what kind of chemical buildup there could be in my home.
- Food. We feed raw and we do feed a lot of poultry, I’m wondering if it’s too much for her, so I’m working on adding some variety to their diet.
- Dental issues. When Delilah had her exam in June our vet could see that she has a broken tooth. While the vet’s office assures me the dental disease they are referring to that can be an underlying cause of dental disease is far more severe than Delilah’s broken tooth, we do know that the tooth is bothering her. For one thing our vet can see the plaque building up in that area and I have noticed her pawing at it a couple of times.
Time will tell. Delilah is having her tooth removed today. We will continue Delilah on the liver supports she is on now, and after her mouth has healed I will begin introducing some different proteins in her diet for variation and I’m thinking of having her checked to see if she might have allergies. Your Designer Dog had a post about an allergy kit that only requires a mouth swab.
Can I eat the swab? It sure sounds tasty.
I have a call in to our Holistic vet to discuss the changes with him and will consult not only with our own vet but another vet I trust in the practice. I don’t know whether I’ll agree to do the biopsy or not, for me the risk is great and I’m not sure what if anything the biopsy would show that would make me do anything differently.
Right now I’m comfortable with the choices we are making for Delilah, but our choices may change down the road. Since this is part of the Caring for Critters Round Robin, I will update this post as the need arises.
Caring for Critters
In yesterday’s Caring for Critters post, JoAnn at Sand Spring Chesapeakes wrote a moving post about her dog Norman and his experience with Osteosarcoma, I think she said it best. “Every medical decision is an individual one, it should be thought out carefully with the help of the Veterinary professionals and family members. To me there is no right or wrong answers as to what or how far someone should go for their pet. Each individual needs to make decisions that are right for them and ones that they will be able to live with.” Thank you JoAnn.
I am now ‘passing the Round Robin baton” on to our next blogger. Make sure to check out SlimDoggy tomorrow as we delve into obesity in pets.
We have our paws crossed that the tooth removal goes OK and D will be back to her usual self. Thinking of you both today. Have a terrific Tuesday.
Best wishes Molly
GAH! She’s drunk on coffee and whiskey! Naughty girl! Mom said I was drunk last week from eating too many pieces of anisette cookies and then being the worst behaved dog at Read to a Pet Night at the library. We may both need to go to AA for dogs, D.
Love and licks,
Cupcake
Im saddened to hear abaot Delilah’s levels as a fellow liver dog owner, oru Ping has had elevated levels up and down for years, I feel your concern about the mystery. I can say I doubt its the coffee whiskey as it seem shed have to helped herself to quite a lot, but it did make me smile. When my husband first heard about Pings levels he said why are you letting you have your wine, as Im fond of having my wine late on Saturday night while I watch tv with the dogs.
I choose not to do a liver biopsy for Ping when they saw no obvious tumors because I just wasn’t sure what the benefit would be and it was risky. I did try Dr. Jean Dodd’s liver diet and I think its a good one but Ping hated it. I really hope you get answers for Delilah we never found out what caused Pings levels to rise then spike then go down again. the vet said it oculd have been a long ago case of hepatitis, old age, or ingestion. I cant imagine she ate something and we didn’t know but like Delilah she does eat junk. I also cant image how she could hav ehad hepatitis.
Wow, Mom hates it when she doesn’t know why something is happening, she isn’t real patient. It would be great if the oral procedures today would solve the liver issues. One never knows because dental health really effects overall health. Paws crossed things get resolved for her.
Thinking of you hun, I can’t say anything helpful but know I am thinking of you all xx
I hope they can get her figured out soon, for your sake as well as hers.
The mysteries can drive you crazy, right? I hope you can figure something out that will bring down those levels. (And I envy your access to a holistic vet.)
I hope you figure out what’s causing the elevated liver levels and paws crossed that it’s nothing serious. Hope all goes well with the tooth extraction!
Paws crossed that all goes well on the dental work today. Sam is now 9 and I have been concerned about dental care since plaque had been building up and the idea of putting him under once a year to get his teeth cleaned not a great option. So I introduced him to elk antlers in February and they have been miraculous in keeping the plaque at bay. They are solid “tooth picks” that have worked better than anything else I’ve tried and even after 8 months, there’s still more than half of the antler left. It’s also kept him engaged, something I never thought possible since he’s kind of an ADHD dog who just can’t seem to focus on anything longer than a nano-second. I love that they come in different sizes, whole, crosscuts and burs and the fact that they don’t get all slobbery and smelly like so many other dental tools is icing on the cake.
So there are no symptoms that go with this? If you hadn’t had that other blood test you might not have known she had liver issues? If that’s true, at least it’s a good thing that she feels well anyway. Now that our two girls are seniors, we have started having the “wellness panel” blood tests done, and I’m glad we do. It’s so frustrating not to know what’s causing something, so I hope you can figure out something soon or at least get her levels down. Hope all goes well with her extraction today.
Hope it’s nothing serious! Once they hit 7 – 8 years old, and are considered seniors, all the signs and symptoms of old age begin showing.
The years just pass too quickly!
A friend of ours used to have a doberman that was a scotch dog…yes they knew alcohol is a “no no” for dogs. But they had a hard time stopping her!
If you left your glass anywhere in reach, even for a second, she’d dip her nose and help herself!!
My hubby didn’t know this, and our dogs curl their lips and make funny faces when they get even a whiff of alcohol. So for sillies he put his glass of scotch in Abby’s face, and know what she did? Dunked her silly nose and lapped at it as quickly as possible!! Haha!
Should’ve seen the shocked look on my hubby’s face!
Good luck with your tooth removal Delilah!!
WE have our PAWS CROSSED fur Delilah… We did NOT know that Cinnamon was a problem… THANKS for telling us that.
Scary stuff for poor Delilah. It seems like you’ve been thoughtful about what might be at the root of things and I hope some of those changes will bring her levels down.
Fingers crossed that you get it figured out soon! That sounds so stressful! I hope Delilah feels better soon after her dental surgery! Poor baby!
I hope Delilah’s tooth extraction went well and she’s feeling better! I totally agree with Joanne that everyone needs to make the medical decisions that is right for them. (I had to skim the post, it brought back too many hard memories.)
Hope the D-dog recovers quickly from the extraction. Interesting about the liver levels. Tests can be so frustrating, we got Schatzie’s results back today and it showed nothing was wrong. Everything was well within the “normal” limits. Think the clinic’s blood work machine was/ is messed up. So glad it wasn’t anything, but sure made me worry. We are going to wait to do the ACL surgery. Give the kids a hug from us.
Oh, poor Delilah.
I wonder if she’ll get some relief now that yard-spraying season is over. Fewer fertilizers and insecticides on your walks.
I’m sorry I didn’t get to read this post until now and saw that Delilah had her tooth removed this day. I hope all went well with the extraction and she is healing up just fine and not having any problems with the extraction. You did a great post on elevated liver enzymes and your thoughts on what could be causing the problem and being proactive to try different things. I do agree that a biopsy isn’t warranted right now, I wouldn’t do it either unless they values went way up or she was showing signs of a problem. I will send healing thoughts and prayers that they don’t rise anymore. Thank you for your kind words on my post from Monday, tears again. You are a good friend!
It sounds like you have a really good plan. I also though about some of the crazy things she has helped herself to and wondered if those may have contributed to her liver issues. I know it has been a while since she indulged, but maybe some of those things stayed in her system.