Heart Like a Dog

The Good, the Bad, and the Oh My God of living with dogs!

Elevated Liver Levels ~ Delilah’s Story

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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.)

Delilah, age 8 1/2.

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.

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

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.

Canine ACL Injury/Surgery

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Today is the first day of the Caring for Critters Round Robin.  Think of the Round Robin as a relay race, each day a ‘blogging team member’ will write a post about a specify injury or illness they have experienced.  At the end of their post, they will ‘pass the baton’ to the next blogger.  This is not your typical blog hop, as there are no linky codes,  and there aren’t a whole bunch of posts on one particular day.  Instead you will be able to read a post a day about how a fellow animal lover helped their furry loves with a particular ailment.
Please keep in mind, I am not a vet and this is not advice on how to handle an ACL injury, this is just my experience, and what worked or didn’t work for me.  Always consult your veterinarian before choosing any course of treatment.

This is the story of Sampson.

Sampson is a 92 pound Golden Labrador Retriever.  He shares a home with me, (Jodi) my husband (Hubby) and Delilah, a 8 1/2 year old Chocolate Lab.  We live down the street from a lovely wooded park with hiking trails.  Walking the trails off leash is one of Sampson’s favorite past times.

I'm Sampson and this is my story about ACL injuries.

I’m Sampson, this is my experience with a torn ACL.

On January 8, 2014 he was diagnosed with a partial Anterior Cruciate Ligament (ACL) tear.  At the time of his diagnosis he was about 9 1/2 years old.

The Treatment

Initially we treated the injury conservatively.  We limited his exercise, allowed him outside only on leash and supported him with Canine Musculoskeletal Support and Ligaplex.

After two months, our vet felt the injured knee was as stable as the uninjured knee and he was cleared for light play with Delilah.  They were running in the house in their first play session and Sampson fully tore his ACL.

When All Else Fails

With a sad heart I made an appointment with a surgeon.  He confirmed a full ACL tear and we scheduled Sampson for surgery.  Two weeks later he had the surgery.

The Outcome

On March 25, 2014 Sampson had ACL repair.  The surgeon said, “It went well.”  His meniscus was intact so he made a slight incision to release pressure and hopefully keep the meniscus from tearing.)

I'm not gonna lie, it sucked.

I’m not gonna lie, it sucked.

Sampson’s recovery was not typical of most dogs.  I kept Sampson on the original supplements, and he was also on pain medication (Gabapentin, Tramadol and Carprofen.)  His exercise was limited to five minute leash walks twice per day and eventually increased to three times per day.  His potty breaks were on leash.   I kept him quiet in a room, but spent as much time with him as possible.  A week after surgery Sampson had a Seroma, which is fluid at the surgery site. I treated this with hot compresses and after a couple of days the fluid was gone.

At the two week mark Sampson’s staples were removed and we started physical therapy twice per week.  This involved hydrotherapy (underwater treadmill) and cold laser.

You want me to do WHAT?

You want me to do WHAT?

Sampson was slow to progress.  Sampson kept turning his knee out when he walked and wasn’t putting the weight on it that he should.  The physical therapist was convinced the meniscus was an issue and thought the surgeon might need to go in and check it out.  I called my own vet who told me sometimes the larger dogs had trouble with a deep muscle called the Iliopsoas.

When Sampson had his post surgery six week check up the x-rays showed the prosthetic was doing its job.  Then the surgeon examined Sampson and diagnosed him with a sore Iliopsoas.

Sampson struggled with the Iliopsoas strain for quite some time.  I also think he was a bit depressed.  Everything he loved, sleeping on the couch, walking in the woods, running in the yard, were all taken away from him.

Around eight weeks, the physical therapist cleared him for the couch, as long as he was climbing up and not jumping, and he was also cleared for off-leash walking as long as we could keep him from running.

At about the ten week mark, I met with the surgeon and we had a heart to heart.  We were both so disappointed in Sampson’s recovery, but neither one of us was ready to proceed with more surgery.  The surgeon felt that Sampson was a dog that just needed more time.  I told him how much Sampson loved walking in the woods and he said, “Take him.”  So I did.

Our first venture into the woods.

Our first venture into the woods.

Changing tactics

We knew after the surgery that Sampson had some arthritis in his knee.  I suspected at almost 10 he also had some in his hips.  We began giving Sampson acupuncture treatments, about one every three or four weeks.  

The combination of the acupuncture plus the limited freedoms he was allowed made a world of difference. Sampson began to progress in leaps in bounds.

After three acupuncture treatments we went back to the physical therapist for our last appointment.  She was thrilled with the way Sampson was walking and acting.

Finally, five months post surgery Sampson is back to doing everything he did before, with the exception of jumping up onto our bed.  He still limps for a minute or so after he first gets up, which is perfectly normal at this phase in his recovery and he does seem to tire a bit more on our walks, but I suppose some tiredness is expected in a dog who is ten years old.  We intend to continue acupuncture treatments probably at about one per month and may consider Adequan injections to help with the arthritis.

What I’d do different

If I could do it all over again, I would have had the surgery done before a full tear.  It felt like so much time was wasted for an outcome that in a dog Sampson’s size was all but inevitable.  I would also allow him a bit more freedom in the first two weeks after the surgery.  No I wouldn’t let him climb on the couch, but I would let him have access to common areas as long as we were there to supervise.

 Tomorrow’s Round Robin Entry

Tomorrow’s Round Robin will be hosted by Linda at 2 Brown Dawgs.  Linda will be sharing Thunder’s life-threatening brush with Canine Bloat.

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