Liver Disease

[Miranda]

Chelsea is showing some symptoms of liver shunt and many dogs are first diagnosed at around two years of age. It's definitely something your vet should be considering especially as the disease is known to occur in bichons. I hope it's something less serious, but I don't think liver shunt can be ruled out until there's been a much more thorough investigation.

[SparkyTansy]

I hope that Chelsea gets better soon.

[skwo2]

Just back from the vet, and they did a blood test on Chelsea, her ALT is back up again, so does TBIL. ALT was 750 when she was discharged from hospital, now, ALT is 23XX

The vet suggested to do a biopsy which involves surgery, to get a liver sample to examine.

When Chelsea was in hospital, they treated her with antibiotics and she was on fluid. She was given some cooked chicken meat. The ALT came down.

I took Chelsea home on Sat, I gave her cooked chicken meat, and she was given antibiotics. The ALT is back up again.

Will it be a sign of liver shunt? Chelsea was healthy and active before this.

The vet said if it is liver shunt, it is unlikely to see ALT rising so high.

It is a vet clinic, and there are several vets in there, one of them has many years of experience and is quite a well known vet around this area.

[Miranda]

skwo2 you asked for suggestions on what might be wrong with Chelsea and I immediately thought of pancreatitis or liver shunt, although I didn't mention liver shunt to begin with because I didn't want to alarm you. But I really don't know what's wrong with her and all I (and other DOLers) can do is guess because we're not vets we're just dog breeders and owners. You could try sending rappie a PM, she's a vet and may be able to help you

[skwo2]

Thanks very much, Miranda. Will PM rappie

At the moment, I am very worried, just reading articles on internet about liver disease. Really want to find out an answer.

[WoofnHoof]

I'd be getting to a specialist too if I were you, like I said Geraldine Hunt is the best of the best and she will know if it's a shunt or not - they don't call her Dr Shunt for nothing! Can you get your vet to fax the blood results to her? An intrahepatic shunt (inside the liver) can be visualised on ultrasound but maybe not on a smaller dog (mine's a husky) although everything I read suggested smaller dogs tend to get the extrahepatic (outside the liver) ones as a general rule. Seizures are a symptom of liver shunt, my boy fell into a coma and almost died and when he woke up he was having seizures and he couldn't see or hear for a day or so afterwards, it's a very serious situation that you don't want to get any worse.

I would be concerned about the vet putting her under anaesthetic if there is any chance of a shunt because if there is the toxins produced as a result of the metabolisation of the anaesthetic can be extremely harmful - I believe my boy's coma was due to sedation he had earlier in the day for an x-ray (trying to identify why he was sick at that stage).

If I were you I would be ringing Dr Hunt and just ask whether she thinks that a shunt is a strong possibility before you allow your dog to go under anaesthetic.

[~Archie~]

Maybe talk to your vet about a product called Denosyl, it helps to support the liver function and detoxifies the liver. If there is a shunt present, it isnt going to change the shunt, but it will help the liver to function and make your dog feel better.

We have used it a few times in the vet practice I worked at and it is really good.

[skwo2]

tkay - have you got the contact details of Geraldine Hunt. Thanks.

The vet has asked the ultrasound specialist again yesterday, to double check what did he see from the ultrasound last week, will he think of any other possible "cause", and the speicalist said the same answer as before, basically "diffuse hepatopathy - consider toxic insult versus immune - mediated choloangiohepatitis vs suppurative cholangiohepatitis"

The seizure I mentioned before, and after asking the vet, she thinks it may be a faint. I told her what I saw, Chelsea was vomitting, then fell onto the floor, 4 legs were moving involuntary for about 4-5 seconds, then she stood up again, look normal, so I went down to grab the phone to call the vet, and then next thing I knew, was she had also came downstairs, jumped onto the sofa and lie down, tired, but not comma or anything. Vet said a faint can sometimes cause involuntary movements, the only way to tell if she was having a faint or seizure is how Chelsea look after the incident, conscious most likely to be a faint, unconscious most likely to be seizure.

I have agreed that Chelsea to have a biopsy done (possibly today, if her condition allows). She looked well and normal yesterday, if anyone just came to see her for the first time, couldn't tell that she has been sick. I guess I will just have to trust that Chelsea is in good hands

Edited May 6, 2009 by skwo2

[WoofnHoof]

Hi skw02 I just pmed you the contact details, hope you get some answers today.

When my boy was having seizures he just looked like he had something stuck in his teeth at first, mainly an uncontrollable spasm but he didn't lose conciousness. Whether that was a side effect of the coma or the toxins I don't know, it was only brief though.

[skwo2]

Chelsea's biopsy result has came back. The diagnosis is "chronic suppurative cholangiohepatitis".

The vet said it could be some bacteria from the intestine travelling thru the bile duct to the liver. The treatment will be antibiotics.

I search through the internet, it is an illness that is more common in cats and rare in dogs.

[poodlefan]

I'm glad you've got a diagnosis now Skwo and I'm even gladder it wasn't a shunt.

Did the vet indicate a prognosis for recovery from this?

[skwo2]

The vet suggested Ursodeoxycholic acid or S-Adenosylmethionine for treatment, in addition to antibiotics Clavulox. This treatment will be about 4 - 6 weeks. S-Adenosylmethionine seems to be a milder drug, and has less chance of side effect, it is kind of like "holistic" medication. However, both the vet and the specialist said Ursodeoxycholic acid is more effective, so I decided Ursodeoxycholic acid.

Chelsea needs to be on Hills l/d food for about 4 - 6 weeks or longer.

The vet said the bacteria that infect the liver is a broad spectrum of bacteria (from the biopsy report), so there is no need to do a culture. It could be bacteria that is normally present in the gut gets into the liver via bile duct. Those bacteria is not harmful when inside the gut, but once it reaches outside of the gut, it infects the liver.

If Chelsea doesn't vomit or in good condition, she may be discharged tomorrow or Thursday

If anyone has more knowledge of the treatement, etc, please let me know. Is milk thistle recommended?

[WoofnHoof]

Good to hear it's treatable and doesn't require surgery! I don't know anything about this condition but I'm crossing fingers that your girl recovers quickly