our dog (well really my mom's dog) has elevated liver enzymes. they tested once a few weeks ago, then put her on some medicine that was supposed to lower it, tested again yesterday and the enzyme levels are still high (possibly higher).

she will be put on a prescrip diet, and the vet suggested looking elsewhere for treatment (he is a small town, small-minded man and doesn't have the facilities nor the mental capacity to treat problems other than simple mite infestations and respiratory infections...a very long and complicated story that i'm not going into just yet - i don't like him).

he suggested the vet school, and my mom is setting up the referral appt asap. she wants to find out anything and everything about liver disorders in dogs and possibly treatments. there's no real cure other than a liver transplant and that's very very very unlikely.

bailey is a 9 year old (10 on april 1st) golden retriever. when she was a tiny little puppy, she got into some slug poison in the backyard and almost died. they pumped her stomach then filled her back up with charcoal and she was sick for a while, but recovered fully. i mention this b/c that could have left her w/ some minor liver damage. this type of liver disorder is common in old dogs, but she isn't that old yet. she has loads of small lipomas (small fatty benign tumors), her belly is rock hard from fluid retention, and her bowel habits have changed recently. she normal wolfs down her food and won't stop for anything, but now she demands to go outside to pee/poop in the middle of her dinner. she's also been throwing up occasionally. all of these the vet says are symptoms.

the point of all of this i guess is to get suggestions as to where to go for treatment (any local vets that specialize in liver disorders in dogs other than at the vet school?), any alternative treatments (mom read something about milk thistle supplements), or any other suggestions. also, if you've been through this w/ your dog i welcome those stories too. we're just trying to find out everything there is to know about this.




[Edited on February 6, 2007 at 2:05 PM. Reason : ]

2/6/2007 1:53:26 PM

All I can give you is the name of our vet - if he can't help with this, I'm sure he'll be more than able to send you to someone who can, based on our one experience with having to deal with a specialist, and his help in setting everything up.

Dr. Ansede, at Ansede Animal Hospital - 919.661.1515
The website, even though it's pretty basic: http://www.docansede.com/

2/6/2007 3:06:48 PM

i definately second your vet's recommendation to go to the vet school. if she hasnt responsed to medicine and diet changes then there is def. something going on that needs to be checked out and the vet school is highly equipped to deal with specialized cases. I do know that it sometimes takes a long time to get an appointment over there, so she may want to try Carolina Veterinary Specialists or the Veterinary Speciality Hospital both of which are more equipped then just a regular practice.

http://www.vshcarolinas.com/
http://www.carolinavet.com/


good luck and i hope everything is ok!

[Edited on February 6, 2007 at 3:22 PM. Reason : .]

2/6/2007 3:10:09 PM

The vet school may be a good bet, but your dog is definately getting older. Not saying it isnt worth treating but goldens rarely live past 12, and 10 is considered the average age prior to death.

However if your dog is healthy otherwise and doing alright, go for what you can.

2/6/2007 3:29:24 PM

she's old, but she is nowhere near the dying type of old. she's not miserable and doesn't seem to be in any pain. this is relatively sudden. as of right now, this is not a situation that involves even considering euthanasia.

she is otherwise healthy and is definitely within the treatable range.

btw, i've heard of many goldens living to 13-15. i'm not saying it's likely or that bailey will be around that long, but that it is possible. she's only 9.

[Edited on February 6, 2007 at 3:44 PM. Reason : ]

2/6/2007 3:43:17 PM

^ hun...i've seen 15 year old goldens before....so she could have a good number of years left!

2/6/2007 3:53:44 PM

Goldens are incredible dogs, I love working with them. Good luck with your issues, hopefull things turn out alright!

2/6/2007 4:00:02 PM

No experience with this type of issue, but I'm sending positive vibes your way.

Are liver problems associated with the breed at all?

2/6/2007 4:50:40 PM

i haven't heard of any...but i'm no expert.

2/6/2007 4:51:21 PM

honestly if they can't help you at the vet school then your proably out of luck. Its the best and most specialized place around

2/6/2007 6:33:17 PM

i don't think the vet school can't help her. we don't even have an appointment yet. i'm just looking for ALL options...like the vet suggestions from ambrosia and skyfallen. thanks

2/6/2007 8:59:19 PM

if you cant take her to the vet school then def. go to another vet, take all her lab results and history with you because it never hurts to get another opinion, someone new to the case that might have new ideas.

always keep an eye on her attitude, eating habits and such, any change in those can indicate when she may be ready to go, its sad but true

poor liver condition will also make them look pale and maybe even yellow if they get really bad off, repeat bloodwork, radiographs, and ultrasound seems like a good idea to me, it sounds like you have put money in this already but the more aggressive you are to find the problem and treat it the more of a chance she has

2/7/2007 6:42:20 PM

I'd agree to the vet school suggestions. Those people know their stuff, very advanced knowledge in vet medicine, and the grad kids are cool because they are still in the "I LOVE ANIMALS!" phase.

2/7/2007 6:45:00 PM

okay, not to sound rude, but some of yall can't read.

we are going to the vet school. there is no question there.

i wanted to know:
1. are there any local vets that [only] specialize in liver problems (besides the vet school)?
2. does anyone know of any alternative/herbal/holistic treatments also (besides the vet school)?

so, once again just to make it clear. we are going to the vet school. we have an appointment at the vet school (as of a couple of hours ago). we are going to the vet school.

i really do appreciate your willingness to help though.

[Edited on February 7, 2007 at 8:23 PM. Reason : ]

2/7/2007 8:21:30 PM

^ well...if you're interested in herbal/holistic....i know bowman animal hospital is really into that thing, but im not sure if anything specific to the liver...

2/7/2007 8:39:06 PM

My childhood golden went through something very similar when her pancreas was failing. I have pictures so similiar, i almost cried when i saw yours, best of luck to your golden.

2/7/2007 9:24:11 PM

how is the dog doing??

2/23/2007 9:06:37 PM

^I 2nd that request! No fair gettin sick on my birthday!

2/24/2007 3:23:39 AM

since Bailey was put on Hill's l/d, she has done a little better from what we can tell. she seems like she feels a lot better (is playing w/ her toys like a puppy again), doesn't vomit much anymore, and can hold her pee/poop until after dinner. mom has changed her food schedule from one large meal once a day to 3 smaller meals at breakfast, lunch, and dinner. this i think has made as much a difference as the food itself. her breath however still smells like death.

our appt at the vet school is this coming wednesday, the 28th, at 11:30am. they're going to do a biopsy and inspect the liver and surrounding organs just to check. we don't know where it'll go from there (it depends on the diagnosis of course), but we're going to do everything possible for her as long as she is maintaining her quality of life.

we're at the beach right now and she's outside wrestling w/ my dog (her best friend). she seems a lot happier since the food...although she did throw up once last night.

2/24/2007 6:43:15 PM

Glad she is feeling better And I hope the appt this week goes good. Keep us posted on your sweet doggie

2/24/2007 10:11:35 PM

will do

thank you for caring

2/26/2007 8:56:11 AM

well, we only know a tiny bit more and hopefully will know more than that tomorrow afternoon.

they did an ultrasound and found a small nodule on one side of the liver, and a large mass on the other side. they aspirated both (results tomorrow). the surgeons will check the ultrasound tomorrow to figure out how to remove the mass. her chest xray was clear.

best case scenario: nodule is just a hard spot common to older dogs (most likely case), and the mass is just a benign tumor

worst case scenario: both results of nodule and mass come back as the same thing - aggressive and malignant...meaning it's cancer and it's spread through the liver.

they are doing a bile acid test tomorrow morning to determine her true liver function. whatever the results are, we are going to do everything possible to maintain her quality of life.

most likely they will be resecting the mass asap. they might do a ct scan to determine if the mass is confined to one lobe or more.

i'll keep you posted.

poor bailey

2/28/2007 8:24:27 PM

I will keep my fingers crossed for the best for ya And plz keep us posted

2/28/2007 8:42:56 PM

the mass is "mild to moderate hepatocellular dysplasia"...which just means a growth in the liver (no shit). the nodule is a mild version of the same thing.

they said it's either hepatocellular adenoma (benign tumor) or carcinoma (malignant cancer). again, no shit.

her bile acid test was normal. her cholesterol is high in addition to her liver enzymes. the numbers are as follows (with normal values in ()):
chol--- 331 (110-314) <<indicates thyroid disorder or liver disease
ALP--- 215 (20-200) <<indicates liver disease or bile flow blockage
GGT--- 59 (1.2)
ALT--- 241 (10-84) <<indicates liver disease
amylase--- 1705 (200-1290) <<<indicates pancreatic disease (which can inflame the liver and cause elevated liver enzymes)

so, we're really not much further than we were yesterday. she will be going in for a biopsy of both the mass and nodule, with the hope that they can just cut it out completely.

we're waiting on (1) the thyroid panel, (2) surgical consult, (3) urine culture

[Edited on March 1, 2007 at 2:25 PM. Reason : ]

3/1/2007 2:11:35 PM

Those first two numbers are too far away from the norms but those last three...DAMN! I hope they can just remove them as well. Good luck on the three things you are waiting on

3/2/2007 7:13:47 AM

just out of curiousity, how much is all this going to cost? is the vet school cheaper than VSH?

3/2/2007 8:42:31 AM

just a doctor's visit is $85 and that's if they don't do anything except talk to you.

we paid $600 for the bloodwork, bile acid test, ultrasound, aspiration, etc.

the surgery will be another $1000-1500 est.

what is vsh?


[Edited on March 2, 2007 at 9:37 AM. Reason : ]

3/2/2007 9:36:16 AM

any update?

3/5/2007 2:59:51 PM

mom JUST called.

the mass is very near the vena cava, so they will do a ct scan to see if it's even removable. if so, then she'll go directly into surgery. if it's removable, then they give her 3-4 years. if not, there are a couple more qualifiers: if the mass is cancerous and the nodule is just regen tissue, then she has a 50/50 shot...if the mass is cancerous and the nodule is a metastasis of the mass, then it's not good at all.

so really we don't know a whole lot more. i don't know when the ct appointment is.

3/5/2007 3:43:03 PM

Aww...that's terrible!

She's not in pain, is she?

3/5/2007 5:32:58 PM

good luck with the ct scan n keep us posted

3/5/2007 10:10:07 PM

My wife is a Pathology resident at the Vet School so I think there is a chance that she is involved in the reading of your dog's biopsy. I hope everything works out, the dog clearly means the world to your family to seek this level of medical attention. I wish you nothing but the best.

OH, and synapse asked if the vet school is cheaper than VSH... Generally, the vet school is going to be the most expensive place you can go. This is because every aspect of medical service has board certified specialists who command much more than most hospitals would employee. You get the best care possible but you definitely pay the premium. In general, the vet school is a last resort or extreme case. People fly horses and other animals in from around the country to be seen for certain things.

3/5/2007 11:43:43 PM

she doesn't seem like she's in any/much pain. when the vet was really sqeezing on her stomach around her liver area, she kinda tensed up a little, but that was it.

when we took bailey in the first day, there was a dog somebody had brought from germany.

money is not an issue in terms of bailey's treatment. we just want what is best for her.

3/6/2007 8:15:51 AM

Talked to my wife tonight about this. She is going to keep an eye out for Bailey's case because the liver is one of her special interest areas. She is not on biopsy this week though so she won't be handling Bailey's case directly.

3/6/2007 10:24:26 PM

That would be kinda cool to have your wifey taking care of her doggie

3/7/2007 12:02:42 AM

her ct scan/surgery date is the 13th (tuesday).

wow, tell your wife thanks for me. that'd be really awesome to have someone keeping an extra eye on bailey & her case. thanks so much.

3/7/2007 8:19:03 AM

Spoke with someone in the Vet Hospital for you and showed her your post.

She said that you've done pretty much what you can and that what she's taking really works but she also suggested http://www.charlesloopsdvm.com/. Her cat takes something from him and it works fairly well.

Hope things work out for you!

[Edited on March 7, 2007 at 9:06 AM. Reason : !]

3/7/2007 9:06:29 AM

mom can't decide what is best. we're definitely having the ct scan done. we will have to make a fast decision most likely then. the mass is close to the vena cava, and if it's really close on the ct scan that may make the surgery too risky.

the sedation for the ultrasound knocked bailey back quite a bit. mom's worried that bailey won't really fully recover from such a major surgery & anesthesia and that she'd just be miserable the rest of her life. she could maybe possibly live longer w/o the surgery.

we just don't know. any thoughts?

my other childhood dog died on march 12, 2005 (see Pepper in my gallery). apparently march is a really shitty month for pets.

[Edited on March 7, 2007 at 9:52 AM. Reason : ]

3/7/2007 9:52:09 AM

Prepare for the worst and hope for the best. As long as she isn't in any pain it might just be best to live out her days instead of operating and making her miserable or causing her any pain. Good luck sweetie and keep us posted. HUGS!!!

3/7/2007 1:18:02 PM

Talked to my wife again, she says that if they tell you the mass is fully removable (though she used some other word) then she would definitely go ahead and have the surgery because she could easily live out her full life (assuming there is no indication of metastasis, of course). If the doctors say they would have to leave portions of the mass in because of proximity to the vena cava then it is not worth it because it will likely grow back and that complications from pressure on the vena cava would be very painful for the dog. She also said not to worry about the anesthesia, you can get no better than the vet school in regards to that (board certified anesthesiologists)... she said they put dogs under that are in FAR worse shape than yours (heart failure and such).

Oh, and my wife is not on Biopsy until the week following Bailey's day so she won't be the primary consult. Actually you don't want my wife to see Bailey at all on the week because that would mean something went really wrong... she is working Necropsy that week. She's definitely going to take a peek at the slides, though.

3/8/2007 2:19:06 AM

Quote :

"If the doctors say they would have to leave portions of the mass in because of proximity to the vena cava then it is not worth it because it will likely grow back and that complications from pressure on the vena cava would be very painful for the dog."

does she mean "it wouldn't be worth it...don't have the surgery" or "it wouldn't be worth it...put her down"???

[Edited on March 8, 2007 at 8:42 AM. Reason : ]

3/8/2007 8:42:35 AM

mom has another question for your wife:

if bailey has the surgery, would we be better off with an early morning appt? would she be able to go home that same day? what kind of aftercare will she need?

thanks!

3/8/2007 9:51:06 AM

Quote :

"does she mean "it wouldn't be worth it...don't have the surgery" or "it wouldn't be worth it...put her down"???"

Combination of both. Basically you should be able to tell if the dog is in pain so you can wait it out and spoil the crap out of her until the time comes. I think they usually say take 3 things she loves the most (be it food, toys, or activities) and if she loses interest in 2 of them then its a good sign she's no longer herself. You've known your dog long enough that I'm sure you can tell when she is clearly suffering more than she needs to. If she's already reached a critical point and the news from ct/biopsy is bad then I'm sure your doctor will talk to you about options.

And I know you don't like to think about this but if you do have to put her down then it is greatly encouraged that you consider allowing the vet school to perform a necropsy. They can learn so much from being able to look at the diseases firsthand. My wife happens to have the liver as a primary interest so she would definitely be intrigued by how the disease progressed in Bailey (of course I am talking in regards to a worst case scenario with Bailey's condition). The more they learn the more they can work towards early diagnosis and better treatment. Just something to keep in mind.

Quote :

"if bailey has the surgery, would we be better off with an early morning appt? would she be able to go home that same day? what kind of aftercare will she need?"

I'll ask her tonight (she's busy as hell during the day). But from what she was saying last night, I doubt even an early morning surgery is going to get her out on the same day. My wife had said that surgery that is in that area is stressful because its invasive in the core of the body. I'll ask her tonight to see what she thinks but it would still be just a guess given she has truely second hand knowledge of the dog's condition.

By the way, do you know the name of the Doctor you are seeing at the Vet School?

3/8/2007 11:08:30 AM

the student is maria evans and the doctor is dr. sarah moore.

3/8/2007 11:29:38 AM

The Vet School is the best. They couldn't save our other cat we had over a year ago. Another vet fucked her up bad. I put two completely healthy never had anything at all ever wrong with them cats into the Crossroads Vet on Jones Franklin (HIGHLY SUGGEST NO ONE EVER TAKE AN ANIMAL THERE EVER!!!) and I got 2 sick cats back. One who later died in the vet school's care because there was literally nothing they could do for her because the vet had not called us to let us know she was in bad shape and it wasn't until almost 36 hours (basically they did something to her early in the morning and didn't check on her until that afternoon before they closed and left her all night with a fever, not eating, labored breathing and not moving) later from what they had done to her that I came to pick them both up that they told me I needed to take her to an emergency vet because they could no longer help her. This really pissed me off because in my opinion I shouldn't have to goto an emergency vet if my animal is already in a vets care BUT I sure as hell wasn't going to let them touch her again. Back to my point though...the Vet School preformed a necropsy on her to try and determine what had gone wrong and why she had died. They saved her collar for us which I picked up a couple days later because I had forgotten it when they told me she had passed I was so upset. We still have her collar and it hangs on J's desk cause she was his kitty Anyways the other cat came out all sickly n shit but we nursed her back to health quickly.

3/8/2007 2:36:01 PM

mom said she would be fine w/ a necropsy if bailey passed away, but she wants her ashes back. if she can't have her back then it's a no go.

3/8/2007 4:05:00 PM

Follow-up... The early in the day the better from a biopsy standpoint, it gives them the most time for turnaround and earlier is less busy things build up towards the end of the day). If they are doing any surgery then odds are it won't really matter what time of day the appointment is because she'll need a good bit to recover. Oh, and no matter how early you schedule the anesthesiologist determines who gets surgery first based upon need/condition. She always recommends the earliest possible appointment though, especially since yours would involve a biopsy. Given the age of your dog I doubt recovery from the surgery will be difficult (trying to keep her calm in those early days would be a pin if she was still a pup).

3/8/2007 10:25:47 PM

Update?

3/13/2007 12:26:32 PM

not really. mom took her up there today, they're doing the ct and surgery tomorrow. they said it would be thurs/fri til she could come home if she does have surgery.

oh she does have a slight heart murmur though.

3/13/2007 1:14:51 PM

she just got out of the ct scan. the mass is fully resectable and not too close to any major vessels. they are starting surgery now and it should last 1.5-2 hours. they will call us when she is awake.

the murmur is low grade (grade 2), and isn't anything to worry about.

she won't be coming home til thursday or friday.

msb2ncsu: can you ask your wife to sneak in and check on bailey for us sometime after the surgery? if it's not possible, i understand. thanks!

things are looking up it seems. i'll keep you posted.

3/14/2007 9:11:16 AM