Apparently Lacy has Hepatic Lipidosis (Fatty Liver). This is a very common liver disease in cats, but it is not usually seen in adult dogs. But I did find an article that said that it is usually toy breed dogs that get it, esp yorkies, chihuahuas and fox terriers. Other than that I just can't find much info for dogs, and her vets didn't have much info about hepatic lipidosis in dogs either.
We also had a GI panel run on her blood to to check and she has diffuse small intestinal disease. Her Cobalamine and Folate levels were low. Cobalamine was 258 which was technically right on the low end of the normal reference range but they really want Cobalamine to be greater than 450. Her folate was 7.4 and normal is over 7.7. They said possiblities are Inflammatory bowel disease, parasites (although none were found on fecal float), allergies, food intolerance, or bacterial overgrowth. We could do an endoscopic intestinal biopsy to find out for sure...but I don't think we are going that route until we try some things first (and she gets sicker).
So I'm going to submit a fecal sample to the GI lab monday so they can run a PCR test for parasites in case any were missed. And she will be treated with Tylan for a month and also Phenbenazol (a dewormer) for any parasites or bacterial overgrowth. And for for both of her conditions we will be changing her diet to a homecooked, low-fat diet. I'm not clear on protein requirements..sent an email to her vet to get clarification. She also wanted her to try a novel protein, but Lacy has eaten almost everything! She's had fish, but some of the recipes suggested include fish, and there is one with bison, and one with crab.
The hepatic lipidosis just confuses me though! It's so uncommon in dogs and I just can't find much info. I found one short article on Hepatic Lipidosis in toy breed dogs. I just don't understand what caused it. She's not overweight and not diabetic. She has been eating Nature's Variety raw medallions for 2 1/2 years and they say MIN 6% fat (which would be MIN 18.75% fat on dry matter basis). The vet was concerned that the true fat content was much higher than their MIN level stated so I'm going to contact NV to ask for exact fat levels if they can give me that. But I have a hard time believing they are higher than any other commercial dog food
Another concern I brought up to her was the Petzlife gel I've been using. It has grain alcohol in it, which the company claims is safe, and I only used small amounts each time I applied it...but alcoholism in humans can lead to fatty liver...so I wondered. I might contact Petzlife to ask as well. Her vet said it's unlikely that Petzlife is the cause but recommended we stop using the product.
So...basically that's what we know right now. I feel good about the results as things could have been much more serious, but I still also have a lot of questions and hope we can get her fatty liver and intestinal disease under control with treatment and diet so it doesn't progress.
Thankyou so much everyone for you concern and advice