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Originally Posted by LillyBug  No she is not on anything other than Lactulose. I have heard of Milk Thistle but have not started her on that yet. I regulate her lactulose on the frequency of stool, consistency. Yes I put the Lactulose in her food- I just recently started to give it to her with small amts of sweet potato or cottage cheese to make sure she is getting it all in. Lactulose- I give twice daily. No, I don't have her on any probiotics- No antibiotics since dx- they talked about that in the future if needed- but didn't want to change anything at this time. Not any signs of UTI that I see? She has infrequently gotten into my golden retrievers food= which is purina pro plan sensitive skin and stomach- just noticed recently but is salmon. |
The Denamarin contains the active ingredient in Milk thistle and another ingredient that help protect the liver cells from cell death and help in regeneration. I would ask the vet about starting her on this as it can't hurt, and may help. There are bacteria in the intestine that produce ammonia as a byproduct of digestion, by giving her AB's you effectively lower the numbers of those bacteria and replace them with better bacteria by giving her Probiotics/enzymes. These help break the food down quicker limiting the amount of ammonia that goes to or around the liver. Talk to your vet about Hepatic Encephalopathy. This occurred in my dog a month ago on the weekend. The toxins that are not removed build up and go to the brain and cause all kinds of neuro symptoms. The symptoms can be stopped by giving an hourly dose of Lactulose until she has blowout diarrhea... to rapidly detox her system. Keep in mind also that Lactulose may be given as an enema to a pup having a seizure, again to rapidly detox the intestinal tract. This is just a friendly warning, better to be aware than caught totally off guard. Also feeding 3-4 meals is recommended by the vets at the U of Tenn. L/D def recommended. Smaller , frequent meals are easier on the liver. As I just checked on surgery and testing... the U of Tenn is the best (most experienced) and cheapest, the trip, testing and sx is usually cheaper than Sx anywhere else!
Portosystemic Shunts FAQ
I had a problem with mine getting into my cats food. That absolutely needs to stop. I usually free feed my cats, but now if I'm not in the room, their dish gets put up. The high protein is too toxic for a liver affected pup.
You could always ask your vet to call the U of Tenn for recommendations. My vet did, and she said they were extremely helpful. My pup's BAT was 40/126 in June, but now her ALT/AST are off the charts. They recommended bringing her in... they would do any further tests and Surgery if necessary. They said many times diagnostic tests need to be redone, and some places charge more to have the results sent to another vet/clinic.
So in summary, my advice would be to talk to your vet about trying the things I mentioned that you are not doing yet, get more strict with her diet, watch for symptoms of H.E., and develope a plan if the new stategy doesn't work. With her BAT Postprandial being under 100, it normally means MVD (symptoms the same as a shunt but no shunt found), over 100 = liver shunt. These are the general guidlines from U of Tenn as they have tested more dogs than anyone, and basically, that is how the results turn out. MVD is inoperable, so meds and diet would be the way to go. Recheck her BAT in 6 months to see if any improvement. If BAT Postprandial goes over 100, consider surgery to repair it. Also, join Yahoo groups MVD/LiverShunt... very informative and helpful group of folks.
Good Luck... I hope I have been of assistance.
P.S. I know what you mean about frustration... but the liver problems are more frequently managed for a while before if ever cured. It's to try and see what helps, and that all takes time, and retesting. And it is frustrating. But keep trying... your pup is depending on you.
Best Wishes,
Kathy