[Scoobstersmom]

I posted last week looking for input on my 14 year old yorkie with the extremely elevated liver enzymes, so I wanted to come back and give you all an update.

To refresh, Scooby's ALKP has been rising - nearly doubling - every time we've checked it since September of 2012. On January 25th, it had reached nearly 7000 and his ALT, which has also been climbing but not quite as fast, was 593. In the past six months, he has had two ultrasounds, bile acid test, and a lot of blood work without determining a cause. We've tried two different antibiotics, flagyl, lactulose, diet changes, supplements (denamarin, fish oil, etc), and it just kept climbing. After his last bloodwork in January, our vet added Actigall even though he did not have any signs of gall bladder issues and his gall bladder looked fine on ultrasound. On Tuesday he had a low dose dexamethamine suppression test for Cushings disease, which also came back negative. At the same time, I twisted the vet's arm to do another liver panel. She felt that the numbers would be the same or even higher, so didn't see the point, but since I was paying and she was drawing blood anyway....

For the first time since September, we saw a drop in his ALKP. Not just a drop, but a HUGE drop. It is down to just over 3500. His ALT has also dropped, down into the high normal range at 102. I had to ask the vet if she was sure she hadn't mixed up the vials and it was actually Scooby's blood that got tested!

Without the benefit of a biopsy to confirm, his vet presumes now that he must have had inflammation in the small bile ducts in his liver - too smalll to show up on ultrasound, but enough to cause a major liver issue - and that the Actigall has made this huge difference. Whatever the case, it is an amazing improvement in one month's time. Recheck in thirty days, and she expects to see another huge drop in the ALKP.

Today we are celebrating. Because we were seriously out of options for little Scooby. His liver enzymes were too high to risk any kind of anesthesia procedure, but it was coming down to presuming he must have some kind of cancer in his liver. Which was tough to deal with, because throughout all this, he has remained symptom free, and a happy, playful and active little guy that did not look like he was dying of liver failure. (He was never actually in liver failure - bile acids were good - but that rising ALKP really put him at risk.)

Thanks for all your good thoughts and prayers.

Diana and the Scoobster