Paranoid about liver shunt

[sadiesamie]

Originally Posted by Ellie May

You don't have to do allergy testing to see if she is allergic to corn. Ellie has never had it... Her vet looked at the ingredients in the Royal Canin and said she thought is was the corn. She has told me that allergy testing is a long road that I probably wouldn't want to get into. And she's right. If your dog itches on a food, pull it. If it is a complex kibble and you don't know what ingredient she is allergic to then pull all of it for a few months and reintroduce individual ingredients to see which one she reacts to. If you are sure it is the corn, then it is the corn and there is no reason to do this.

I elected not to use Actigall with Ellie. One of the reasons is it does alter bile acid numbers and I want to get good readings. I might go with it someday though. Retesting bile acids will be pretty close to pointless (but maybe still necessary) for Samie now.

I didn't know what to do or what not to do. Do you think we shouldn't have started the actigall? is this the denamarin? or the ursodiol that has the actigall? i am pretty sure it is the denamarin that contains the actigall. how do you get good readings w/o using the actigall? by just changing foods? i am just curious about retesting bile acids with samie would be pointless. do you think that her readings will be normal giving her that. I'm sorry i sound so stupid but just want to understand what you meant :-) i was under the impression that bc of samie's readings and bc the vet prescribed it that i "HAD" to give it to her. I waited about 4 days after picking up the ursodiol and researched it and also talking with YT members. but i really still didn't understand it. and i was worried that "if" things with her are getting worse bc of the numbers going up after being on the denamarin, that i was told by the vet to give it so i went with it. but i don't know if i did the right thing or not?

i just went through my notes and the actigall is the ursodiol. sorry.

[Ellie May]

I did NOT do the wrong thing.
Either way is fine (giving it or not giving it).
I prefer the Denosyl (or VetriDMG) because it helps protect/heal the liver and any change in the bile acids from it (lowering them) is good but I don't think it always lowers them...not sure. I think maybe they would stay up with a shunt or MVD?
With the Actigall, it can effect the bile acids in such a way that you could redue the BAT and have no idea if the numbers lean toward a shunt or not....

Ellie's post meal was 47 and she went on Denosyl for a month. Her post meal was then 15. I took her off the Denosyl and it went back up to 106 (who knows why). I just think it is possible to get a better reading with a dog on Denosyl then with a dog on Actigall because Denosyl doesn't necessary change bile acid numbers... I hope I explained this okay. I can't keep it all straight, so it is a bit hard explaining.

[sadiesamie]

Originally Posted by Ellie May

I did NOT do the wrong thing.
Either way is fine (giving it or not giving it).
I prefer the Denosyl (or VetriDMG) because it helps protect/heal the liver and any change in the bile acids from it (lowering them) is good but I don't think it always lowers them...not sure. I think maybe they would stay up with a shunt or MVD?
With the Actigall, it can effect the bile acids in such a way that you could redue the BAT and have no idea if the numbers lean toward a shunt or not....

Ellie's post meal was 47 and she went on Denosyl for a month. Her post meal was then 15. I took her off the Denosyl and it went back up to 106 (who knows why). I just think it is possible to get a better reading with a dog on Denosyl then with a dog on Actigall because Denosyl doesn't necessary change bile acid numbers... I hope I explained this okay. I can't keep it all straight, so it is a bit hard explaining.

that was a great explanation :-) i don't know if i should continue the ursodiol or not now though. I'm with you- it makes sense that the reading could now be off with giving the ursodiol. at first my husband and i both thought that if this works then we are out of the woods and will keep her on it. so you are basically saying that by leaving her on the ursodiol we may not need to retest bile acid bc it could be normal. but-- it could not be accurate in determining why her bat increased in the first place. Was this when you decided to home cook. i can't wait to talk to a nutritionist- but we need to get her results back in a few weeks first. in the mean time i am compiling all of our labs and tests to have it all ready. I guess i could always make the decision and disc the ursodiol especially if we go to home cooking, she may not need it any longer. then retest and see where her numbers are at. I am still all new to this all and i am trying to take it all it and understand it. I learned more today then i did researching myself for the past 3 wks :-)

i am also getting ready to order the Heppasupport and the VetriDMG as we get closer to running out of the denamarin. it' just too hard on me with my work schedule and making sure she gets this on an empty stomach. I mean- if there is something out there as the heppasupport and vetri-dmg that does the same thing w/o me having to get up in the middle of the night then you know which one i am going to choose. all of last week i was wiped out. :-) But if that was our "only" option- i would sacrifice sleep for my baby girl samie. i love her so so so so....much......

[Ellie May]

I meant to say you did not do the wrong thing, not I did not do the wrong thing.

Anyway, that is exactly what I was saying.

Lets just take a scenario:
Samie has a shunt or MVD.
Actigall helps and lowers bile acids.
You recheck bile acids and they are normal, so you suspect nothing is wrong...
Now there is a hidden problem that is covered up with the Actigall.
Hopefully this is not the case.
That is why I don't like it though.
Please, if you decide to take her off do it under the supervision of a vet. If your vet says she needs it, maybe she does. If it were my dog, I would use Denosyl or Vetri and skip the Actigall until shunt and MVD are ruled out, then I would consider it to get the bile acids down. This needs to be a decision between you and your vet though.

[Ellie May]

Ellie's specialist talked about putting her on Actigall, but here is what she said about it:

addition of the cholerectic medication Actigall could increase water solubility of the bile, reduce stagnancy and irritation of liver cells from bile, and normalize ALT levels. Bile acids would no longer be accurately measurable, since Actigall consists of synthetic bile acids which will affect the assay.

I'm not sure if Actigall makes them go up or down. I thought it wold make them go down but this seems to say it could make them go up. I don't know...

[sadiesamie]

Originally Posted by Ellie May

I meant to say you did not do the wrong thing, not I did not do the wrong thing.

Anyway, that is exactly what I was saying.

Lets just take a scenario:
Samie has a shunt or MVD.
Actigall helps and lowers bile acids.
You recheck bile acids and they are normal, so you suspect nothing is wrong...
Now there is a hidden problem that is covered up with the Actigall.
Hopefully this is not the case.
That is why I don't like it though.
Please, if you decide to take her off do it under the supervision of a vet. If your vet says she needs it, maybe she does. If it were my dog, I would use Denosyl or Vetri and skip the Actigall until shunt and MVD are ruled out, then I would consider it to get the bile acids down. This needs to be a decision between you and your vet though.

how she decided it was since we said that we wanted to do more research on whether or not to have a biopsy first. she said she understands that cost is an issue for some people so they opt to treat with meds. that was when she said to continue the denamarina and that she could prescribe the ursodiol. I am going to have my husband talk with the vet next week. Hubby is kinda making me mad bc he said lets just retest- he is getting upset bc i am so involved in it and he says it's all i talk about :-( he means well but yes- things are not perfect right now with both of our girls and i just told him tonight that he needs to understand a few things- for one- i am compliling loads of info about what is going on and each day i learn something more. It's not like i am trying to research something that doesn't make sense or looking persay to find different info. i am learning more about bat and food and all kinds of things. Never have i been at a point where i know everything and i am sorry but i will continue to talk about this until we find out the cause of this. so he will just have to deal with me i guess in the meantime :-) he is a truly wonderful man to me and i love him dearly. i know he is tired of listening to me but Samie is his baby too. he loves that dog so much. and she definitely is a papa's girl too. she favors him over me and sadie favors me over my husband. not sure why? it just is like that. so my only explanation for him getting this way is i guess he just does not realize that this is more than something like ok- here is the problem and this is how we treat it kinda a thing. it needs researched -that simple. :-)

[Yorkieluv]

I read on another group that Actigall is also used as an antioxidant...What kidney problems does she have?? Can you go into detail? Has she had a blood workup done recently? Do you have ALT, BUN, etc...?

[sadiesamie]

Originally Posted by Ellie May

Ellie's specialist talked about putting her on Actigall, but here is what she said about it:

addition of the cholerectic medication Actigall could increase water solubility of the bile, reduce stagnancy and irritation of liver cells from bile, and normalize ALT levels. Bile acids would no longer be accurately measurable, since Actigall consists of synthetic bile acids which will affect the assay.

I'm not sure if Actigall makes them go up or down. I thought it wold make them go down but this seems to say it could make them go up. I don't know...

yep-that makes perfect sense. thank you so much for sending me that. i wish we had already seen the specialist... i know i am going to tick off the vet questioning something once again bc i researched something on line... but i want her to know if we decide to disc the ursodiol. and i also want her to know that we are going to switch to the heppasupport and vetri-dmg too. and she better help me with the correct dosage too even though she did not prescribe either of those two things. i have a feeling that she will refuse to help me with it though just based on past experiences. she is very hard to talk to. and she is also very dramatic to add to that. she made me worried sick so many times- literally. just by the way she would explain things to me. She also has told me that my sadie girl will die someday of kidney failure or some type of kidney disease. always dramatic though. i mean it's enevitable with the glomelur disease sadie has.

there i go again- talking about both dogs with 2 diff conditions on one post. it's so hard not too. Sorry :-(
I need to keep this post on samie only.

[sadiesamie]

Originally Posted by Yorkieluv

I read on another group that Actigall is also used as an antioxidant...What kidney problems does she have?? Can you go into detail? Has she had a blood workup done recently? Do you have ALT, BUN, etc...?

only ALT I have is from June 2007. I don't know why i don't have the one from December?? i will get it though.

Samie's ALT was 25 (range is 5-107 U/L no remarks next to it.

the high values from her total health plus bloodwork were:

CK: 273 (normal range is: 10-200) remark says HIGH
Amylase: 1443 (normal range is: 450-1240 remark says HIGH
Potassium: 5.7 (normal range is: 4.0-5.6 remark says HIGH
NA/K Ratio: 29 (normal range is: 27-40 (remark says LOW)
Abuib Gap: 27 (normal range is: 12-24 mEq/L (remark says HIGH)

BUN was 24 (normal is 7-27) no remarks though
Creatinine was 1.0 that is normal

[sadiesamie]

Originally Posted by Yorkieluv

I read on another group that Actigall is also used as an antioxidant...What kidney problems does she have?? Can you go into detail? Has she had a blood workup done recently? Do you have ALT, BUN, etc...?

i'm sorry i may have confused you- from now on i will only discuss one dog at a time. I know i am so bad at that. Please don't be upset with me. Sadie is the one with the kidney issue /Glomerulonephritis Disease (Protein losing disease) her kidneys are not filtering properly. vet described it as holes in her kidneys leaking out protein. the benezeperil works by closing the holes and keeping protein in. By constricting blood vessel i believe.

samie's only kidney issue was her forming calcium oxalate crystals in her urine and we are currently giving her the potassium citrate granules. her ph is currently 8.0

BUT just for the record:

SAMIE: is the one with the liver issues right now, she also has a history of forming calcium oxalate crystals and collapsing trachea- Currently on potassium citrate granules, Soloxine, Flovent, Denamarin and Ursodiol.
WE have Hydromet also for her just in case she coughs sometimes really bad. ---

(which since i have altered my home she is doing better -no hairspray,perfume, febreeze or glade plug in's. No spraying of anything Or burning candles)

She have 2 episodes of coughing maybe 2 times a month if that since i started picking up on things that bother her.

SADIE is the one that has Glomerulonephritis Disease -protein losing disease and skin allergies. she is currently on Soloxine and Benazeperil

i promise to discuss one dog at a time- it gets hard with so much going on.

[sadiesamie]

Originally Posted by sadiesamie

yep-that makes perfect sense. thank you so much for sending me that. i wish we had already seen the specialist... i know i am going to tick off the vet questioning something once again bc i researched something on line... but i want her to know if we decide to disc the ursodiol. and i also want her to know that we are going to switch to the heppasupport and vetri-dmg too. and she better help me with the correct dosage too even though she did not prescribe either of those two things. i have a feeling that she will refuse to help me with it though just based on past experiences. she is very hard to talk to. and she is also very dramatic to add to that. she made me worried sick so many times- literally. just by the way she would explain things to me. She also has told me that my sadie girl will die someday of kidney failure or some type of kidney disease. always dramatic though. i mean it's enevitable with the glomelur disease sadie has.

there i go again- talking about both dogs with 2 diff conditions on one post. it's so hard not too. Sorry :-(
I need to keep this post on samie only.

...........

[Yorkieluv]

Thanks for clearing that up!! I think I understand a little better now
Were you able to join the liver group?

[sadiesamie]

ok now after talking to my husband he told me that the vet saw something on Samie's bloodwork that could be something but she wasn't for sure. so that was why she suggested wanting to do a bat. Mind you we had this blood work done bc samie had fainted. we are assuming it was bc of the little spat both of my girls got into over their food. (sadie tried eating out of samies dish) so we decided to run some blood tests and now here is where we are at with this liver issue (i will request these tests on Monday and post a few things after i get that)

but my husband can't recal exactly what the vet saw on samie's bloodwork. it couldn't have been anything major bc she did tell him that she was only putting samie on the demarin and an antiobiotic (amox) as a precaution. she said her numbers were not "that" high and that normally when there is trouble numbers are in the 100's. so we started her on the denamarin and then i stated giving more of the canned food. Lots of it- in her food and as treats and with meds. (not knowing that i was supposed to do everything exactly as i had for her first test) which hey it's easy to do- i thought more protein is better for them so i stated giving more of the canned wellness venison and duck also. plus a learning experiece- i honestly thought nothing of it. i gave her her heartguard 2 wks before her bat. because someone said that could mess with her bat results also. this time around she isn't getting it all month though.

so then we went and had a retest after 30 days and then the numbers went up. my husband is leary about getting her next bat test now since the ursodiol may mask the problem now. so NEXT WEEK he wants to see the specialist. He doesn't trust our vet anymore. He said he is beginning to question everything about the place.

she told him (again) for those of you who already heard this :-) that she is aware that people can't afford testing so they opt to try and treat with meds and supplements. then she said we'll see where we are at in a month with another bat. he is upset with her bc she never told us this could perhaps mask a problem and skew her results. Now is is very angry with the vet and he wants me to stop giving the ursodiol. He said he finds this hard to believe because samie has no symptoms. i told him that they don't have to have any symptoms though. but you see- my girls have had so much blood work and urinalysis done in the past 6 mos he said he finds it hard to believe that our visit that day in Dec after samie's (so we think) ct episode/fainting spell) brought all of this on. and bring up the need for a bat. ( i guess we will not know until we get a copy of those labs on monday)

but blood work also was done to determine Hypothyoidism too. lots of blood work done on her. is this just a coincidence?

[sadiesamie]

Originally Posted by Yorkieluv

Thanks for clearing that up!! I think I understand a little better now
Were you able to join the liver group?

they never sent me anything the second time i joined. Last time i rec'd the email from them and tried to access but was not able to. I did what it said-i sent them a brief explanation of why i wanted to join a second time and this time around i never got anything back. i am going to try now using my old info they sent me a couple weeks ago.

I read a couple of my last posts and I apolygize again. it was very easy to confuse the two of them.

[Yorkieluv]

That is so strange...People have been joining without a problem. Did you send an email to the second link I sent you to the owners/moderators of the group?? Try that...Pm your email address to me, and I'll see if I can help..