Dying from Liver Disease/seizure meds

[Beachitmom]

My Roxy is only 4 years old. She has been having seizures since she was 2 months old. She also has liver disease. She has been on PhenoBarb16.2 mg 2X a day and Potassium brom 100ml 2X a day.

She has not been herself lately, I thought due to the meds. We had increased them recently. I explained her symptoms, panting, coughing when taking a walk, not being able to jump up on couch and bed, etc.

The vet did a X-ray and took me in the back.
He put his arm around me and said, "I'm really sorry, her liver is huge. It is pushng on all of her organs."

Needless to say, I am in shock. The vet put her on an additional 4 meds to make her "comfortable".

Roxy’s meds

Phenobarbitol 16.2 mg 2X a day

Potassium Brom 100ML 2X a day

Hepatrophin PMG 1 Tab 2X a day

Aminophylline ½ Tab 2X a day

Denosyl 225 MG once a day 1 hour before breakfast

Tramadol 50 MG ½ Tab 2X a day

She was really bad the last 2 nights. Peeing where she sleeps, panting from pain and not eating. I wanted to put her to sleep, but my husband and 12 year old son can't bear to do it.
Today she is doing pretty good. She ate dinner, not breakfast and took all of her meds. Now I can't seem to think about putting her to sleep when she perks up. I know she is suffering, but when she seems like herself it's too hard.
I will update on her status soon.
Roxy's Mom,
Maria

[bchgirl]

I am so very sorry and I understand how difficult it is. But pets rely on us ....sometimes you have to get past the idea of sparing yourself the pain and put the animal's needs ahead of your own feelings. The hardest decision is sometimes the most loving.

[dwerten]

i would recommend joining this group and maybe they can help - so sorry

Liver_Shunt_And_MVD_Support@yahoogroups.com

[Ladymom]

My Lady has been on Phenobarbital for seizures for nine years. Phenobarbital is known for damaging the liver.

Has your vet been monitoring Roxy all along? That is critical for dogs on Phenobarbital:

PHENOBARBITAL DOSING AND PRECAUTIONS

When it reaches a toxic level, it is necessary to lower the dose or even stop the pheno. Other drugs that are not metabolized through the liver like Keppra can be added:

Reducing Phenobarbital

Lady's ALT values went up to 300 a few years ago (normal is under 100). She was just rechecked a few weeks ago and her ALT was 79 - back to normal! The liver is a wonderful organ that is capable of regenerating itself. With Lady, I switched to a homecooked diet for dogs with liver disease and added Denosyl. She has been getting Marin (milk thistle) for the entire nine years she has been getting pheno to protect her liver.

Dr. Dodd's liver cleansing diet is an excellent one:

Liver Cleansing Diet and Milk Thistle

I would definitely try to see if you can reverse the damage before putting her to sleep. You may want to consult an internist about her medication if your vet isn't familiar with alternatives to pheno or isn't regularly monitoring Roxy's levels.

[Ellie May]

Did the vet give you a diagnosis when she was a puppy?
What tests were done?

[YorkieShadow]

poor baby. keeping her in my thoughts & prayers.

[capt_noonie]

Just seeing this, I am sorry. Hope she can pull through.

[Beachitmom]

Wow lady'smom. Did your girl have liver disease also?
Yes, my vet has always monitored Roxy's levels. He will not fill the perscription unless I have the levels checked. I have been with my vet since Roxy was 2 months old. She has been on the pheno since then, along with the Hills L/D perscription diet.

He just added the Potassium Brom within the past 4 months because she had another grand mahl seizure and was having petite while sleeping.
We all thought the symptoms she was having were due to the meds she was on.

The kicker is he called me with the results of her levels for meds and they were perfect! Finally got her seizure free, but the pheno attacked her liver. Since she already had liver disease, the pheno just made it worse. Can't take her off of the pheno or she will die from the seizures. There is no winning.

Here is a list of what Roxy is on now. Vet added the last 4 this week to help her liver and keep her "comfortable"

Roxy’s meds

Phenobarbitol 16.2 mg 2X a day (Started when she was 2 months old)

Potassium Brom 100ML 2X a day (started about 4 months ago)

This week-

Hepatrophin PMG 1 Tab 2X a day

Aminophylline ½ Tab 2X a day

Denosyl 225 MG once a day 1 hour before breakfast

Tramadol 50 MG ½ Tab 2X a day

She was terrible last night, she peed on herself 2 times and was up all night panting in pain even with the pain meds.

Today she perked up. She was able to jump up on the couch. She did not use the ramp we borrowed for her to get up on the couch and bed. She is very bloated from the fluid and her huge liver. She did eat dinner tonight, but not breakfast.

Right now as I write this she is panting in pain again. This is very hard to take.
Do you really think that her liver can repair itself? The vet said it is HUGE in the xray.

Thanks for the advice and info.
Roxy's mom,
Maria

[yorkiehugs]

I'm so sorry that you and your family has to go through this.

Please know your in my prayers

[Ladymom]

Has Roxy been getting regular bloodwork to make sure the pheno wasn't damaging her liver? She should have been getting her ALT checked at least every six months, more frequently if the values were elevated. A liver dosen't get damaged over night. It happens over time.

Absolutely, the liver can repair itself. Whether or not it can in Roxy's case will depend on the extent of the damage. What are you feeding her now? I'd suggest switching her to either Dr. Dodd's Liver Cleansing Diet immediately or I would be happy to share Lady's recipe with you. You have to lighten the load her liver has to do in order for it to start to heal. I would also add Marin/milk thistle. She should have been on a special diet and milk thistle all along.

Why did your vet start Roxy on pheno when she was only two months old? Was she ever tested for a liver shunt as the cause of her seizures? Has she had a bile acids test? Protein C test?

Are you anywhere near a vet school? If Roxy were my dog I would take her there at this point. Her seizures may have been from a liver shunt all along. If so, the shunt should have been treated instead of just giving her anti-convulsants to prevent seizures.

[Patti]

I am so sorry to hear about Roxy. My Pom has severe liver damage from medicine she was on for her Cushing's disease and was in liver failure, in fact she stopped breathing when they were doing her liver biopsy but the critical care vet was there and got her breathing again, after they had called and told me she wasn't breathing but were working on her. The specialist put her on liver medicine and stopped the Cushing's medicine and within 6 months her liver tests were all normal. She was 10 years old at the time and lived another 2 years and died from congestive heart failure, so the liver can repair itself. I hope Roxy has enough good days to give the medicines time to work. It is so difficult to know when enough is enough especially in a younger dog. I will keep Roxy in my prayers.

[phall1069]

So sorry to hear Roxy is so sick. I cant imagine. It will be hard to put her down,but atleast she wont be hurting anymore. I know it must be a horrible thing to have to go through.Praying for Roxy and your family.

[Beachitmom]

I am losing my mind. I posted all of her meds 2X, sorry.
Roxy's mom,
Maria

[Ladymom]

Did you read this article I posted the link to?

When liver damage has been determined by a urine bile acid test or a pre- and post-meal bile acid test or chemistry panels, which show elevated values of Alk Phos, Alt (SGPT), and GGT, our Guardian Angels have had great success in reversing liver damage by doing three things:

1. Reducing the amount of Phenobarbital on a program determined by your vet or Dr. Dodds.
2. Feeding the liver cleansing diet
3. Adding Milk Thistle to the diet

Reducing the risk of liver disease

I noticed you are in New Jersey. I know there isn't a vet school in your state, but I there are some excellent internal medicine specialists. I have heard wonderful things about Red Bank:

Red Bank Veterinary Hospital

[Beachitmom]

Thanks Patti for the upbeat story!

Thanks for all of the well wishes. Yes, this is a crazy time and all of the support is much appreciated! The sleepless nights are also starting to get to me.

Ladysmom, I really have done everything for my little girl that I could have possibly done to help her.

Yes, when she started having the seizures she had the bile acid tests pre and post eating. She had an ultrsound they couldn't see a def. shunt- they thought MVD.

Why did my vet put her on pheno? I have no clue. I just listened to him and followed his instructions, because he is the vet. It helped her, but we had to keep ajusting the dose because she would have cluster seizures again. She has continued to have seizures her whole life until recently.

Yes, she has had blood work done at least 2X a year. The levels are always crazy -again because of the meds.
The levels he just took- I have to call for ther exact numbers- were not that high he said. But, the liver is so huge it is pushing on her organs.

I will call him and ask what he thinks about the diet change from Hills L/D to this diet your are talking about. She is so sick right now, I don't know if it's a good idea to introduce the runs with the diet change.

I will also ask about the milk thistle.

I did read the article but, as far as REDUCING her pheno barb. I don't know how we could do that when she is finally seizure free. That would just bring her levels down and she would start up again.

Thanks for all of your input. I will check into Redbank.

Roxy's mom,
Maria