Prednizone for liver disease?

[ladyjane]

Originally Posted by kjc

The main issues I have addressed in this thread are:

Is prednisone prescribed for dogs with liver disease?
Yes, but I have never seen it prescribed for dogs with a Liver Shunt for treatment a Liver Shunt.

Does the OP's dog have Liver Shunt?
The OP stated that Her dog had a liver biopsy and the result was Liver Shunt.

I have never heard of this, biopsies are done to rule out MVD and other disorders, not LS. Futher testing is needed to make a diagnosis.

Was a Bile Acid Test done?
The OP is unsure, but will ask her vet.

The dog's AST and ALT are/were very high.
These two values will become elevated when toxins are involved. (By toxins, I mean anything ingested to vaccines received.) In dogs that have Liver Shunt, these values are most often only mildly elevated. Vaccines, such as Lepto, can cause higher elevations of these liver enzymes, and the OP's dog has been repeatedly vaccinated against Lepto. Or maybe the dog has contracted Lepto.

Why is prednisone being prescribed?
To bring the AST and ALT levels down, per the OP. The problem with prednisone is that it suppresses the immune system. If this dog is fighting an infection, this could be an unwise decision.

Did I PM or telephone the OP?
No, I have not, but I am willing to talk with her over the phone or via PM, if she wants to. Just send me a PM.

I have to leave for a while, but let me know if I missed anything....

Originally Posted by kjc

The 'L' Part of the DHL vaccine is Lepto, and is not recommended for use in small dogs... and can cause liver and/or kidney damage. Vaccine reactions (acute and chronic) are treated with prednisone. I will contact some members that may be able to answer your questions.

I sort of messed this up, but it is for lillymae's question.

In the beginning I thought kjc was saying that the lepto vaccine causes LS. She went on to say that the vaccine causes liver and kidney damage (as highlighted above). She also further stated that LS causes only mild elevations of liver enzymes. Certainly not what I have been told. ANd, she further stated that the Lepto vaccine causes higher elevations in liver enzymes than LS does. I simply have been asking for her source because I need to know if this is true!

[107barney]

Originally Posted by lillymae

I have read & reread & can't for the life of me see where anyone said that lepto vaccine can cause a LS. I did see where someone said that it can raise liver enzymes, but not higher then a LS. Could someone show me this please.

KJC stated that the lepto vaccine can cause liver and kidney disease and asked the OP, whose dog was diagnosed by exploratory surgery and histological report with a liver shunt, whether the dog had been given the leptospirosis vaccine. KJC was misinformed both about the safety, date of entry into the marketplace and coverage of various serovars of the bacteria with regard to the newer Leptospirosis vaccine.

KJC further went on to suggest that enzymes would be higher following a lepto vaccine than they would in a dog with a liver shunt and we have been repeatedly asking for her information that she had on her computer which has been in repair for what seems like eons.

She now claims K/D may have been prescribed to flush out elevated enzymes??????????? Last I checked, a diet and water did not flush out liver enzymes. It might flush out the kidneys or bladder but the liver?

[ladyjane]

My vet does not give lepto to my pups because it is not prevalent here. I had a discussion with her not long ago about the lepto vaccine because one of my adopters was advised to give it to her newly adopted pup. I was very concerned. It was then that my vet explained that since he was living in an area where it is prevalent, it should be given AND that more than likely he would be just fine. While the lepto vaccine can cause reactions, it was not my understanding that they caused liver and kidney damage.

When people are being told that the lepto vaccine is dangerous for pups I believe that those people need to be advised what will happen to their pups if they contract lepto!
I also want to know, if kjc does indeed have information that shows such severe liver and kidney damage, because I would simply get sick if it happened to one of mine. Never know if/when I might be in a position to make such a judgement call.

[107barney]

Originally Posted by ladyjane

I sort of messed this up, but it is for lillymae's question.

In the beginning I thought kjc was saying that the lepto vaccine causes LS. She went on to say that the vaccine causes liver and kidney damage (as highlighted above). She also further stated that LS causes only mild elevations of liver enzymes. Certainly not what I have been told. ANd, she further stated that the Lepto vaccine causes higher elevations in liver enzymes than LS does. I simply have been asking for her source because I need to know if this is true!

When a poster says their dog has been diagnosed with a liver shunt and then someone (KJC) comes on and asks if the dog has had the lepto vaccine and follows that up with a dissertation on how the lepto vaccine can cause kidney and liver damage, isn't that what she is doing? Perhaps she did not mean to imply this. I am still interested in her data about the lepto vaccine and liver enzyme elevations too. I hope the info comes soon, my dogs are not getting any younger.

[ladyjane]

Originally Posted by 107barney

When a poster says their dog has been diagnosed with a liver shunt and then someone (KJC) comes on and asks if the dog has had the lepto vaccine and follows that up with a dissertation on how the lepto vaccine can cause kidney and liver damage, isn't that what she is doing? Perhaps she did not mean to imply this. I am still interested in her data about the lepto vaccine and liver enzyme elevations too. I hope the info comes soon, my dogs are not getting any younger.

Yes, I was very confused. This entire thread has been that way....or shall I say I have been confused throughout it.

[Becca1]

Received Lexie's BAT results and they were kind of shocking, especially since she is showing no symptoms. - Pre: 159 and Post: 380. My vet and I discussed this at length and basically our plan is to do nothing at this time. Does that seem crazy??? I talked to him about her being on Prednisolone prior to drawing her blood (but I didn't have her on this therapy but for about a week before at 1/2 tab every other day); he didn't think that amount would make these numbers high. I had read that it could.

[ladyjane]

If this were me, I would be making an appointment with a board certified specialist...and sooner rather than later!

Will keep Lexie in my thoughts and prayers.

[Ringo1]

Well, those are some pretty high BAT's. If they were only mildy elevated - then I might agree with your Vet and re-test in 30 days.

But those numbers are HIGH and I agree with LJ - time to make a plan.

[ladyjane]

I just ran across this site. I really like the way it was written. It is very informative and written in lay terms. Don't be mislead by the title: All About Shih Tzus .. it is about Liver Shunt!

All About Shih Tzu

[Becca1]

Thanks for your ideas; however, she's eating well, has put on great weight, plays, sleeps and is comfortable, I think I can get on it if things change. We will recheck her numbers; my vet and I discussed getting her to a specialist if something changes. Has anyone else out there gone further just because numbers were high - or has there been extinuating circumstances such as how the dog is feeling and acting?

[Becca1]

Originally Posted by ladyjane

I just ran across this site. I really like the way it was written. It is very informative and written in lay terms. Don't be mislead by the title: All About Shih Tzus .. it is about Liver Shunt!

All About Shih Tzu

Thanks for the link - I will read this.

[ladyjane]

Originally Posted by Becca1

Thanks for your ideas; however, she's eating well, has put on great weight, plays, sleeps and is comfortable, I think I can get on it if things change. We will recheck her numbers; my vet and I discussed getting her to a specialist if something changes. Has anyone else out there gone further just because numbers were high - or has there been extinuating circumstances such as how the dog is feeling and acting?

Lab studies and x-rays do not lie. I really don't understand this at all. What is your issue with getting the opinion of a specialist? You don't even know what will be suggested....or is it because deep down you know?

I don't mean to sound harsh, but honestly this is just mind boggling to me. If it were one of mine, I would be high tailing it to a specialist. I would be so afraid of what might happen if I waited too long.

[Becca1]

Originally Posted by ladyjane

Lab studies and x-rays do not lie. I really don't understand this at all. What is your issue with getting the opinion of a specialist? You don't even know what will be suggested....or is it because deep down you know?

I don't mean to sound harsh, but honestly this is just mind boggling to me. If it were one of mine, I would be high tailing it to a specialist. I would be so afraid of what might happen if I waited too long.

No, you're not sounding harsh - that's your right to say - I wouldn't be on here if I couldn't handle some criticism. I just don't feel like it is a matter of life or death. Here's what I'm thinking. If it's HMD or MVD then it's managed thru dietary and meds anyway, as we're doing - if it's an extrahepatic shunt, then it can be fixed surgically. My vet still feels that it is intrahepatic based on the biopsy (even though I know, it can't be shown for sure based on a biopsy whether it is intra or extra and intrahepatic are usually in large dogs). The hemolysis was also shown to be high on the BAT results which from what I've read on could adversely affect the test results; which has something to do with the guage size of the needle to draw the blood.

If my puppy was in anyway feeling bad, I would be hightailing it to a specialist to get something done. I know that surgery may be something that has to be done and am prepared to do that. But even if an outside shunt was fixed, my vet feels like we are still going to deal with the interior shunting. He also feels that since she was diagnosed at a later age, it is a better sign. As he said, these are numbers and it is good to have these numbers to show liver function, but she has improved dramatically from where she was a year ago - based on meds and diet.

[Ellie May]

This case has always confused me too. If the blood hemolyzed, the BAT could be redone. The longer you wait to fix a shunt, the riskier it can get. All suspected liver shunt should be looked into by an internal medicine specialist.

In the case of very high bile acids, my girl's vet insisted on a specialist. Most general vets are good at what they do, but they aren't trained to handle this. They aren't trained to assess whether or not surgery is the best option. After an IMS sees a pup and says no surgery needed or whatever, then a general vet is usually able to manage the problem knowing what they are dealing with. The bile acids are really too high for just a general vet to be involved imo.

[107barney]

Originally Posted by Becca1

No, you're not sounding harsh - that's your right to say - I wouldn't be on here if I couldn't handle some criticism. I just don't feel like it is a matter of life or death. Here's what I'm thinking. If it's HMD or MVD then it's managed thru dietary and meds anyway, as we're doing - if it's an extrahepatic shunt, then it can be fixed surgically. My vet still feels that it is intrahepatic based on the biopsy (even though I know, it can't be shown for sure based on a biopsy whether it is intra or extra and intrahepatic are usually in large dogs). The hemolysis was also shown to be high on the BAT results which from what I've read on could adversely affect the test results; which has something to do with the guage size of the needle to draw the blood.

If my puppy was in anyway feeling bad, I would be hightailing it to a specialist to get something done. I know that surgery may be something that has to be done and am prepared to do that. But even if an outside shunt was fixed, my vet feels like we are still going to deal with the interior shunting. He also feels that since she was diagnosed at a later age, it is a better sign. As he said, these are numbers and it is good to have these numbers to show liver function, but she has improved dramatically from where she was a year ago - based on meds and diet.

Hi Becca,

Hemolysis can affect BATs, but not to the degree where your #s would be as high as they are.

I do think a consult with a Board Certified Internist would be worth your while. I think you more specific information and a second opinion from someone with advanced training. MVD #s are usually not that high. Feeling good or not, the liver is not functioning well and your dog should be in the care of a specialist. Yes, I take my dogs to specialists even when they are feeling good if the blood work isn't right.....I just posted about my Barney in another thread and I took him to an internist just because he had two mild abnormalities on his blood work.

Good luck.