Prednizone for liver disease?

[kjc]

Originally Posted by 107barney

The article cited by KJC was" The diagnostic approach to asymptomatic dogs with elevated liver enzyme activities".

Yes, this is one of 3 articles I refered to in providing proof for my prior statements in this thread concerning Elevated Liver enzymes, Lepto and vaccines in general, etc.

Originally Posted by 107barney

I disagree with KJC's inferences and conclusions overall..

No problem... Friends are not expected to see eye to eye on everything...

Originally Posted by 107barney

I also wanted to point out that the article above DOES NOT mention the word "leptospirosis" one time..

You are right, that specific article does not mention Lepto, but it does mention drugs, and toxins. From: The diagnostic approach to asymptomatic dogs with elevated liver enzyme activities - Veterinary Medicine

Pertinent historical information includes the administration of any potentially hepatotoxic drugs, supplements, or nutraceuticals; exposure to any environmental toxins or infectious agents; recent anesthetic events; ...

I am assuming vaccines, including Lepto, are included in at least one of these above mentioned categories that can have an effect on elevating liver enzymes.

Originally Posted by 107barney

KJC research is good, but it is not going to fix your or others' dogs. Yes the liver regenerates itself, but not in the face of structure abnormalities like a liver shunt. It's like putting a piece of plastic over your house when your roof blew off. You have to fix the roof, and there is no way around it.

I don't get this at all... do you think I think research can 'fix' mine or others dogs? Vets fix dogs. Research helps me to understand what is going on with my dog, and I try to help others understand what may be going on with their dogs, using the information they provide in their posts, and research, and some by my own personal experience. Hopefully this allows me and others to have more meaningful discussions with our vets, and to make better informed decisions regarding the heath care of our pets.

I'm almost positive Tink's liver regenerates all the time. I believe she has enough good, functioning liver to keep her asymptomatic for the most part. No, I agree it will not repair the liver shunt... if that did happen there would never be a Liver shunt or the need for surgery. Hmmmm.... I'll be looking into stem cell therapy next.... that might help!
Also, when she ate the rancid grease, this caused her ALT to skyrocket to 400, then a month later to 800. This number is directly proportional to the number of damaged hepatocytes, or in my vet's words...death of liver cells. I would think if these hepatocytes had not been regenerated by her 'available' liver, she would not have returned to her 'normal' state, or as she was before the grease ingestion event occured.

This is from the University of Tennessee, about what the liver does after the shunt is 'fixed':
Portosystemic Shunts FAQ
The liver will begin to grow as the shunt closes, and will often be normal sized in 2-4 months.

[ladyjane]

[quote: kjc]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.


[...[/quote]


Again, highlighted in red was your quote and is the ONLY thing I asked for....data to back it up and the link you provided what not what I asked for. No matter how you turn this, it comes back to that...I really don't understand your resistance to simply saying it was not a true statement. We all make mistakes. Someone could read that as gospel and not get their pup vaccinated and perhaps the pup might contract lepto and die. Surely you would not want that. Saying "I am not a vet" does not excuse a person from saying just anything they believe imho. I keep saying I am finished. This just boggles my mind.

[107barney]

Originally Posted by kjc

Yes, this is one of 3 articles I refered to in providing proof for my prior statements in this thread concerning Elevated Liver enzymes, Lepto and vaccines in general, etc.

No problem... Friends are not expected to see eye to eye on everything...



You are right, that specific article does not mention Lepto, but it does mention drugs, and toxins. From: The diagnostic approach to asymptomatic dogs with elevated liver enzyme activities - Veterinary Medicine

Pertinent historical information includes the administration of any potentially hepatotoxic drugs, supplements, or nutraceuticals; exposure to any environmental toxins or infectious agents; recent anesthetic events; ...

I am assuming vaccines, including Lepto, are included in at least one of these above mentioned categories that can have an effect on elevating liver enzymes.



I don't get this at all... do you think I think research can 'fix' mine or others dogs? Vets fix dogs. Research helps me to understand what is going on with my dog, and I try to help others understand what may be going on with their dogs, using the information they provide in their posts, and research, and some by my own personal experience. Hopefully this allows me and others to have more meaningful discussions with our vets, and to make better informed decisions regarding the heath care of our pets.

I'm almost positive Tink's liver regenerates all the time. I believe she has enough good, functioning liver to keep her asymptomatic for the most part. No, I agree it will not repair the liver shunt... if that did happen there would never be a Liver shunt or the need for surgery. Hmmmm.... I'll be looking into stem cell therapy next.... that might help!
Also, when she ate the rancid grease, this caused her ALT to skyrocket to 400, then a month later to 800. This number is directly proportional to the number of damaged hepatocytes, or in my vet's words...death of liver cells. I would think if these hepatocytes had not been regenerated by her 'available' liver, she would not have returned to her 'normal' state, or as she was before the grease ingestion event occured.

This is from the University of Tennessee, about what the liver does after the shunt is 'fixed':
Portosystemic Shunts FAQ
The liver will begin to grow as the shunt closes, and will often be normal sized in 2-4 months.

You are right, not everyone will see eye to eye. I am ok with that, and I will do for my dogs what I believe is correct. I could never and would never sit by and lull myself into a belief that my dog's liver was regenerating all the time when the organ was structurally flawed. In biology, it is said that structure dictates function. So while it is true that the liver is forgiving, at some point, it will just give out. It's why people waiting for liver transplants die waiting.

My point of the research not "fixing" your dog or others was not literal. What I was saying to you was you are not understanding the information you are reading, because if you were, you would have had the dog attended to a long time ago. For two years you opted to research this matter as you recently shared with the entire YT community. By your own admission you now say that you believe in your mind that your dog's liver was and is constantly "regenerating". I see differently her situation. I see that the liver has been failing her and working overtime and what you thought was regeneration was really a liver so broken that it was producing kidney stones. So now you have to fix both conditions, at a higher cost to you financially and a higher cost to her in terms of risk.

So just as you have trouble with my thinking, I can't get yours. Friends tell friends the truth, and the truth is, I think your research has failed your dog. But, maybe you think the same of me, and that is ok.

I've said all I can say on this topic of leptospirosis and the vaccine and I've offered what I could to the OP and to others reading on this topic. At the end of the day, we all have to live with our decisions. I can live with mine, whether they work out how I wanted them to or not. I know my posts probe people to think about some issues, and I leave the ultimate arbitration to them on these matters.

As for you and Tinkerbell, you remain in my prayers. I only hope for a good result for her and for you with this situation.

[kjc]

Originally Posted by Ellie May

I agree with you KJC in that all drugs can potentially cause enzyme number changes and/or damage to the liver and/or kidneys because drugs are metabolized to the greatest extent by these organs.

But I've seen nothing that would indicate that vaccines do this to a greater extent. It would also have to be rare because otherwise every vaccinated dog would be walking around with high liver enzymes. There is also nothing indicating that lepto is the worst on the liver or that it increases liver enzymes more than the rest. I guess that goes along with remembering that all drugs have the potential to do strange things to the body and a veterinarian should assess whether or not there is enough benefit before using them. In hte case of most vaccines and for most dogs, it is worth it.

The two to three fold thing is interesting. I'm not so sure that toxins almost always make liver enzymes skyrocket though. This is something I will have a talk with E's vet about when I get a chance because I'm sure she has treated things like this many times.

The OP wanted to know if prednisone was ever prescribed for Liver disease. Her dog has a Liver Shunt. I said no, I've never seen pred prescribed for Liver shunt. Then I questioned why her vet wanted to treat her LS dog with pred. I have seen pred given most often to lessen bad reactions to vaccines, and I said "such as Lepto" only bc her dog had received the Lepto vaccine for the previous 2 years, in a combo vac, DHL.
My vet said that LS dogs should not be vaccinated, as vaccines can cause liver and/or Kidney damage in dogs with LS.

The OP then stated the pred was to lower the liver enzymes ALT/AST. So I pointed out that LS dogs have been reported as having a twofold to threefold result above normal levels for these enzymes, resulting from the LS, and that values over those numbers may be resulting from a toxin, which the vaccines could be hepatotoxic in this dog, because it has LS.

And concerning the Lepto vac, in general, I found that a 4way Lepto had been developed in 2004, for dogs at risk (hunting dogs and such). I couldn't find that any safer alternative had been used prior to 2009 in combo vacs. I do remember reading about quite a few dogs having reactions to the Lepto vaccine on YT alone, as that was the year I joined YT, and I do believe that they were given the Lepto in a combo vac, but I am not sure.

As for if vaccines raise liver enzymes in all dogs, that would be hard to say, because first the dog gets a clean bill of health from the vet before they give the vaccines (sick dogs should not be vaccinated). All mine come home and lay around for a day or two after getting vaccines... I do wonder what is going on inside them. But who gets bloodwork done 1-2 days after being told their pups are healthy? So I doubt there would be much data on this.

(If you read back in this thread, concerning anything I said, only read my actual posts, bc I have been misquoted so many times it's not funny.)

[107barney]

Originally Posted by kjc

My vet said that LS dogs should not be vaccinated, as vaccines can cause liver and/or Kidney damage in dogs with LS.

That is just amazing to me. Your vet said not to vaccinate a LS dog for lepto, but forgot to tell you to do an ultrasound of the abdomen which would have discovered the shunt and the kidney stones that Tink has? I have to say I don't think I'd personally place a lot of weight in that one's opinion. Just saying.

And concerning the Lepto vac, in general, I found that a 4way Lepto had been developed in 2004, for dogs at risk (hunting dogs and such). I couldn't find that any safer alternative had been used prior to 2009 in combo vacs. I do remember reading about quite a few dogs having reactions to the Lepto vaccine on YT alone, as that was the year I joined YT, and I do believe that they were given the Lepto in a combo vac, but I am not sure.

So if these dogs were given a combo vaccine DHLPP and had reactions, isn't it fair to say it is impossible to know which portion of the vaccine the dog reacted to? The dog may have reacted to Distemper, and the owner may have thought it was lepto, possibly because of what they previously read on YT which also could have been mistaken (and that is how anecdotal evidence gets "developed").

As for if vaccines raise liver enzymes in all dogs, that would be hard to say, because first the dog gets a clean bill of health from the vet before they give the vaccines (sick dogs should not be vaccinated). All mine come home and lay around for a day or two after getting vaccines... I do wonder what is going on inside them. But who gets bloodwork done 1-2 days after being told their pups are healthy? So I doubt there would be much data on this.

My dogs lie around after veterinarian visits in general. The day I started Teddy on his seizure medication was the day we had a vet visit (not a vaccine visit) and we became very alarmed that this new drug was making him catatonic. Turns out the little guy was pooped from his outing. I have never in all 11 years now of vaccinating my two yorkies for core and noncore vaccines see them lay around any more than they would have otherwise from any outing.

(If you read back in this thread, concerning anything I said, only read my actual posts, bc I have been misquoted so many times it's not funny.)

I don't think anyone misquoted you. There was one point we might have misunderstood you. You clarified your statement. But, you continued to say that dogs will have higher liver enzyme elevations after the lepto vaccine than a dog who has a liver shunt. We asked for the information upon which you relied, and you produced a lot of things that are interesting for discussion but none that answered the exact statement you made. The articles you point to do not say what you say they do. There is no credible statement or article in a veterinary journal stating that leptospirosis vaccine will raise the liver enzymes higher than a dog with a LS and that was your statement.

I am curious though. I'm going to have have my dog's blood drawn after the lepto vaccination is administered just to see if this is true. Let's poke Teddy since he has no liver problems and his liver enzymes and BATs are completely normal. Of course, he could have a reaction to the vaccine which might throw off my 'study.'

[kjc]

Originally Posted by ladyjane

[quote: kjc]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.


[...

Originally Posted by ladyjane

[Again, highlighted in red was your quote and is the ONLY thing I asked for....data to back it up and the link you provided what not what I asked for. No matter how you turn this, it comes back to that...I really don't understand your resistance to simply saying it was not a true statement. We all make mistakes. Someone could read that as gospel and not get their pup vaccinated and perhaps the pup might contract lepto and die. Surely you would not want that. Saying "I am not a vet" does not excuse a person from saying just anything they believe imho. I keep saying I am finished. This just boggles my mind.

I disagree, the article does verify what I said. I also posted exactly what I referred to in my post #101. Another problem I see is might be an individual's thoughts on exactly what a vaccine is.

I think, and this is my opinion, that maybe some members may have missed the statement I made in the beginning "In dogs that have Liver Shunt...", because the OP's dog has a shunt, and all my posts have been intended to address the issues of elevated liver enzymes in dogs that have a Liver Shunt, what can affect these enzymes, and some treatments for those issues.

Others have posted about Lepto and the general canine population, and have tried to connect my statements to those individuals, and no, that is not what I posted about. I mentioned Lepto as part of a group of vaccines that the OP's dog had been given previously.

It is common protocol to cease giving any and all vaccines to dogs that have a Liver Shunt because of the adverse effects the vaccines can have on a dog whose liver that is not functioning correctly, as occurs in dogs that have a liver shunt.

When a healthy dog is vaccinated. the liver deactivates the vaccine and breaks it down, then reactivates parts of the vaccine and attaches it to special molecules that are then sent out into the dog's body where these molecules will stimulate the dog's immune system to produce antibodies againt the disease that is contained in the vaccine.

So one can see where vaccinating dogs that have Liver Shunt will not be effective, as the varying amounts of the vaccine in the blood will bypass the liver through the shunt, and activated vaccine will be circulating through the dog's body and add to the toxic load that is a major issue in dogs with a liver shunt, and can, may , might cause the liver enzymes to increase, as toxins do this, as stated in the article I referred to earlier.

You have made these statements in another thread about a dog with high liver enzymes:

Originally Posted by ladyjane

The only way anyone would know if she was fine before that is if lab tests were done. She could have had elevated enzymes for a while. If there were any tests done recently, that would be helpful in determining cause.

I am sorry if it was from the medication because it is a good medication that I have given to many dogs. As a matter of fact, it is helpful with heartworm treatment (Wolbachia parasite), but that is another topic. Unfortunately, all medications can cause issues like this.

Daisy is in my prayers. I so hope she improves.

Originally Posted by ladyjane

The Lepto vaccine is well known to cause problems in dogs.

I remain very confused as to how that would have anything to do with a reaction to a medication.

[kjc]

Originally Posted by 107barney

You are right, not everyone will see eye to eye. I am ok with that, and I will do for my dogs what I believe is correct. I could never and would never sit by and lull myself into a belief that my dog's liver was regenerating all the time when the organ was structurally flawed. In biology, it is said that structure dictates function. So while it is true that the liver is forgiving, at some point, it will just give out. It's why people waiting for liver transplants die waiting.

Tinkerbell is on Denamarin, which helps the liver in cell regeneration.

Your Daisy is on a similar product, as we discussed in PMs a while back, but you do not believe a compromised liver can regenerate?

Originally Posted by 107barney

My point of the research not "fixing" your dog or others was not literal. What I was saying to you was you are not understanding the information you are reading, because if you were, you would have had the dog attended to a long time ago. For two years you opted to research this matter as you recently shared with the entire YT community.

I would also like to take this opportunity to share with 'the entire YT community' that Tinkerbell has been under a vet's care since before she stepped foot in my house and that she has never missed an appointment and has had everything done that was suggested for her during her treatment. There are some extenuating circumstances involved that I won't disclose now, bc this thread is not about me or my dog.

Originally Posted by 107barney

I see that the liver has been failing her and working overtime and what you thought was regeneration was really a liver so broken that it was producing kidney stones. So now you have to fix both conditions, at a higher cost to you financially and a higher cost to her in terms of risk.

So you have taken up 'Diagnosing over the Internet'? Welcome to the club!

Last time I checked.... kidney stones are produced in and by the kidneys, not the liver....

And, no. Once the Liver Shunt is repaired, the kidney stones will resolve on their own, as per my 2nd vet. (I have two that confer on her case). Kidney stones are a common occurence in dogs with Liver Shunt.

My point that research helps owners understand what is going on with their dogs and others....

[ladyjane]

I hope someone closes this thread as it has become ridiculous. I know that I will not be reading it again.

As for your so called "research"....since it has made a pup live with a horrible condition for two years now, I have zero respect for it.

I said I was finished with this thread...for SURE I am now.

I have prayed for Tinkerbell for some time now and will continue to do so since there is nothing else I can do. She does not deserve to suffer like she is. You have chosen to ignore standard accepted treatment methods with your so called "research". It bothers me greatly to see this but out of my hands. I will also pray that you see the light and do the right thing by her.

I know FULL well what you said....and that you have nothing to back it up. That is perfectly clear. You can take quotes from me all day long....bottom line you were wrong and won't admit it. I NEVER suggested that the lepto vaccine raised liver enzymes higher than LS does.....you did! And you are wrong. Perhaps you don't vaccinate your pups...I DO! And, if Lepto was a risk in my area, I would vaccinate my pups for it. Just because I said it is known to cause problems...I did NOT say it does what you say. All vaccines and meds carry risks......people must weigh the benefits vs the risks. I have also said that time and time again. You are reaching...and failing.

[ladyjane]

Originally Posted by Becca1

Thank you and glad to know you take yours to a specialist if only the bloodwork is off. We are going to re-run the BATs and if the numbers are still high, I will go to Univ of MO Vet school for specialist which is fairly close to where we live.

Hope things go well.

[ladyjane]

On second thought......I will stay but refuse to read some things on here. They make no sense to me at this point.
What is important is that the OP's pup is ok. I hope that you do go to a specialist as relying on online information is often dangerous imho.

[Maximo]

Originally Posted by Becca1

Her liver shunt was found upon biopsy and was stated to be a "congenital portosystemic shunt"

Becca, sending best wishes for your little one. If I understand correctly, the shunt was discovered when your baby was 3 years old. Is this unusual for a congenital shunt to go undetected that long? I'm asking because Max will be 3 later this year.

[Maximo]

Originally Posted by Maximo

Becca, sending best wishes for your little one. If I understand correctly, the shunt was discovered when your baby was 3 years old. Is this unusual for a congenital shunt to go undetected that long? I'm asking because Max will be 3 later this year.

My apologies, I'm having a hard time following this thread...I see your girl had a biopsy...I'll re-read the whole thread to get the story straight.

[kjc]

Originally Posted by 107barney

That is just amazing to me. Your vet said not to vaccinate a LS dog for lepto, but forgot to tell you to do an ultrasound of the abdomen which would have discovered the shunt and the kidney stones that Tink has? I have to say I don't think I'd personally place a lot of weight in that one's opinion. Just saying.

This makes the 12th time I've been misquoted.

Originally Posted by 107barney

So if these dogs were given a combo vaccine DHLPP and had reactions, isn't it fair to say it is impossible to know which portion of the vaccine the dog reacted to? The dog may have reacted to Distemper, and the owner may have thought it was lepto, possibly because of what they previously read on YT which also could have been mistaken (and that is how anecdotal evidence gets "developed").

I'll play.... One would have to compare 2 similar groups of dogs, one group that got the DHLPP, and the other group that got the DHPP, and if the occurance of reaction was the same in both groups, yes, it would be impossible.

But, if the percentage of reactions to the vaccine was way higher in the group that got the DHLPP, that would make me very suspicious of the Lepto portion being the cause.

And as I know you know, the only way to difinitively tell is by giving the Lepto separately, which is recommended because of it's history of causing reactions.

And just to note, the new lepto came out in 2004 as you stated, the date on the article (written by a vet) citing Lepto vac reactions in small dogs... was published in 2008. So that still leaves me to question it's claimed 'safer' status...

Originally Posted by 107barney

My dogs lie around after veterinarian visits in general. The day I started Teddy on his seizure medication was the day we had a vet visit (not a vaccine visit) and we became very alarmed that this new drug was making him catatonic. Turns out the little guy was pooped from his outing. I have never in all 11 years now of vaccinating my two yorkies for core and noncore vaccines see them lay around any more than they would have otherwise from any outing.

Nice to know, but mine are only knocked out on 'vaccine' visits, and soreness and malaise has lasted up to 3 days too. My bigger dogs do recover quicker though. That's why I believe vaccines should be adjusted according to the dog's weight, not given as a one-size-fits-all.

Originally Posted by 107barney

I don't think anyone misquoted you. There was one point we might have misunderstood you. You clarified your statement. But, you continued to say that dogs will have higher liver enzyme elevations after the lepto vaccine than a dog who has a liver shunt. We asked for the information upon which you relied, and you produced a lot of things that are interesting for discussion but none that answered the exact statement you made. The articles you point to do not say what you say they do. There is no credible statement or article in a veterinary journal stating that leptospirosis vaccine will raise the liver enzymes higher than a dog with a LS and that was your statement.

This makes the 13th time I've been misquoted... this is what I said:

"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."

All this means is that the liver enzymes of a Liver Shunt dog can be 2-3 fold higher than normal bc of the Liver shunt. When this Liver shunt dog gets a vaccine(s) (any vaccine, including Lepto) it could possibly raise this LS dog's enzymes higher than the elevation seen when tested before the vaccine was given, when the elevation was due to the dog having LS.

The point of this statement is: depending on how elevated the enzymes are of the OP's dog, (she did not state the actual number), the elevation of the liver enzymes could be due to the dog having a shunt, and/or being vaccinated. If the elevation of the dog's ALT is 200-300, that elevation is reflective of the elevation commonly seen in LS dogs with out vaccine involvement. If the OP's dog's ALT is 600, then the vet has to take into consideration that half of this elevation may be caused by the LS, and the other half may be caused by the vaccines or another factor. As "coticocosteroids are potentially hepatotoxic" per The diagnostic approach to asymptomatic dogs with elevated liver enzyme activities - Veterinary Medicine, (see chart), I was just questioning their use in this LS dog.

Originally Posted by 107barney

I am curious though. I'm going to have have my dog's blood drawn after the lepto vaccination is administered just to see if this is true. Let's poke Teddy since he has no liver problems and his liver enzymes and BATs are completely normal. Of course, he could have a reaction to the vaccine which might throw off my 'study.'

Yes, you could, but, again, I was talking about LS dogs and elevated liver enzymes, not normal, non-LS dogs.

[kjc]

To the OP... my apologies for the sometimes off-topic discussions....


I did find this about surgery for intrahepatic shunts....

Surgical Management

[107barney]

I just have one thing to say and I'll make it brief.
I did not diagnose anyone. I don't even "diagnose" my own dogs. I go to vets, regardless of "extenuating circustances" and they do the diagnosing. I spent more money than my money tree in the backyard can grow but I find a way...I share those experiences not to dictate to others how to live their lives but not everyone has the resources or lives in urban areas with top notch vet care. So if someone thinks something is interesting that I posted, they can talk to their own vets about it. I do the same. As for my dogs, No extenuating circumstance will ever be an excuse in my world, it's not in my constitution.

I shall leave this thread now.