Positive update on my Scooby with the elevated ALKP 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 |
Yay!!!!! :bravo::cheer::cheer::cheer::yay_jump::yay_jump: :mademyday:woohoo::happyboun |
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Diana and the Scoobster |
I am glad they figured it out. Good thoughts to you both |
How is Scooby doing? |
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Diana and the Scoobster |
This is such wonderful news! I'm so very happy for you and Scoobers! It's time to PARTY!! :happyboun:happyboun:happyboun |
Dianna, I am in about the same boat with Zoey who is 9 1/2 yrs. old. Actually Zoey was born in one of my litters and given to a friend as a puppy. We have kept her over the past 9 years at least a week out of the month for the friend to go to conferences. The friend died in Nov. last year unexpectedly and Zoey came to me because the friend's children didnt want a dog. She seemed fine until 3 weeks ago and had a seizure. Vet decided it was hypoglycemia. A week later the same thing happened and this time she didnt seem to come out of it. She is at the vet's now and an IV and having tests done - bile acid, etc. When her regular vet saw her last time in 2012 he had noted then that the alt was high but obviously didnt explain the condition to Sandra and Sandra had Addisons Disease and was having her own problems I guess by then. I didnt have the benefit of those tests until recently. So now we are dealing with a liver condition that has possibly been going on for a years. Please send up prayers for Zoey and a diagnosis that we can work with. Thank you all so much. |
Absolutely, Julia. Liver disease can be so frustrating, as the answers don't come easy. Over the past eight months, I've spent thousands and have had every test done - some of them more than once - and we stopped just short of an open biopsy. We still don't have any real answers. Obviously something was seriously wrong for his ALP to climb to over 7000, but his liver function remained good (bile acid only slightly elevated) and he continued to eat well, didn't lose any weight, and is pretty frisky for a 14 year old. We added ursodial a couple of months ago, mainly just for the antioxidant effect, and either it had an immediate positive effect, or all the other stuff we'd been doing for months finally caught up. ALP is still quite elevated but his ALT is normal now and for the past two months the ALP has been dropping so hopefully we are finally on the right track. Has your pup been tested for Cushings? We were finally heading in that direction but his test was negative. Definitely sending prayers and good thoughts for Zoey. Hope you get some answers soon. Is the ALP the only number that's elevated? Diana and the Scoobster |
ALT was elevated, GLU was low, BUN was low, TP was low, ALB was low, Alt was high, and AMYL was low. In 20 years of having yorkies this is the first time I have dealt with liver issues and she is 9 1/2 so if there is a LS, I assume it is an acquired LS. |
Julia, have her kidney numbers been checked? Also has she had a recent urinalysis? Some of those numbers could also have something to do with kidney function or proteinuria. Which really complicates things when you have multiple issues going on and don't know where the numbers point to. The BAT will give you a good idea of whether you're dealing with a shunt. Diana and the Scoobster |
She has had UTIs last year and one this year. When I got a copy of her medical records from last year it showed UTIs and this episode started with blood in the urine. We put her on antibiotics and it cleared up but she had her first seizure the day after she finished her antibiotics. So my guess is she does have some kidney involvement. |
Ahhh....poor little Zoey. I'm sure you have a competent vet that will put it all together, but it just makes me so sad when these little babies have this kind of trouble. My Scooby has had a few seizures too. One in May, then another in September when he got really sick with the liver thing, another in January. Nothing since, and now his liver numbers have dropped significantly so I hope that was the cause. If not, he's about due, since they've been happening every three or four months. Diana and the Scoobster |
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