We're Numb and Need Advise

[Bam Bam SF]

She is beautiful!! Sending Prayers from California, Please keep us posted.

[Ladymom]

Here are some links for you about liver disease from Dr. Center (Cornell) and the University of Tennessee:

Hepatic Vascular Disorders - WSAVA 2006 Congress

Clinical Services

[LuvMySissy]

John - I know nothing about liver disease, but I wanted to offer up my prayers for little Sophie. Glad you found YT - you'll get the best information from this group!!!!

[DENISE517]

Wish I had some advice for you, but I dont really know anything about this. Just wanted to say I'll be praying for you guys and your baby

[chattiesmom]

Hi John, first off I would like to welcome you to YT. I am glad that you found this group. Even though we can't cure your little Sophie directly, we can certainly help with all of the prayers, being said in your family's behalf.

Unless you have complete confidence in your vet, I would suggest getting a second opinion. I always question vets who start with the "big $$ diagnosis items". There are many things that can cause slightly elevated bile acid test results, including eating a high protein diet. I am surprised that the vet didn't first recommend changing diet and doing a full blood panel - which is much more valuable than just a bile acid.

After re-reading your original post, it seems rather odd to me that the neurologist offered a 1,600 - 3,200 diagnosis and when you said that you were not in a financial position to pay that amount of $$, then all of a sudden he recommended the bile acid testing. I would really consider looking for a new team of vets. Even though the group you are using might be talented, it also sounds like they are trying take as much of your $$ as possible.

My prayers are with Sophie, you and your wife.

[Lexi Rae]

im sorry i have no information i can offer you, but i am praying for your
baby to get better... and will continue to pray for her. we are all here
for you, as you came to the right site for the love of our babies.
welcome to you and your wife..

[TLC]

I have to agree with everyone here. Please seek a second opinion, that $ is crazy...

I also have a dog with a compromised liver. Her first BAT (bile acid test) was pre: 43 and post: 100.9 - at the time she was eating a Raw food diet (high in protein and organ meat) - which can be very hard on the liver. I did see an Internal Medicine Specialist. We did a CBC, urinalysis, coagulation and an ultrasound. All results came back normal. The U/S showed a normal size liver and normal shape liver, no shunt was seen, but as Ellie May stated, a U/S is not 100% accurate and may not really be needed.

Since last year, I have done about 5 or 6 BATs on Roxy. With her diet changed to a low, but quality protein diet and supplements, we have brought her post # down into the 60 to 85 range, but she most likely has MVD - which is being controlled by diet and supplements.

Best of luck and keep us posted!

[Ellie May]

If you are going to change her diet there are a few options.
Canned Science Diet L/D is used often.
Dry Science Diet L/D is used but it contains a couple things that are not recommended for liver compromised dogs or that shouldn't be in dog food at all (like ethoxyquin).
Royal Canin LS 14 kibble is good for liver compromised dogs but it is very important that these dogs get lots of moisture, so if you go with kibble, you might want to add equal parts water (1/4 cup kibble with 1/4 cup water...). Royal Canin has also made several Yorkies very itchy (including mine), so I hesitate to recommend this food but it is one of the better choices.
Vets will sometimes try to give Science Diet K/D because it has less protein than L/D but one of the ingredients in hard on the liver, so I would stick with canned L/D or Royal Canin 14 kibble...

Natural Balance also makes a vegetarian kibble that might work for some dogs.
The goal with feeding protein is to feed as much as you can without seeing symptoms. Neurologic symptoms (like shaking) mean that the toxins from the food are going to the brain and aren't being filtered by the liver.

Red meat has the most ammonia and should not be fed at all.
Non-meat protein is considered best so far.

If you don't want to feed any of these, you can homecook.
There are recipes available for liver compromised dogs or you can talk to a nutritionist.

As for supplements, in my opinion, all dogs with compromised livers should be on Denosyl (the dog version of SAMe) or a similar product that is liquid called VetriDMG. Entirelypets.com sells Denosyl for about $19,00 a month which is way cheaper than some vets sell it for. No prescription is required but it is always best to talk to the vet about it first. It is very safe. Lactulose will also be needed if she is having symptoms. It helps push the toxins out of the body. Fish oil and vitamin E wouldn't hurt.

While I think that with the shaking and high bile acids your girl does have a liver problem, I really think a new team of vets as Chattiesmom said would be a good idea.

[JRitchie10]

Again, thanks to everyone for their prayers and information. We have scheduled a second BAT for Friday morning to see if the original count is consistent with another. I inquired about changing Sophie's diet first and then doing the BAT, but my vet indicated that the neurologist preferred to do both, with the BAT first.

What is very interesting is that we have seen a marked improvement in the shaking with really no change in nutrition, although we are going to get away from the protein diet (her current food is a minimum of 25% protein). They did a full CBC panel on her and all came back normal...not sure what this means in the big scheme of things, but it's good there were not other underlying blood issues. She is very frisky tonight and both the bowels and urinary tract seem to be normal, although they have not taken a urine sample.

We just keep plugging along and appreciate all of your thoughts and support. I'll drop a note when we know more.

God Bless and thanks again for being there.

John and Chris

[Ellie May]

It is good to do a blood panel but the ALT sometimes doesn't elevate until 70% of the liver is damaged, so it can be inconclusive. Looking at the BUN is good also (which is part of a blood panel).

Twenty-five percent protein isn't too high for a healthy dog.
When this started to happen, had she just been given medications or vaccines or possibly red meat? These things could've set her off.

[mscat]

I am very sorry about your Sophie. She is a beautiful Yorkie. I wish you and your family the best, and will keep Sophie in my prayers and thoughts.

[4doggiemama]

Sophie is adorable and beautiful. I pray that she will be okay and that her liver is not compromised; if it is that it is MVD because you can control that with diet. I'm glad you found YT. There are some very educated members here. Welcome to you, your wife, and Sophie.

[magsy17]

Originally Posted by Ellie May

If you are going to change her diet there are a few options.
Canned Science Diet L/D is used often.
Dry Science Diet L/D is used but it contains a couple things that are not recommended for liver compromised dogs or that shouldn't be in dog food at all (like ethoxyquin).
Royal Canin LS 14 kibble is good for liver compromised dogs but it is very important that these dogs get lots of moisture, so if you go with kibble, you might want to add equal parts water (1/4 cup kibble with 1/4 cup water...). Royal Canin has also made several Yorkies very itchy (including mine), so I hesitate to recommend this food but it is one of the better choices.
Vets will sometimes try to give Science Diet K/D because it has less protein than L/D but one of the ingredients in hard on the liver, so I would stick with canned L/D or Royal Canin 14 kibble...

Natural Balance also makes a vegetarian kibble that might work for some dogs.
The goal with feeding protein is to feed as much as you can without seeing symptoms. Neurologic symptoms (like shaking) mean that the toxins from the food are going to the brain and aren't being filtered by the liver.

Red meat has the most ammonia and should not be fed at all.
Non-meat protein is considered best so far.

If you don't want to feed any of these, you can homecook.
There are recipes available for liver compromised dogs or you can talk to a nutritionist.

As for supplements, in my opinion, all dogs with compromised livers should be on Denosyl (the dog version of SAMe) or a similar product that is liquid called VetriDMG. Entirelypets.com sells Denosyl for about $19,00 a month which is way cheaper than some vets sell it for. No prescription is required but it is always best to talk to the vet about it first. It is very safe. Lactulose will also be needed if she is having symptoms. It helps push the toxins out of the body. Fish oil and vitamin E wouldn't hurt.

While I think that with the shaking and high bile acids your girl does have a liver problem, I really think a new team of vets as Chattiesmom said would be a good idea.

The only thing I would add to this would be the Hepato Support that can be purchased from here HomeVet Online Store it is actually comprised of milk thistle. Good luck!

[JRitchie10]

[QUOTE=Ellie May;2130576]It is good to do a blood panel but the ALT sometimes doesn't elevate until 70% of the liver is damaged, so it can be inconclusive. Looking at the BUN is good also (which is part of a blood panel).

Twenty-five percent protein isn't too high for a healthy dog.
When this started to happen, had she just been given medications or vaccines or possibly red meat? These things could've set her off.

[B]No, she actually was due for her heartworm meds but she was a week away from getting them when we noticed the shaking. She is currently on dry food (Natural Choice Lamb Meal and Rice). We don't give her any red meat at all; trying to keep her as healthy as possible. She gets no table scraps or leftovers. She loves (or should I say loved) peanut butter in her Kong but that has been stopped all together for the last week. Amazingly, the shaking has subsided substantially (her head). She is still very nervous during thunderstorms, so last night didn't help her here in Ohio.

Her ALT was at 43 (in the normal range) and BUN was 17 mg, also in the normal category. Actually, everything in her panel was normal except for her AMYL which was just a bit low at 358, but the vet wasn't concerned with it.

[Patti]

Welcome! I am sorry you are going thru this with Sophie. Cali, my 3 year old was diagnosed with very mild MVD. Her bile acid tests were 0/90 and on retest 0/47 or close to as I remember. She did have a liver biopsy when she was spayed and it showed a very mild MVD (internal liver shunt) that requires no treatment. I do keep her on a lower protein diet and I watch closely all treats as they can have high protein counts. Maybe try and lower her protein intake and redo the bile acid test. I will keep Sophie in my prayers.