Heart Like a Dog

The Good, the Bad, and the Oh My God of living with dogs!

On The Right Track

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In June we discovered our dear Delilah’s liver levels were slightly elevated.  Since then we’ve had them checked twice and each time they seem to increase ever so slightly. 

You're talking about me again?

You’re talking about elevated liver levels again?

Last Tuesday she had her dental cleaning and a very bad tooth was removed.  While Delilah doesn’t have dental disease I’m very hopeful the tooth is the root of the liver issues.  

Still I want to be as proactive as possible, so I had my vet fax over the results of the latest blood tests to our Holistic Vet.

He called me Tuesday while Delilah was having her cleaning.  Bottom line, he’s not super concerned about the slightly elevated levels.

Here’s why:

Delilah’s ultrasound showed her liver was the correct size, shape and texture and there were no obvious signs of liver disease, and no masses.

He did say that Gastrointestinal issues can cause the liver levels to become elevated.  On the surface Delilah (or Old Iron Guts as we often call her,) doesn’t appear to have stomach distress.  

I think she’s vomited three times in the entire seven years she’s been with us, and her stool is usually firm.  She has however taken to eating grass lately.  Not mowing on it, like a cow, but she takes bites here and there.   

My vet has recommended a liver biopsy as the next step and both Hubby and I are very uncomfortable with it.   I discussed the biopsy again with the Holistic Vet who asked me, “Will you do anything differently if the biopsy showed you something was wrong?”

Our answer to that is no.  Don’t get me wrong.  We want Delilah to be healthy and happy and are willing to spend the money to make her feel better.  We just don’t want to do it with synthetic drugs, or chemicals.

The Holistic Vet wants to try supporting Delilah’s Gastrointestinal system and Hubby and I are on board with that.  Since last Tuesday we’ve added Enteric Support by Standard Process and a Chinese Herb called Leaky Gut.  I’m also going to be adding a probiotic (although they do get Kefir) as well as a good multi-vitamin.  In addition, I’m making some dietary changes by trying to incorporate some new proteins.

With the tooth out, we will keep her on this new protocol and recheck her levels in two months.  We’ll adjust our plan from there, when and if it warrants it.

Because I have a tendency to second guess myself, it helps to talk things over with a professional.  I felt much better after chatting with the Holistic Vet.  

Like we are on the right track.

Elevated Liver Levels ~ Delilah’s Story

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Delilah is a Chocolate Lab.  She went for her annual checkup in June.  At that time she was about 8 1/2 years old. At her appointment I asked to have her thyroid checked as she appeared (to me) to be drinking a lot. (**Note, she does take thyroid medication twice a day.)

Delilah, age 8 1/2.

What do you mean my liver levels are elevated?

I was floored when the vet called and said her thyroid was normal but her ALT (Alanine Transaminase) liver levels were slightly elevated. By slightly I mean, the range for ALT is 18 – 121) Delilah’s were right around 200.

First it’s important to know exactly what the liver does. According to Pet Education “The liver is an extremely important organ in the body. It is responsible for protein, fat, and carbohydrate metabolism; vitamin and mineral storage; digestion of food and detoxification of wastes.”

Since the liver’s job is to detoxify wastes, we started out with a double dose of antibiotics and a hard dose of Denamarin, thinking perhaps her liver was just feeling sluggish or something she’d eaten or been exposed to had made it angry. Denamarin is a combination of SAMe (Sah-me) and Milk Thistle. Milk Thistle is a natural herb used for liver problems. SAMe is a reaction between amino acids and molecules that carry energy. It is also used to treat liver problems as well as bile flows.

Delilah was on the antibiotics for three weeks and the Denamarin for a month. As the treatment wore down we had her tested again and the liver levels had once again risen slightly. Our vet recommended a change in supplements and suggested an ultrasound of Delilah’s liver.

The ultrasound showed the liver to be the right shape and size with no masses detected. We were advised the next step was a biopsy of the liver.

We stopped the Denamarin and added in Hepagen-C from THORNE Research. I also called our holistic vet who was not surprised that the levels had risen slightly after a course of antibiotics. He liked the Hepagen-C but wanted to add another liver support as well, so we started her on Canine Hepatic Support from Standard Process.  He and I were in agreement that a biopsy wasn’t warranted at this stage.  Our regular vet agreed we had time before the biopsy was necessary and I also discussed it with another vet in the practice and we all agreed no biopsy at this point.

Delilah has now been on the new protocol for about two months. Since she’s having her dental cleaning this morning, we had her blood work done last Friday and the vet called with her results Saturday afternoon.  Her levels have gone up again.  Her ALT is now at 236.  Additionally her TBIL (Bilirubin) is right on the borderline of normal/high and her A/G Ratio (Albumin to Globulin Ratio) is creeping up to the high end of normal.

I won’t lie and tell you I’m not concerned because I am.  But having researched this topic for a number of months, I feel like there could be outside factors contributing to the elevations.  Since the liver’s job is to remove toxins, is there something Delilah is exposed to that isn’t agreeing with her liver?

My initial thoughts:

  • Something she eats.  This dog eats EVERYTHING.  Stuff she finds in the yard, stuff she finds in the woods or the road, stuff that’s bad for her, like Chocolate.
  • Coffee/Alcohol.  I admit to liberally lacing my coffee with whiskey on the weekends.  If I’m not diligent with my cup, she WILL help herself.
  • Flea and tick spray.  I use a natural Flea and tick spray.  When I first showed it to my vet she mentioned some dogs have a problem with one of the oils.  I googled it this weekend and the spray I’m using has 1% cinnamon oil which can be toxic to dogs.
  • An environmental toxin.  While I try and use natural cleaning products, there is no telling what kind of chemical buildup there could be in my home.
  • Food. We feed raw and we do feed a lot of poultry, I’m wondering if it’s too much for her, so I’m working on adding some variety to their diet.
  • Dental issues.  When Delilah had her exam in June our vet could see that she has a broken tooth.  While the vet’s office assures me the dental disease they are referring to that can be an underlying cause of dental disease is far more severe than Delilah’s broken tooth, we do know that the tooth is bothering her.  For one thing our vet can see the plaque building up in that area and I have noticed her pawing at it a couple of times.

Time will tell.  Delilah is having her tooth removed today.  We will continue Delilah on the liver supports she is on now, and after her mouth has healed I will begin introducing some different proteins in her diet for variation and I’m thinking of having her checked to see if she might have allergies.  Your Designer Dog had a post about an allergy kit that only requires a mouth swab.

Can I eat the swab? It sure sounds tasty.

Can I eat the swab? It sure sounds tasty.

I have a call in to our Holistic vet to discuss the changes with him and will consult not only with our own vet but another vet I trust in the practice.  I don’t know whether I’ll agree to do the biopsy or not, for me the risk is great and I’m not sure what if anything the biopsy would show that would make me do anything differently.

Right now I’m comfortable with the choices we are making for Delilah, but our choices may change down the road.  Since this is part of the Caring for Critters Round Robin, I will update this post as the need arises.

Caring for Critters

Caring for Critters

In yesterday’s Caring for Critters post,  JoAnn at Sand Spring Chesapeakes wrote a moving post about her dog Norman and his experience with Osteosarcoma, I think she said it best. “Every medical decision is an individual one, it should be thought out carefully with the help of the Veterinary professionals and family members. To me there is no right or wrong answers as to what or how far someone should go for their pet. Each individual needs to make decisions that are right for them and ones that they will be able to live with.”  Thank you JoAnn.

I am now ‘passing the Round Robin baton” on to our next blogger.  Make sure to check out SlimDoggy tomorrow as we delve into obesity in pets.

Lick Granulomas-Caring for Critters Round Robin

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Today’s post is part of the Caring for Critters Round Robin.

Please keep in mind, I am not a vet and this is not advice on how to handle a Lick Granuloma, this is just my experience, and what worked or didn’t work for me.  Always consult your veterinarian before choosing any course of treatment.

We’ve been battling Lick Granulomas with Sampson for a couple of years now. (I wrote about it HERE, HERE and HERE.)

What is a Lick Granuloma you ask?  Web MD defines it this way, “A lick granuloma is an open sore, usually at the ankle or wrist, perpetuated by constant licking. It is seen most often in large, shorthaired dogs such as Doberman Pinschers, Great Danes, Labrador Retrievers, and bird dogs.” (To read the total definition, click HERE.)

As I said, we’ve been battling the Lick Granulomas for a couple of years now.

A little back story.

At the time of his first Lick Granuloma Sampson was almost eight years old.  Our lifestyle is quiet, nothing much had changed except for the occasional visit from small grandchildren.  Originally I thought it was a hot spot, but I found out differently.  I began dabbing some Witch Hazel on it twice a day and that seemed to help.

At his scheduled vet appointment my vet thought he had a soft tissue injury.  He was put on some Gabapentin which also seemed to help.  The Lick Granuloma healed up.

The following spring Sampson started at his wrists again.  I called the Holistic vet who examined him and felt he had some seasonal allergies and a sluggish liver.  He gave me some supplements which helped, but as soon as the supplements ran out, Sampson was back to licking his wrists again.

The dark areas on his paw indicate areas he licks at causing the Lick Granuloam

The dark areas on his paw indicate areas he licks at causing the Lick Granuloma

He is not discriminative, he makes Lick Granulomas on both wrists.

He is not discriminative, he makes Lick Granulomas on both wrists.

Back to our vet for a consult who suggested cold laser therapy along with the Gabapentin, once again it seemed to help.

Until he tore his ACL.  Since that time the Lick Granulomas come and go.

Since we started him on acupuncture for the sore Iliopsoas muscle and his arthritis, he seems to leave his wrists alone.  Once I notice him picking at his wrists, I know it’s time to schedule another session.  His yearly examine is coming up next month and I’ll definitely be talking to our vet about this, and getting him on a good joint supplement to help ease his discomfort.

Some theories say that once a dog starts on a Lick Granuloma it can become a habit.  There are also thoughts that a dog who is bored will lick.

In Sampson’s case, I suppose it’s possible that the Granuloma has become habit.  Although he willing leaves it when I call him off it.  I don’t believe he licks out of boredom, if anything his life has become a bit more exciting since his surgery, because his walks have increased from once to twice per day and we vary the walk.

I’m pretty certain Sampson licks when he’s in pain.  This is certainly not something we want, which is why we will be continuing the acupuncture as well as finding a good joint supplement.

Tomorrow’s post for the Round Robin will be on Giardia, make sure to check DZ’s Adventures for that post.

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