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. 

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.

 

In Friday’s post I showed a partial comment left by Retro Rover.  After I scheduled that post there were a couple more that really resonated and I thought it would be good to address those as well.

First up, Retro Rover’s comment: ” Pings levels have fluctuated quite a bit over her liver disease journey of two years. Also I would ask the vet about what will be gained from the biopsy. In Pings case we elected not to do it as they said it would only possibly reveal the big C and there was basically nothing to be done about that. Of course I’m sure the situation could be very different with Delilah and there might be much to gain. I was also told that the procedure was somewhat risky.”

One of Red’s dogs has been having liver issues.  In fact, Red and I have had a couple of e-mail conversations and she’s been very helpful.  She has Ping on Denamarin which she buys online.   Delilah has been on the Denamarin for a month.  BUT since it hasn’t helped, our vet is switching the medication to Hepagen-C , this has Milk Thistle like the Denamarin does but it also has B6, B12 and Curcumin which is one of the properties in Turmeric.  While reading up on canine liver issues I found one of the suggested supplements was Turmeric.

Thursday afternoon the vet called with the results of the Acid Bile test.

What is a Bile Acid test?

My understanding of a Bile Acid test is such.  The dog is fasted and blood is drawn, the dog is then fed a (fatty) meal and two hours later the blood is drawn again.  This tells the Vet how well the liver is functioning and doing it’s job.

According to our Vet Delilah’s levels were ‘slightly’ elevated and she recommends a liver biopsy.  I asked her, what is the purpose of the biopsy. Here’s what she told me.

She feels Delilah’s liver issue (for lack of a better word) is one of three things, 1) Chronic Hepatitis 2) Reactive Hepatitis 3) the liver is storing copper.

Each of these illnesses is treated in a different way.  Without knowing what is causing the elevated liver levels, we cannot treat the underlying issue and make Delilah feel better.

What about risk in performing a liver biopsy?

There is a risk with any procedure, but they take precautions.  They will check her vitamin K levels and will be checking her blood to make sure it clots.  From what I understand the biggest risk is bleeding.  Trust me, this did not reassure me in the slightest.

I asked could these just be normal levels for Delilah.  She is after all an extraordinary dog. 🙂

The vet said her levels have always been normal before, so no.

Seeing as Delilah’s liver levels are only slightly elevated, my vet feels we have time before needing to perform the biopsy.  Which turns out well as funds are a bit tight right now and I’m really on the fence about this test.

I also had a comment from Hailey and Zaphod who said, “Our first dog had immune mediated hepatitis that caused psoriasis of the liver. It was a difficult journey for him and us. I hope your lovely girl does not have anything as serious. POTP.

I’m so sorry to hear about this.  I cannot imagine how heartbreaking and difficult that was for you.  I’m hoping since we caught this early we will have a good shot at getting to the bottom of whatever it is and making sure Delilah gets the best treatment possible.

Sherrie Petrie said “Jodi – Ask your Vet about putting Delilah on Milk Thistle it helps support and clear toxins from the liver. I had a Sheltie who had liver difficulties and this helped decrease her numbers. You never know anything could help. ”

Thank you Sherrie, the Denamarin we had Delilah on is a combination of Milk Thistle and SAMe.  Our vet leans towards the holistic which is one of the reasons I love her so.

Rachele Baker DVM said, “If you ever feel that you would like more information about her liver issues or that you would like a second opinion, you might consider taking her to a board certified veterinary internal medicine specialist in your area. You could ask your veterinarian for a referral or just check online and/or talk with friends to find a specialist in your area that has a good reputation. It is usually possible to take your pet to a specialist without a referral from your veterinarian and it is usually not that expensive for an examination and consultation with a specialist.”

Thank you Dr. Baker I am going to ask my vet about seeing a specialist.  

Interestingly enough, as I was researching some of the potential reasons causing elevated liver levels, I discovered they can be caused by dental disease.  While Delilah does not currently have any dental disease, she does need a tooth extracted and because of this she is beginning to get some tartar build up.

While the person I spoke to at my vet’s office said Delilah’s tooth should not have any bearing on her liver levels, I prefer to have them checked again after her cleaning and extraction.

I thank you all so much for sharing your knowledge and experiences with me.  I hope this has helped in explaining a little bit about what Delilah is going through.  I will of course keep you informed of any changes in Delilah’s health or changes in our decisions regarding treatment.