Questions about a liver biopsy and elevated enzymes.

Janice -- honestly?  I wouldn't have it done.  IF it is just inflammation (they can have bacterial hepatitis with pancreatitis -- Billy did and it made his liver look AWFUL) you can get that down as the abx work and you get milk thistle and sam-e in there to get down those numbers.

If it's liver cancer?  in honestly there's not a lot you can do -- but I'm not sure I'd further stress her with a liver biopsy.  If they've done an ultrasound and the liver just looks WEIRD -- well, that happens when the liver is "sick" with infection.  I had this happen with BOTH Foxy and Billy -- both of them had vets telling me "the liver looks awful - it's probably cancer" along with the other lovely euthanasia speeches.

 IN NEITHER CASE was it liver "failure" NOR was it liver cancer!!  It was just a sick, inflamed liver.

 Billy's liver never was "pretty" after IMHA -- when he swallowed that quarter my vet was SO WORRIED about how bad his liver looked when he was in there removing the quarter.

 I flatly said to him (and I LOVE this man) "Did you HONESTLY think Billy's liver was gonna look ok after ALL he's been through??"

"Well, yes, the liver regenerates"

"yeah, it regenerates, but it has ALSO been damaged by the drugs.  I'm giving him liver support supplements and SAM-e and TONS of milk thistle to keep the liver supported enough so it will do its job.  Frankly, it's NOT a surprise to me that his liver looks ratty - but it's DOING what it should."

After abx -  both with Foxy and Billy for those respective infections/traumas -- the liver functioned fine -- particularly fine for an older dog who has been thru heck.

 I'd ask them for some time -- time to try and get rid of the infection AND to get the liver numbers down.

THEN -- go to Vitamin Shoppe and get her some CellFood SAM-e (it's about $40 - but probably 15 drops twice a day), and give even more milk thistle.  Maybe give both tincture *and* powder for a while and I betcha you can get those numbers down without having to have a biopsy done.  At least I HOPE SO.  But if the pancreas is THAT inflamed, that wouldn't be when *I* would want something invasive like a liver biopsy done.

 Have they considered given the look of the liver and the pancreatitis, that maybe it's both pancreatitis and hepatitis both?  I'm talking about bacterial hepatitis, not the viral hepatitis like humans get.  The liver and the pancreas are REALLY close so if one gets infection it's not a far step to both of them getting sore.

and YEAH -- that's enough to give pain and put her off food.  A toxic liver alone will cause her to be nauseated.  You may want to ask the vet about something easy like lactulose -- it's a laxative BUT it's used a lot with liver toxicity  -- it binds with liver toxins and gets them out of the body so then they feel less nauseus.

Liver toxins shunt to the brain -- they FEEL sick to their stomach.  They technically aren't -- it's the toxicity making them feel that way.  So lactulose can be helpful.  Now it gives them diarreha -- but if you can handle it, sometimes it's a quick way to find out if liver toxins are causing the lack of appetite.

  Thanks Kate and Callie. I'm going to order the CellFood SAM-e; it's been hard to give Jessie SAM-e because she's so wary of pills. Drops should work great. If my vet thought she had liver disease, he would have told me when he said the blood work indicated pancreatitis, so I'm sure he thought her liver enzymes were elevated because of the flare up. It was only the ALT and Alk- Phos; her bilirubin and GGT were normal.  Her ALT went down 300 points the next day, and the Alk-Phos was down about 200 points, but I think it would be a good idea to have her on the SAM-e as a precaution. I think she's allergic to milk thistle because her ears got very itchy when I gave to to her before, so I'm going to wait a while before trying it again. It's in a family of weeds that she's allergic to.

  Callie; I remember when Foxy was sick and they thought it was cancer of the liver and suggested putting him down, and you insisted that he be treated for an infection. I thought of it when I told that I wouldn't agree to a biopsy, at least not at this time. I have learned so much from your posts.

jessies_mom

I think she's allergic to milk thistle because her ears got very itchy when I gave to to her before, so I'm going to wait a while before trying it again. It's in a family of weeds that she's allergic to.

Wow -- that would be TOO sad because it's SO beneficial so often.  You might want to try milk thistle tincture (and see if it was the plant matter that was the allergen or the rest of the plant) -- HerbPharm is going to be the "best" (he uses only wildcrafted herbs so no fertilizer, etc.) AND that's also drops.  (Some companies are making it decocted in glycerite now BUT typically it's not nearly as beneficial -- for some reason the stuff you need is released better in alcohol.)

Email me if you'd rather, but tell me specifically what the plants are that she's bothered by?  (Remember -- this is me, Ms. Can't--eat-basil-and-tons-of-herbs.  I always need to learn stuff like that.)  some of the stuff that bothers me is plant "families" but I'm also completely convinced that often it's what something was *washed in* that bothers me more than the item!! 

The CellFood SAM-e drops are incredible (made by 'Lumina Health' I think).  SO FAR the best place, believe it or not, that I've found is Vitamin Shoppe (which isn't normally on my top 1000 of the cheapest places to buy **anything**).  Their price isn't bad and it's usually available for most.  It's a couple of places on Amazon and if you've got Prime it's no more but no less (and you have to watch it -- most of the places are *not* eligible for Prime).  I've seen it on E-Bay but you gotta watch E-bay -- some merchants charge you postage on EACH ITEM and man, that can get insanely pricey. 

 The CellFood SAM-e *does* have the CellFood supplement in it which I do like a lot but *do* read the label since this is Jessie we're talking about. 

calliecritturs

Email me if you'd rather, but tell me specifically what the plants are that she's bothered by? 

  Milk thistle is in the same family as daisy's and asters;     Asteraceae - Wikipedia, the free encyclopedia  It is a very large group. Jessie is very allergic to chamomile, which is in this family.

David's allergic to chamomille -- it makes him almost shake apart.

And *I* can't use calendula (I can't even use homeopathic calendula!) -- I break out into massive itch.  Calendula is made from marigolds.  MAJOR allergen for me.  *sigh* I get it!