Hi -- you are doing a *lot* of good things. The first thing, tho - and you already realize this - is you need better vet help. Altho, honestly rather than "ditch" the vet you have (who seems willing to try) I would suggest you *add* a vet. I would suggest something like a TCVM vet (Traditional Chinese Veterinary Medicine -- not an Oriental vet, but rather one who is certified in acupuncture, herbology, nutrition, etc.).
TCVM absolutely rocks for dogs with liver issues -- the liver can be supported, and you are doing a lot of good things. I can help you with some of this but If you will email me your zip code I can help you find a vet who may be better able to help support the liver, and yet still work *with* your regular vet. My email is callieatcritturs@yahoo.com and once you email me I'll send you all my contact info.
Also -- if you possibly can call the vet and ask for the bloodwork to be sent to you via email (that's usually how they get it now) and then forward it to me?? Bloodwork isnt' just specific values. Bloodwork is really all a big set of numbers that aren't taken one by one .. but rather this in ratio with that. If *this* is high, then is *that* low??? Or is "that" high also? So you can't just post various values -- it kinda all has to be viewed togehter. I'm no vet, but I can at least give you an idea of questions to ask
Yes, the liver *does* regenerate. However, you don't say how old Cody is? The liver will regenerate up to a point .... you sort of have to balance that with supporting the liver and what else is going on.
Re things you are doing:
SAM-e. The Cell Food SAM-e is incredible. It's far better than the tablets. BUT to use what you have now:
1. Crush the pill before you give it to her. Human SAM-e is enteric, meaning it digests in the small intestine and dog's don't do that well. So you have to defeat that enteric coating on the pill. (don't do it long in advance -- as soon as SAM-e sees light and air it begins to deteriorate). -- give **with** food, not before.
2. Give it to her **twice** a day. Not once. Most liver stuff needs to be given more times a day than once in order to continually support the liver. Generally I do breakfast and supper. (If you've been feeding once a day, try twice a day with smaller meals - generally it works better.)
3. Tell me how much she weighs and I'll tell you how many drops of the CellFood SAM-e I would use. Probably about 4-5 drops given in food (not on an empty stomach) given twice a day.
4. Milk thistle -- TWICE a day (or three times). Empty it out of the capsules. I'm also going to suggest you get that in bulk, rather than capsules. *Much* depends with milk thistle on the quality of it. And honestly nothing that comes in capsules thru most stores is a very good quality. You want something at least certified organic -- there are several places on the web you can get it, but the ones I use are: http://www.leavesandroots.com, and also www.mountainroseherbs.com.
What you've been giving -- there's about 60 -80 caps in a bottle? Usually about $15 - $20 a bottle? There is about 1 1/4 oz in that whole bottle. You can get a whole pound of certified organic milk thistle (in powder form) for $20 plus shipping. Why a pound? you will use it, trust me!!
Dogs don't digest cellulose well. That's why I'm saying dump the capsule contents into food of some sort (babyfood meat, or just in her food). Milk thistle isn't bad tasting at all.
Increase what you are giving to 1/2 teas. (that's about 2 caps) and give that TWO times a day. From there, and depending on how Cody does you will give more than that.
Some herbs are strong ... some are not. Milk thistle is not a strong herb. And we're asking it to do a lot here.
SAM-e is the big "detox" for the liver. It helps get the liver numbers down.
Milk thistle, on the other paw, does 3 things for the liver. 1 -- it protects the liver from further damage; 2 - it helps detox the liver (not as "big guns" a detox as SAM-e but it does a decent job of helping detox the liver; 3 -- the **biggie** tends also to be the unsung hero!! The third thing milk thistle does is aid liver function. it literally helps the liver work **better**.
This is why I'm saying give it twice or three times a day. You honestly can't give too much. That can't be said for many herbs. There are a lot of studies/trials that have been done showing that in high doses milk thistle actually helps protect the kidneys as well as the liver. My point being ... it is incredibly well tolerated and has huge benefits even in extremely high doses.
But this is also why it is **critical** to use as high quality milk thistle as possible. You can also use milk thistle tincture -- but stick with HerbPharm as the brand (it's even better than "certified organic" -- all HerbPharm's tinctures are "wild crafted" -- meaning it's all hand grown and hand picked - no fertilizers, herbicides, etc)
Depending on how Cody reacts -- you could use a full dropper of HerbPharm tincture in food. it has an alcohol taste and smell. Don't bother getting another brand to get "alcohol-free" -- milk thistle needs to be decocted in alcohol to obtain the maximum amount of benefit. The non-alcohol stuff just doesn't produce tincture that is as effective.
Or-- you could use half and half (half HerbPharm tincture and half powdered milk thsitle. I've done that as well.
Once I see your bloodwork -- there are other herbs that can be helpful -- but they tend to be better given in concert (meaning a blend) aimed at different liver problems. Like if the ALT and AST are both high, that can mean a bile duct problem and I'd use dandelion. But I hesitate to just say "use this blend" until I know more about what's going on with Cody.
This is where the advice of a vet who is **extremely** well versed in herbology is critical. It's honestly not good for you or I or anyone else to just suggest this or that. To target the specific areas of concern, you need a vet who really knows their stuff regarding the liver and herbs.
There are vet products like Marin and Denosyl -- (milk thistle and SAM-e respectively) but you can't give them in high doses. They are simply milk thistle and SAM-e hyper-processed and hyper-refined for consistency. They are high quality -- you can't use them in large doses however and you lose some of the safety you gain with the actual herb.
TAIL:
That can be another whole arrow pointing in a new direction. Typically when you see a naked tail tip, tips of the back toes, ear tips - that can be ringworm (it's not a parasite - it's a fungal thing) related to low immunity. HOWEVER -- what you describe sounds more like "thinning" of the coat on the tail rather than total hair loss (like in ringworm) -- if the coat is scraggly or patchy and particularly at Cody's age, it could also be thyroid in nature.
The thing about the thyroid is -- if the thyroid is out of balance that whacks everything else out!
Don't have the vet do a typical lab thyroid test. That won't tell you anything as accurately as you need. Instead you want the vet to send the blood to either Hemopet in California or Michigan State Vet School so you get a breed-specific reading. Even tho Cody isn't purebred, the particular mix will impact the thyroid a lot. I have used both, and I strongly prefer Hemopet (http://www.hemopet.com ). You want the Thyroid 5 panel (not just T3 and T4 -- that 5th TGAA level is really important). I think it's $85 now ... and the blood can be sent Priority Mail -- it doesn't have to be sent overnight. But have your vet pay particular attention to the Sample Page -- it will tell them the amount of blood to send in each tube. They require more blood than usual because they re-test a lot).
Sorry -- this is a WHOLE lot -- and honestly there is even more. But this will help start you, but please email me?? callieatcritturs@yahoo.com -- the honest "story" here is I'm going thru a particularly bad spell of sciatica and my time "sitting" at the computer is highly limited. So I'm trying to get you to email me where I can access it easily and quickly so I can help you. (Sorry -- I am so **OVER** this "not being able to sit" thing I could tear my own hair out!! But I can lie in bed and read emails!! LOL).