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Frankie, Kelsey, & Poochie. Tanner & Jamie at The Bridge
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Discussion Starter · #1 ·
I took Tanner to the vet yesterday for his annual shots--he does not like to get stuck. I asked them to run an ALT on him. I've had him on Denosyl and the Hill's Prescription Diet L/D for several months now. I was so hoping the ALT was down, but it's up from 750 to 800. After the ultrasound which did not show a shunt, the vet suggested a biopsy but also said he was at risk for the anesthesia and even then they may not know what the problem is. He doesn't have any symptoms, he's frisky, eats well, eats even better since I took him off the rice & water and got some low protein food with real food in it. He seems like a normal playful little dog except for that one BIG thing. Oh, bile acids were 41/43 when we did that a few months ago, too. So if anyone has any suggestions, I would appreciate your input.
 

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Originally posted by Tanner's Mom@Sep 15 2005, 01:37 PM
I took Tanner to the vet yesterday for his annual shots--he does not like to get stuck.  I asked them to run an ALT on him.  I've had him on Denosyl and the Hill's Prescription Diet L/D for several months now.  I was so hoping the ALT was down, but it's up from 750 to 800.  After the ultrasound which did not show a shunt, the vet suggested a biopsy but also said he was at risk for the anesthesia and even then they may not know what the problem is.  He doesn't have any symptoms, he's frisky, eats well, eats even better since I took him off the rice & water and got some low protein food with real food in it.  He seems like a normal playful little dog except for that one BIG thing.  Oh, bile acids were 41/43 when we did that a few months ago, too.  So if anyone has any suggestions, I would appreciate your input.
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Be sure to pm or e-mail to Jackie (JMM) if she doesn't see this thread. She will have lots of great advice.
 

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1. Who did the ultrasound?

2. What other testing has been done?

My recommendation would be to consult with an internal medicine specialist. Ultrasounds with a really, really, really great operator are only 80% accurate for finding shunts. Nuclear scintigraphy, portogram, or MRI are best at ruling out a shunt. After that, exploratory surgery and biopsy are the next step. You should include cultures and metal analysis with the histopathology. I would recommend the pathology be sent to Dr. Center are Cornell.

That is a pretty high ALT. I would definately pursue it.
 

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Frankie, Kelsey, & Poochie. Tanner & Jamie at The Bridge
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Discussion Starter · #4 ·
Originally posted by JMM@Sep 15 2005, 06:17 PM
1. Who did the ultrasound?

2. What other testing has been done?

My recommendation would be to consult with an internal medicine specialist. Ultrasounds with a really, really, really great operator are only 80% accurate for finding shunts. Nuclear scintigraphy, portogram, or MRI are best at ruling out a shunt. After that, exploratory surgery and biopsy are the next step. You should include cultures and metal analysis with the histopathology. I would recommend the pathology be sent to Dr. Center are Cornell.

That is a pretty high ALT. I would definately pursue it.
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The doctor who did the ultrasound was an internal medicine specialist. Said she didn't see a shunt, his kidneys looked fine. She suggested a biopsy but also said he was at risk for anesthesia and even after surgery, they still may not know what the problem is. Another question, when this first happened in May, Tanner's ALT was around 350. It has increased since he's been on theDenosyl and low protein diet. I thought that was supposed to bring it down. Could there be another problem?
 

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Originally posted by Tanner's Mom@Sep 19 2005, 08:14 AM
The doctor who did the ultrasound was an internal medicine specialist.  Said she didn't see a shunt, his kidneys looked fine.  She suggested a biopsy but also said he was at risk for anesthesia and even after surgery, they still may not know what the problem is.  Another question, when this first happened in May, Tanner's ALT was around 350.  It has increased since he's been on theDenosyl and low protein diet.  I thought that was supposed to bring it down.  Could there be another problem?
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Different types of liver disease require different treatment protocols. Denosyl and diet may not be the ideal treatment for what he has. I think you should discuss the biopsy options (laparotomy vs. laparoscopic) and also make sure you discuss sending the sample to Dr. Center at Cornell. Is he receiving any other drugs?
 

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I need to take a look at kodie's levels and see if they are around that level... i forget what they were....

Does your dog show signs of the disease?
 

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Discussion Starter · #7 ·
Originally posted by Kodie@Sep 20 2005, 09:25 AM
I need to take a look at kodie's levels and see if they are around that level... i forget what they were....

Does your dog show signs of the disease?
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No, his health is wonderful. His eyes are fine, his attitude is fine, he is a perky active little 7 pound dog. His appetite waned a bit but picked up when I changed his food to Innova Senior, same level of protein as the Hills L/D. Some of the literature I've read recommends supplements such as milk thistle, vitamins, etc. I've been reluctant to give him any of that since getting the Denosyl in his mouth is such a struggle. Do you give Kodie supplements or vitamins. JMM do you recommend supplements/vitamins?
 

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Originally posted by Tanner's Mom+Sep 20 2005, 11:24 AM-->
<!--QuoteBegin-Kodie
@Sep 20 2005, 09:25 AM
I need to take a look at kodie's levels and see if they are around that level... i forget what they were....

Does your dog show signs of the disease?
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No, his health is wonderful. His eyes are fine, his attitude is fine, he is a perky active little 7 pound dog. His appetite waned a bit but picked up when I changed his food to Innova Senior, same level of protein as the Hills L/D. Some of the literature I've read recommends supplements such as milk thistle, vitamins, etc. I've been reluctant to give him any of that since getting the Denosyl in his mouth is such a struggle. Do you give Kodie supplements or vitamins. JMM do you recommend supplements/vitamins?
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I do not have to give any supplements or vitamins at this time... My doc (which is also Dr. Center from Cornell University) said those will only be needed if the disease progresses. It was an option for me to have him on hill's l/d as well... since hes not showing any signs of the disease... reading the articles I have read... I am still watching how much protein kodie gets because its toxicians in his blood stream when the liver counts are high...and the protein causes that. The vet did tell me that veggies are wonderful for the dog.
I believe JMM had to use medicine or supplements or something. Pico's mom uses supplements for Pico.. (I dunno if you have met her... but her pup has MVD)
 

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Lady has epilepsy and has taken two different kinds of seizure medications, both of which can damage the liver. Unfortunately, she has to take high dosages to control her seizures (30 mg of Phenobarbitol, 225 mg of potassium bromide per day for a 9 pound dog).

I heard about Milk Thistle and it's benefits on the canine epilepsy website many years ago. I asked my vet about it and she researched it as she was unfamiliar with it. She told me to go ahead and try it, that she didn't find any adverse effects.

Lady has been getting seizure drugs for 5&1/2 years now, Milk Thistle for probably 4 of those years and her liver values are still in the normal range. My vets can't believe it!

I just sprinkle a little on her food once a day and she doesn't even notice.

Here is more information, including dosage:

http://www.canine-epilepsy-guardian-angels...ilk_thistle.htm
 

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Liver dogs only need restricted protein if they show signs of protein intolerance (hepatic encephalopathy). Otherwise use a high quality protein source, particularly soy or dairy. A poultry or fish product would be the next choice. Avoid red meat. Avoid preservatives. Dr. Center at Cornell has a home cooked diet that is actually called the Maltese diet.

Denosyl (SAMe) and Milk Thistle are the most common liver supplements. Standard Process makes a nice hepatic support formula that is a very palatable powder. I've also used Chinese Herbal Medicine for liver disease.

I personally do not recommend messing around with diet and supplements with an ALT that high without consulting a veterinarian.
 

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Discussion Starter · #11 ·
Thanks to everyone for your replies, this has been so helpful. I'm going to try the Milk Thistle and see if that helps.
 

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Tanner's Mom:

I had the same results with Denosyl at first......Pico's ALTS actually ROSE to my alarm. But my vet has an MVD Maltese, too and he said to stay the course and at the next yearly exam, they were down. Then they went up at the next exam but his TBIL is normal and all other readings were good. I inferred that you can't really get normal ALTS in MVD babies.

We will be getting his yearly readings early October and it will be interesting to see where he is. In '03 the ALTS were 315, in '04 they were 685 but again, this is just a picture in one point in time.

Since his last readings I have him on a home-cooked diet using high quality proteins like chicken and eggs, oatmeal and veggies and calcium. And Denosyl faithfully, daily. I put a dab of cheez whiz on my finger, dip the pill in it and he eats the pill off the end of my finger then I offer him the other finger that has a 1/4 tsp of cheez whiz and the licking and swallowing ensures the pill gets down.

Sometimes we have a miss and it sticks in his fur at the corner of his mouth and I'll find it later in his bed or someplace.
 

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Originally posted by Pico's Parent@Sep 22 2005, 11:28 AM
I inferred that you can't really get normal ALTS in MVD babies.
I believe that is true too because kodies levels were never consistant... and sometimes they were completely in the normal range. One specialist told me it depends on when something empties(I think they were talking about a certain organ)... i forget which..
 
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