My dog's liver is enlarged with symptoms after NSAIDs. What to do?

Pardale is a non-steroidal anti-inflammatory medication that contains acetaminophen and codeine. Acetaminophen can cause liver toxicity in some dogs, especially if used inappropriately. Since he seems to be feeling better, there is a chance his liver will go back to normal with the discontinuation of the drug. Your vet could put him on a liver supplement, like Denamarin, to help his liver function better. Your vet can repeat bloodwork in a month to recheck his values. I would definitely be reluctant to put him back on a non-steroidal type medication for his arthritis or use one in very low doses. You could put him on a joint supplement, like Dasuquin and see if that help his joints.

If the liver mass grows slowly then with medication Blue may continue to do well. The pills won't stop working but the liver disease and mass may continue to progress causing Blue's condition to decline. Since you've had improvement on the medication there is a good chance that Blue will continue to do well for some time. Remember to enjoy every day with Blue. Thanks for using Petco Pet Education Center, formerly Petcoach to help you get answers to your veterinary questions.

I assume when you say liver enzymes you mean ALT? There a few enzymes we look at and elevation in 1 value makes us consider different causes then elevation in another. ALT elevation is caused make liver cell injury and leakage of enzymes in to the bloodstream. As the liver sees all the blood of the body it can be quite a reactive organ. So the question is whether the liver enzyme is up because of something wrong with the liver/vessels to liver themselves (such as an infectious or inflammatory cause (hepatitis) or a shunt (more common in younger dogs)) or something the liver is responding too (toxicity, disease of over organs). Unfortunately all parts of sago palm are toxic to dogs with the seeds (nuts) being most toxic. And it can be quite challenging to know if this is the cause. If it is sago it depends on the degree of ingestion as to how severe the case is. Unfortunately the treatment for this is supportive as you have been doing. The values may continue to increase or hopefully may plateau off and remain mildly elevated or decrease again. Ultrasound will help to rule out other things going on in the abdomen, assess the liver for changes in texture (although a liver can appear normal on an ultrasound and not be functionally normal), and sometimes identify a portosystemic shunt. After the ultrasound then sampling either first by fine needle aspirate or with a biopsy (needed for many cases of hepatitis, some other issues) can be performed. Checking platelets and clotting times should be performed prior to liver sampling in patients whose livers are not normal to decrease the risk of bleeding from sampling. As shunts are more common in younger animals , if this is suspected, additional imaging may be recommended prior to sampling as ultrasound will not identify all shunts. There is also a disorder called microvascular dysplasia that can be found in the liver. This is best diagnosed by liver biopsy and the sample sent to a pathologist who specializes in liver pathology. I hope this has helped and not confused you more. It sounds like your vet has taken the appropriate steps thus far and has recommended the next best steps to try to rule out some other causes. Thank you for using Petco Pet Education Center, formerly Petcoach!

I am sorry to hear that Mello has not been well. If liver ultrasound is not conclusive, the best way to go forward is to take liver biopsy - this usually gives definite answer what is going on with the liver. Gall bladder stones are very rare in dogs but relatively easy to pick up during ultrasound scan. My advise would be to discuss liver biopsy with your vet. The supplement you bought is not going to hurt your dog, but at the same time it is very unlikely that it is going to help much if it is not used alongside proper diagnostics and other medical treatment.

Excellent question! It sounds like Bear may have some elevated liver enzymes, and if he is not showing signs of illness, your vet is likely just recommending a supplement that can help support the liver and in some cases bring the enzymes down to normal/ closer to normal . See the link below for more information on liver enzymes: https://www.vin.com/veterinarypartner/default.aspx?pid=19239&id=4952533 It may be long term, or if the liver enzymes stabilize, your vet may decide that Bear does not need the supplement anymore. This usually involves rechecking the bloodwork at intervals to see if the enzymes are increasing or decreasing

This supplement is unlikely to influence any liver enzymes and can be stopped anytime if there is any suspicion of that. ALP is elevated but moderately and I would not focus on that. Albumin is low and that is a main concern at the moment. Vomiting should be treated with symptomatic medications. If there is high temperature, antibiotics should be given/continued. Hope this answer was helpful, but please do not hesitate to contact us again on the forum or by requesting a consultation if you have any more questions or to discuss it any further. If this answer was helpful please let us know, this will be used to improve our service!

Hello and thank you for contacting Petco Pet Education Center, formerly Petcoach. Elevated liver enzymes and abnormal liver appearance on ultrasound scan does not necessary mean liver tumour or liver failure. Older dogs often have abnormal liver appearance, which is not related to any serious underlying problem. Liver enzymes level is a measure of 'damage' to liver cells but it is not directly related to prognosis. Again, older dogs often have mild elevation of liver enzymes I would think that the specialist will perform full abdominal scan and possibly take liver samples through a needle - this is commonly performed procedure in dogs with signs of liver disease. Based on the findings of the aspirate, the doctor will recommend further testing or prescribe treatment for Mars.