How to help my dog's high bilirubin after plant toxicity exposure?

Poor Flash. UV light is used in thin skinned babies to help breakdown bilirubin but this is not likely to be effective in dogs due to the difference in the skin type and also different mechanism of disease; likewise a blood transfusion would rarely be recommended to affect the course of disease but may add additional pressure on the liver (your vet may decide to proceed with such if protein levels drop or clotting factors become reduced). The liver has a good capacity to repair and regenerate and fluids and denmarin are very helpful in supporting perfusion and promoting recovery. Other targeted medications may be required depending on blood results (protein, bilirubin etc)

Hello, thank you for using Petco Pet Education Center, formerly Petcoach. If Sancho's liver values are elevated due to the ingestion of some foreign material, be it a plant or other toxin, & he is eating with no vomiting or diarrhea, your veterinarian may be taking a wait & watch approach. Usually, we will administer emetics ( to induce vomiting ) & an intestinal absorbant such as charcoal if this was an acute issue. But often we do not see these elevations for hours to days after an insult to the liver has occurred. If Sancho is well, rechecking the values in several weeks is prudent. The values may change by this time. If not, we need to see if this is a chronic issue with the liver, or possibly even the gall bladder. Medications may be need ed at this time, including some neutraceuticals such as Sam-e and milk thistle. It is important that you stay in close contact with Sancho's veterinarian for any recommendations. Take care.

Bilirubin is a pigment found in bile. An elevated bilirubin level may indicate liver disease, a toxicity, infection, autoimmune disease or a rapid breakdown of red blood cells. If levels are high enough, your dog may appear jaundiced (yellowing of the mucus membranes or skin). It would be best to have Dahlia checked or rechecked by your veterinarian to diagnose the underlying cause.

The bilirubin is a bit high, as is the ALP (alkaline phosphatase) but neither of these values is super specific in terms of what the cause or the best treatment is. We can see the ALP be elevated with stress, age, and sometimes even normal cell regeneration within the liver. The bilirubin can be slightly elevated when the blood sample is what we call "hemolyzed," which can sometimes happen when blood is spun down for a blood test to be run. Therefore, if he is still showing symptoms of illness, I would echo what Dr Ana said; it may be time to consider imaging. Either X-rays or an abdominal ultrasound maybe helpful in identifying the problem and therefore identifying the best way to treat it. Take him back to the vet if he's still having troubles, as he probably is in need of some more fluids as well. Thank you for asking Petco Pet Education Center, formerly Petcoach, I hope he's feeling better.

Hello and welcome to Petco Pet Education Center, formerly Petcoach. Hepatitis (infection and inflammation of liver) is a very serious condition and is very hard to treat. If there is an internal medicine specialist in the area I would recommend having Nala seen by them. Otherwise I would be talking with your vet about testing for infectious diseases. However, it looks like they have treated her with broad spectrum antibiotics as well as IV fluids. I would recommend continuing treatment. She may need a feeding tube placed to try to keep her protein up during this illness. Unfortunately, with how severe this is, she may or may not pull through it, but the best chance of her making it through is to be aggressive with her treatment. I would suggest continuing to monitor her liver and white cell count, and to have imaging done and possible samples of her liver to try to determine the cause of the infection. Otherwise I would be talking to your vet about the parasites and infections present in your area and get covered with certain antibiotics. The white cells have increased however not that much, and the liver enzymes are actually improving if I can read the dates right from your picture. This is very hopeful. I would continue with antibiotics (IV if you cannot get them in orally), as well as IV fluids and I would think about syringe feeding or placing a feeding tube. Best of luck with Nala, I hope she makes a good recovery.

Hello there! Thank you for choosing Petco Pet Education Center, formerly Petcoach. Treatment typically consists of using copper chelators (medication that binds the copper and allows the body to eliminate it without adversely affecting the body), low copper diets and supportive to care to address any clinical signs of hepatic disease the patient may or may not be experiencing. This is definitely a condition that needs to be monitored regularly by a veterinarian, especially if the patient is experiencing clinical signs associated with hepatic disease. I hope this information is helpful and that Maisie has a speedy recovery.

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!