My dog won't eat, has jaundice & liver patches. Is a biopsy needed?

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, I am sorry to hear about Patches. The blood work that you’ve attached shows that Patches liver enzymes are elevated. There are a variety of causes for elevated liver enzymes including infection, inflammation, old age change, etc. Liver disease can definitely make dogs feel nauseous and have an altered appetite. If Patches is not acting like himself I would recommend having him evaluated by a veterinarian again. Having an abdominal ultrasound performed might be a helpful test as it would allow further evaluation of the liver. I hope this helps, good luck!

Thank you for using Petco Pet Education Center, formerly Petcoach. There is no clinical significance to a low amylase, and I do not believe I would have been concerned with this finding. That bile acid result is high, but I don't see a fasting level. I'm not sure if the blood was obtained only once, or if you did a 12 hour fast and then offered a fatty meal and had another blood sample drawn. Regardless of how it was obtained, it is a high value, and I suppose it is hard to completely ignore. There are a couple different ways to approach this. Recommending ultrasound and biopsy is not wrong, but you could be a little more conservative and simply recheck the bile acids in 2-4 weeks. I would definitely recommend a 12 hour fast for the pre-prandial blood draw, and then feeding a fatty meal, and then obtaining another sample two hours later. A single bile acid level is not enough information. If upon recheck the findings are abnormal, then you can feel more justified in pursuing ultrasound and biopsy. I hope this helps.

Hello, sorry to hear about your dog. Its likely that his liver disease needs to be further evaluated to rule out the need for antibiotics or steroids and ensure that his liver disease is not secondary to inflammation in another organ such as his pancreas. I would recommend speaking with your veterinarian about obtaining further information with an abdominal ultrasound and recheck bloodwork. It may be necessary for your dog to obtain more aggressive medical management with hospitalization. Hope this helps and best of luck.

The next logical step is liver biopsy. Please, discuss it with your vet. If they are not able to take a biopsy (not every veterinary practice is capable to perform this procedure) you should ask to be referred to specialists in internal medicine. They will be able to offer much wider range of investigation and treatment.

Hello, and thanks for using Petco Pet Education Center, formerly Petcoach. When you get Rocky I would have your own primary vet repeat the bloodwork to get an updated baseline, and because the units measured and normal range can differ from one lab machine to another. If decreased liver function is suspected, you should plan to run a fasted bile acids (liver function blood test). The next diagnostic step would then likely be an ultrasound with a liver biopsy, if your vet thinks that’s necessary. Of course, I would defer to the vet who’s actually examining the dog, as there may be clues in the exam to justify going a different direction with diagnostics. But this is what I’d be anticipating. Hope this helps.

Hello, thank you for your question about Pogo. Based on the results attached and the evidence of jaundice I would be very concerned that Pogo is experiencing some kind of liver disease. There are many liver conditions that can lead to these signs such as infection, inflammation, gall stones, or cancer. If possible I would strongly urge you to have Pogo seen by a veterinarian that can perform an abdominal ultrasound. If this is not possible I would recommend having Pogo rechecked by your veterinarian and discussing antibiotics and other liver supportive medications. Hope this helps, good luck!