My dog has jaundice. What are the treatment options and next steps?

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.

Sounds like she had acute liver failure. I'm so sorry this happened. Unfortunately, liver failure can have any number of possible causes. Without a necropsy (autopsy) with histopathology of the tissues you will probably never know exactly what happened. I'm so sorry for your loss :( ( https://www.petmd.com/dog/conditions/endocrine/c_multi_hepatic_failure_acute )

Poor Kiko! Jaundice is usually by either liver dysfunction or destruction of red blood cells. The doctor will run some blood work to determine which is present and then determine appropriate treatment. You are doing the right thing by having her seen quickly. Best of luck and please feel free to post any additional questions.

I'm sorry Meddy is sick. I am trying to understand exactly what is going on with him. It sounds like your vet is suspicious of an immune mediated disease (where Meddy's own immune system is malfunctioning and destroying her platelets (as well as possibly her red blood cells and/or white blood cells). A blood transfusion may have been required help Meddy survive. Let me briefly review the medications you've listed: *Zip vit- I am not familiar with this, but it seems to be a vitamin supplement. *I suppose "sucroll" may be the drug sucralfate, which is a medication that helps to decrease bleeding in the stomach and intestine. *Livotas is not something used in the US and I cannot find any information on it. *Thrombup is an herbal that may be beneficial when platelets are low (I don't have any experience with this one, and it is not generally used in the US) *Lisybin is a supplement for liver health. *Alamin R Forte is not something I have experience with but appears to be used for a number of different indications in India. *I assume Doxypet is doxycycline, which is an antibiotic commonly used to treat possible underlying infection that results in immune mediated cell destruction. Doxycycline also has some anti-inflammatory properties that can be helpful. *udiliv300 is ursodiol, which helps with bile flow from the gallbladder and through the liver *Venol is not a drug used in dogs in the US, so I am not sure what the purpose of this mediation would be for Meddy. *azathioprine suppressed the immune system and helps treat immune mediated diseases. Azathioprine can have negative side effects on the liver, so the liver protective medications listed may be to help try to minimize these negative effects on the liver. * I do not know what you mean by NS DNA D10. Regarding the pictures you've attached : The first picture is shows small spots of bleeding under the skin, which would commonly be seen with low platelet counts. The second picture looks like what is an amino acid supplement that can be given as an injection. I am not sure of the purpose of this medication for Meddy, but I don't see a reason it would cause harm. The third picture of the lab findings- shows the red cell count a little low (mild anemia), and there is no number for either the platelets or the total white blood cell count. Generally that means those counts are very low--too low for the machine to read. To try to answer your questions: I am not highly suspicious that this is liver cancer, but it is possible. We can see immune mediated cell destruction AS A CONSEQUENCE of cancer, so it may be that liver cancer, or another type of cancer, is the underlying cause. It is possible that the liver value abnormalities on the lab work are a side effect from the medication. You can talk to your vet about potentially having an abdominal ultrasound (sonogram of the belly) performed. This may help identify a tumor in the liver or elsewhere that may be the underlying cause of disease. The picture that you took with the spots on the skin-- this would be seen from low platelets. I suspect that the medications were all started BECAUSE of low platelets. It takes time to get that platelet count up, so bleeding will continue while platelets are low. So more bleeding will occur until the meds are working. I do not think that this is reaction to medications. (Having said that, unfortunately sometimes patients just do not respond well to treatment and we cannot get the platelet count up despite our best efforts). Regarding the jaundice that you've seen after the medication was given-- again I doubt this was a result of the medication. If his red blood cells are being destroyed by his immune system, this will result in jaundice. Additionally, following transfusion (even from a known blood source) jaundice is common. I hope that information helps, I can try to help more with a consult. Thank you for asking Petco Pet Education Center, formerly Petcoach!

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.

Bilirubin can be present due to a liver problem or rapid destruction of red blood cells. Blood work and an abdominal ultrasound are the two most commonly used diagnostics. Treatment depends on the cause. Liver disease is managed with medication and diet. Red blood cell destruction is managed with medications (depending on the cause). I hope this helps and please feel free to post any additional questions.

Jaundice can be caused by many things but kidney stones are not one of them. Gallstones can sometimes cause jaundice but this is actually very rare and would typically be from obstruction of the biliary tree or sepsis, both of which are very serious. Did your pet have a full abdominal ultrasound to look at the abdominal organs? If jaundice is present, and these 2 entities are not players, then another cause is likely which would mean a different treatment approach. Medical therapy for gallstones can be employed (especially if underlying liver disease is the cause) but if there is obstruction surgery is typically needed. What i would recommend is that your Sandy see a specialist. Your family vet can likely provide a referral for an internal medicine specialist in your area. An internist is a great person to manage an older pet with liver and kidney issues and they may have medical options for her. I hope this helps and thank you for using Petco Pet Education Center, formerly Petcoach!