My dog has kidney and liver problems, vomiting brown. What's next?

I'm sorry to hear that Goldie is feeling so unwell. Thank you for attaching his blood results. They do show signs of liver disease (high ALT, ALP). Low albumin can also be tied to liver disease, as the liver is responsible for making albumin. A low creatinine value is less of a concern than a high value. Some possible causes of elevated liver enzymes may include infection, toxicity, liver shunt, liver mass, or chronic hepatitis. I would suggest an abdominal ultrasound and a bile acids test as a next step. If Goldie is still vomiting and feeling unwell, he may also need to be hospitalized back on IV fluids again to restore his hydration and energy. I hope this helps, and that Goldie is feeling better soon!

Poor Bruno! I can see the brown material in his vomit and the very dark stool, which is likely digested blood. This happens because acids build up in the blood when they are not filtered by the kidneys, these acids are very caustic to the tissues of the stomach, and result in ulcers, which bleed. The prognosis depends on the cause of the kidney disease, as certain conditions can be treated and managed for some time, but unfortunately, the prognosis is typically poor to grave. Bruno likely needs fluids to prevent dehydration, and medication to protect the lining of his intestines. The kidneys are also responsible for making a hormone, erythropoeitin, which helps the bone marrow make new red blood cells. Along with the gastric bleeding, this is causing the drop in hemoglobin. The decision is not easy, but humane euthanasia may be an option to consider for Bruno, as kidney failure is known to be painful and very uncomfortable in humans. Unfortunately, treatments such as subcutaneous fluids and toxin binding agents such as Azodyl and Epakatin are palliative at best. I am happy to answer any additional questions you may have.

Hi, Oscar needs to be hospitalized and treated with IV fluids, antibiotics, and gastrointestinal protectants. Additionally, he should be tested for infectious diseases such as leptospirosis and ultrasounded to determine if he has any problems in his liver or kidneys.

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.

That sounds like a tough situation. Depending on the current physical exam, repeat or additional blood work and x-rays may be needed. If those tests come back normal again, then surgery may be needed to explore the intestines and take biopsies.

Mild increases in liver values can be seen for a number of different reasons, and sometimes it can be very difficult to determine what the underlying cause might be. Infections like leptospirosis, migrating parasites, congenital diseases like a portosystemic shunt or some toxins can cause liver values to increase. It seems like Leo is on supportive medications for the liver - it would be helpful to know if his values are increasing or decreasing since trends are most important. An abdominal ultrasound might be the next step, or you could also ask about referral to a specialist if available in your area.

Hello, thank you for your question about Loki. ALT is a liver enzyme and elevations can be a sign of underlying liver disease (caused by infection, inflammation, etc). BUN is considered a marker of kidney function but can also be elevated for other reasons, such as GI bleeding. Depending on the severity of these elevations and Loki's history I would recommend testing him for an infection called leptospirosis, as this disease can cause liver and kidney abnormalities. Alternatively, If Loki is still feeling well and the metronidazole is improving his symptoms, you could continue with this treatment regimen and monitor him for development of any symptoms. I would recommend rechecking these values after he has finished the course of metronidazole and considering the need for other diagnostics at that time. Hope this helps, good luck!