Why is my dog lethargic despite normal bloodwork and Denamarin?

I would continue the Denamarrin for at least 4-6 weeks because this is how long the effects of steroids on the liver can last. I'm sorry you're having to go through this. Hopefully since his numbers are improving his mood and energy will follow. Good luck!

I would talk to your vet about alternative supplements to Denamarin. This is an antioxidant supplement containing S-Adenosylmethionine (SAMe) and silymarin, which can usually be found at a human pharmacy, but you need to get the dose from your vet.

Hello. There are many underlying causes for high liver values, some more serious than others. The beauty of our livers is it is the only organ that can heal & regenerate once an insult is removed. I am not sure what your veterinarian hoped to accomplish keeping Lucy over night, but if she is otherwise feeling well, use of the Denamarin & prudent monitoring of the liver values is a good start. It would be helpful to obtain a bile acid assay & abdominal ultrasound to try & get as much information as possible about the liver, but the Denamarin can protect the liver from further oxidative injury. It will not help much if this is cancer, or an active hepatitis or infection, but it has helped to bring the enzyme levels down in some patients. Once you can obtain more detailed information about the liver can you determine how absolutely serious this might be. Stay in contact with your vet & try to follow their recommendations as closely as possible. Hopefully, Lucy will do very well. Thanks for using Petco Pet Education Center, formerly Petcoach.

Acute hepatic intoxication is the main suspicion, considering the signs you reported. Denosyl (SAMe) will protect liver cells from further damage and death and it will certainly help to detoxify the liver. It is important to monitor ALT and AST, but clinical improvement is even more important. So i think that he is already improving, since he is eating and surely he is brighter than onset of the signs. It will take time the intoxication will resolve. 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.

My best recommendation to supplement liver function is a supplement called Denamarin. It contains several of the known ingredients we historically used to support liver health all in one supplement. Very often, I observe my patients Liver enzymes decreasing dramatically on this supplement.

The best next steps would be more tests to help get to the bottom of her symptoms. Typically we start with xrays and ultrasound if bloodwork is normal. Mainly looking for any cause as lethargy and weight loss are non specific. If nothing is found on imaging then loss of nutrition via the GI tract is possible and so sometimes additonal testing is needed to assess this. If your family vet is stumped, some pets get referred to see a specialist (a veterinary internist) for additional help in diagnosis. Additionally medications can be tried to help with any nausea/stimulate the appetite but if an underlying cause can be found and treated that will always be better. I hope this helps and thank you for using Petco Pet Education Center, formerly Petcoach!

Denamarin isn't a treatment for liver disease, it is a potent antioxidant that can help limit further damage as the liver heals. Missing one dose won't hurt. It is best given on an empty stomach, but it can make some pets nauseous. In that case, you can give it with a tablespoon of wet food or a piece of meat or cheese.