My dog has suspected liver disease and CBC results. What's next?

Hello and thank you for contacting Petco Pet Education Center, formerly Petcoach. The blood results show that Finn definitely has some problems with the liver. Some of the liver enzymes and bilirubin are mildly elevated, which is never normal. What is more, ALP and GGT results could not be determined. It means that there was a machine fault when measuring these parameters, or these values were too high for the machine to read. I would suggest to run bile acid stimulation test, ultrasound scan of the liver and repeat the blood test that was run at your vets on the 7/15/20. You may consider running ACTH stimulation test to check for Cushing's disease, but it is unlikely that Finn has this problem. Based on these results, it can be decided what to do next.

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.

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!

Hi, thanks for using Petco Pet Education Center, formerly Petcoach! Poor Luna! Can you post the blood work results so we can see the normal ranges from this lab and the units of measure? Also WHY was the blood work done, was she sick? Was it a routine screening? For a young growing large breed the ALP doesn't really worry me by US measure (again I don't know your labs reference ranges or what units of measure). The ALP can be increased in growing puppies due to bone growth. Also if this isn't an animal lab and is based off human values I am not sure we can really believe the results. Her values should be measured against normal dog ranges. To be honest I think her values are likely normal for a puppy. Please take a picture of the blood work and repost. We can help you much better that way. Have a good day

Hi there, Based on the blood work it looks like Bella has a disease affecting her liver that is also decreasing her red blood cells. I would recommend you consulting with your vet about what they found on a physical exam to get a true diagnosis. Blood work is good to have but without knowing her symptoms, exam findings and history it's difficult to give an accurate diagnosis. I hope that helps and thanks for using Pet Coach!

I would be suspicious of a few things to cause these elevations, including: liver disease, or cholestatic disease (involving the gallbladder). Neoplasia also can't be ruled out here. I would highly recommend the next step here to be an abdominal ultrasound and a bile acid test to check the liver function. The ultrasound is valuable here b/c we can get a good look at the gallbladder and check for a mucocoele. I do hope that Bear's condition is able to be managed well moving forward. Best wishes and take care.

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.