My dog has liver disease symptoms. Is an ultrasound worth it?

Hello, I am sorry to hear about Ginger. Based on the recheck liver values I would be concerned that Ginger has a problem in her biliary system, such as a GB mucocele or potentially a biliary duct obstruction. I would recommend rechecking the ultrasound to look for either of these developments. One thing that is interesting is that the other values are improving. Did your vet have any concerns about the blood sample when he ran/submitted the bloodwork. If there is a large amount of hemolysis (or breakdown of red blood cells) secondary to a traumatic blood draw or mishandling of the blood tube, this can lead to a false elevation of bilirubin. Although this value seems quite high to be due solely to sample error, I wonder if it may be contributing somewhat. If Ginger has a repeat ultrasound it might also be wise to recheck her total bilirubin level. Hope this helps, good luck!

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.

It is difficult to state exactly what would be the next step if I do not have the actual blood work but if the liver values are elevated I would agree with your veterinarian that an ultrasound is not a bad idea for Tiny. With the ultrasound they will be able to see if it is generalized enlargement and damage or if there are lesion that would be a good thing to biopsy. I would recommend having an internal specialist perform the ultrasound (and biopsy if they feel it is needed). I would not change Tiny's diet yet until they find out what is going on with Tiny's liver. Thank you for using Petco Pet Education Center, formerly Petcoach.

A urinalysis would be needed to see if the increased kidney values are because of kidney disease or dehydration. I am concerned about liver failure causing the low protein levels and hypoglycemia. Additional diagnostics would be needed to determine the cause and most appropriate treatment. An ultrasound, biopsy or culture may be indicated. Symptoms can be treated individually, so discuss the use of anti-nausea medications with your vet. Other medications may also be indicated to reduce the effects of digestion with a failing liver, like metronidazole, lactulose, denamarin, and others.

Thank you for submitting your question regarding Remi. In the bloodwork that was run, did it include GI specific testing such as cobalamin, folate, PLI and TLI levels. These are values that will give information such as the location of GI disease (small intestine vs pancreas) and treatment options. I typically do this planel in conjunction with an abdominal ultrasound. This information with the ultrasound can give insight into conditions such as inflammatory bowel disease, pancreatitis, exocrine pancreatic insufficiency, food sensitivities or as you mentioned cancer. The anti-inflammatory properties of the antibiotic she was on could help even with a tumor in GI tract, but there are so many other causes of diarrhea that would respond as well. I think it is worth pursuing further bloodwork and the ultrasound. If you can get a diagnosis, then a treatment plan can be developed. I hope this information helps!

I'm very sorry to hear this. Unfortunately, liver disease is very complex. We notice elevation of the liver enzymes on the blood testing but that does not tell us why the liver is sick - only that it is sick. Multiple tests need to be done and even then, sometimes we can't figure it out. This happens in human medicine too. There are just some cases that are difficult. A liver ultrasound to look at the liver and gall bladder along with a biopsy should be done to look at the liver tissue. That would probably give you the most definitive answer if that has not already been done. ( https://vcahospitals.com/know-your-pet/liver-disease---testing )

This is a very valid question and it is important to consider his overall wellbeing and comfort above and beyond prolonging the length of his life. If he is mobile, greeting family members as he normally would and eating enough (a specialised liver diet and supplements can help to reduce some of the symptoms of poor liver function by reducing the amount of toxins the liver needs to excrete. As long as his appetite is sufficient to prevent significant weight loss then it is likely he is feeling ok in himself. The following link can be very helpful for all family members to sit down together and discuss and can help in the medium term decision making https://vet.osu.edu/vmc/sites/default/files/import/assets/pdf/hospital/companionAnimals/HonoringtheBond/HowDoIKnowWhen.pdf