My dog vomits blood with high liver values. Is his treatment working?

Thank you for submitting your question regarding Leo. In the bloodwork that he had done, do you know of his cobalamin, folate and pancreatic values were tested? These are important tests with chronic gastrointestinal disease. Cobalamin and folate are vitamins used in digestion. If either are low, they will require supplementation. This can help a lot. Next, has he undergone a strict diet trial with a prescription diet? This will help if he has a food allergy, food intolerance or inflammatory bowel disease. These are a few things I think of when hearing of Leo's problems. I hope this information is a good starting point for you.

I am so sorry to hear that Bravo isn’t feeling well. Bright red blood in the vomit often means that the esophagus is bleeding usually secondary to forceful vomiting and irritation. However, I would encourage you to have a follow up appointment with your veterinarian. If the liver isn’t working well then clotting function can be disrupted and bleeding can be concerning. Anti nausea medication may be helpful and further testing may be recommended. Best of luck and I hope he improves soon. Thank you for using Pet Coach.

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.

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!

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.

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!

There are many different causes that would include hepatitis (which can be bacterial or sterile), cancer, or an issue with his gallgladder. The next step I would recommend is an abdominal ultrasound with fine needle aspirate (FNA) to try to get some information about what is going on in the liver, and possibly a biopsy of the liver after that. The other courses of action is to try treating him to various medications to see if anything helps -- however this doesn't really make sense if he has no signs of illness. Or finally, doing nothing and checking again in 2 months to see if they are rising or staying the same. Sometimes we decide not to get to the bottom of something when there are no clinical signs.