My Dog Pip is an Angel 08.30.13...

[pgcor]

Re: My Dog Pip

I don't think so, but he was just tested for Addison's disease. I'm going to send you his lab work that I keep in one Excel file. It's fairly complete.

Thanks Patty!!!!

[Patty]

Re: My Dog Pip

Pam,
I asked because I was just reading an article that discussed rising ALP values corresponding to lower thyroid function. Was worth asking about.

So this is what I pulled from your post as symptoms currently seen:
- Out of regulation (are you still using ketodiastix as a measurement tool?)
- Insulin needs climbing
- Overall health declining - what types of things are you seeing here?
- Antibiotic use lowers insulin needs
- Arthritis/possibly secondary pain

Is Pip currently on a probiotic as well? I didn't see that listed. If not, I would add it in.

Has Pip been diagnosed with chronic liver disease in the past?

What made them think Addison's, do you know? I think typically lower blood sugar spells are indicative of Addisons.

Patty

[pgcor]

Re: My Dog Pip

Hi Patty - Yes, I still test urine. Since he's been out of regulation it's been tested every one to two hours. We are diligent, if nothing else.

When I think Pip is not feeling well he is very lethargic, pants, and continues to cry/bark at us. His ears are also always back.

Pip was on a special probiotic, but we took him off. There is one in the vitamin/herb mixture he gets.

No Pip has never been diagnosed with anything except diabetes. He started to require antibiotics about 1 - 1 1/2 years ago and that's when the testing began. He did beautifully with blood sugar as long as he was on an antibiotic. First it was Clavamox than Baytril...this past summer we noticed that as soon as we stopped the Baytril, his BS went out of whack again.

He's had two ultrasounds and both show thickening in the liver and digestive system. The Specialist thinks he may have inflammatory disease.

The Addisons Disease was run at the suggestion of someone on the liver board. The Specialist did not think he had that. However, about two weeks ago - 13 units of insulin was too much and we had to lower his dosage. His urine tests were up and down dramatically, so I suspected as much. He did fine on 12 units, but only for a couple of days at the most. I e-mailed Natalie about it because his urine results have been so strange.

I bet that if they would give him Baytril he would be fine again. The Specialist said that Bayril is not a good antibiotic for long-term use - hence the Tylan. Which has been ineffective.

As you can see, it's been a hellish month!

[Patty]

Re: My Dog Pip

Awe, poor guy. Don't you wish they could talk to us?!

Pam, is Pip on heartworm prevention? If so, which type?

Has he had a fecal flotation done recently?

I've been told whipworm can mimic Addison's:
"A second syndrome of infection has emerged but is not well understood, this being symptoms mimicking those of Addison’s disease (Hypoadrenocorticism). Here, a waxing and waning weakness with inability to conserve salt ultimately creates a dehydration crisis. The syndrome mimics Addison’s disease in every way except that testing for Addison’s disease will be negative and deworming yields a complete recovery."
http://www.marvistavet.com/html/body_whipworms.html

The article says Heartguard is usually not enough to kill them but Interceptor or Sentinel are.

[Joan]

Re: My Dog Pip

Hi Pam,

Sorry I did not see your posts sooner, just a really busy time right now.

My pug Bella is diabetic and was dx with CAH (chronic active hepatitis) nearly 2 yrs ago now. Her values are about 6 times the level of Pips. She is happy, hungry and pretty active considering she is blind and 12 yrs old.

I feed her home cooked as well, chicken, green beans (sound familiar?) but add whole wheat pasta as well. One thing you could look at adding to Pips diet either as treats or to his meals is cooked egg whites. They are very high quality protein that is easily digested, easy on the liver with no ammonia build up.

One thing that Bella has been on for a yr now is metronidazole (flagyl), she is on a maintenance dose of 62mg (1/4 tab) and she weighs 17 lbs. It is a antibiotic and also soothes the bowel. On the liver board I was on, there are a lot of dogs on this for life. Very few side effects, and makes a wrold of difference to many dogs. Without it Bella has constant attacks of indigestion and diarrhea. With it, she is perfect in that regard.

When Bella was first dx with CAH we had an ultrasound and needle biopsy done. A few months later, my vet recommended having another one, and my main question was " how will that change the treatment?" Her ALT and ALP are still extremely high, but she is feeling very good, and this is 2 yrs after my vet said I should leave her to die. That was my EX-vet! That is a question I would ask my vet if I were you before the biopsy. There are so many dogs that are showing liver enzyme elevations, and they live perfectly happy healthy pain-free lives with just the samE, and diet routines that you are already doing. Ask your vet specific questions on if they find this or that, then how does the treatment change? These answers will either help you to be more confident in your decision, or help you to re-assess.

If you decide on the natural route either following the biopsy, or instead of it, one person who helped me an incredible amt is Carla, if she has the time.

To me (and hopefully all 9 of my pugs) I consider quality of life as the most important issue. If an elder dog is comfortable and thriving despite blood tests etc, then I tend to leave them be and do everything in my power naturally to keep them happy. If, on the other hand, one is suffering and a surgeon/specialist can reassure me that surgery will help in dx and resulting treatment, with good odds of success, then the decision is more easily reached.

You have Pips best interests at heart, and obviously love him deeply. You will make the right choices, and my prayers and thoughts are with you as I have been there.

BTW one of our first rescue pugs was found by the highway, had been thrown out of a moving car, and left to die. We found him at the SPCA, paraplegic among other things. Took him to a leading neurologist, who said he would never walk after ultrasound and MRI. Said it would be interesting to do exploratory surgery on his spine. NOT!!!! That was 5 yrs ago, and the neurologist was correct, Solomon still does not walk...but he trundles around in his cart, and everyone that sees him says he is the happiest dog they have ever seen. That will be 5 yrs this month.

Prayers and pug hugs, Joan

[Joan]

Re: My Dog Pip

Sorry, just wanted to add one more thing. I know that in most cases, milk thistle is good for liver troubles, and does not affect diabetics. But I cannot give it to Bella. For some reason when she is on it, her bgs are all over the place. Some days she was high, some low. I was testing her blood every couple hrs for months, and could not get her regulated, but after I nixed the milk thistle from her regime, she has levelled out and now is a very well regulated diabetic if there is such a thing. BTW her appetite is much better as well.

[pgcor]

Re: My Dog Pip

Gosh, there are so many things I forgot to say! Luckily you all have reminded me! Pip was on Revolution for quite some time when I was told to get him off the stuff!!!! Bad for his liver. He has had none for the past two months. He did get one dose of something (forgot the name) but it has NO IVERMECTIN in it.

Actually I discussed the whipworm and brought it to the Specialist's attention. Pip had whipworm about 2 years ago, was treated and was given the all clear. Patty, I don't think Pip has had a fecal flotation? He's had many fecal tests where I've had to bring in a sample, but I don't recall that name?

Joan, Pip has been on milk thistle since he was diagnosed three years ago. I guess anything is possible, but it's never bothered him before. BTW, metronidazole is the drug name I couldn't remember. Pip is on the same dose as Bella.

For months now the Specialist has been recommending a biopsy and we have resisted - actually since Spring. If I knew his liver enzymes were just going to be elevated and would pose no problem for him I could gladly let this go. I just don't know that for a fact. Treatment options for Pip could include steroids if he has inflammatory disease. I'm concerned about that but the Specialist insists that not all steroids can mess up blood sugars in diabetics. She claims to have one in her practice now that is doing fine. Non-steroids could also be used but could exacerbate his liver - depending on what is actually happening to it.

BTW I do know Carla - as far as I'm concerned she saved Pip's life when he was first diagnosed. I've never had excellent Vet care, so she was a god send. She helped me get Pip on the food he's on now and also helped me when Pip had whipworm.

Carla does not suffer fools gladly - of which I may be one! LOL. If you're out there Carla - Pip and I love you dearly!!!

[Patty]

Re: My Dog Pip

Hi Pam,
Gosh, there are so many things I forgot to say! Luckily you all have reminded me! Pip was on Revolution for quite some time when I was told to get him off the stuff!!!! Bad for his liver. He has had none for the past two months. He did get one dose of something (forgot the name) but it has NO IVERMECTIN in it. I just wondered since the article mentioned it. And many dogs are taking it.

Actually I discussed the whipworm and brought it to the Specialist's attention. Pip had whipworm about 2 years ago, was treated and was given the all clear. Patty, I don't think Pip has had a fecal flotation? He's had many fecal tests where I've had to bring in a sample, but I don't recall that name? That's good Pam. That's the test they use to determine the presence of worms. I know whipworm is one that can live in the soil for a long time. "Soil contaminated by whipworm eggs is contaminated for years. It is virutally impossible to remove the eggs from the soil or kill them." http://www.marvistavet.com/html/body_whipworms.html How long ago was the last test done?

For months now the Specialist has been recommending a biopsy and we have resisted - actually since Spring. If I knew his liver enzymes were just going to be elevated and would pose no problem for him I could gladly let this go. I just don't know that for a fact. Treatment options for Pip could include steroids if he has inflammatory disease. I'm concerned about that but the Specialist insists that not all steroids can mess up blood sugars in diabetics. She claims to have one in her practice now that is doing fine. Hmm...this concerns me too! Lisa's Daisy was on steroids for inflammatory bowel and she worked to adjust for them, but I'd be very surprised if they don't have quite an effect. Non-steroids could also be used but could exacerbate his liver - depending on what is actually happening to it.

I'll try to post a couple of your lab pages here but I can't get them all up.
Patty

[Patty]

Re: My Dog Pip







Hmm...not sure how to make them larger but zooming in on the internet browser helps.

[pgcor]

Re: My Dog Pip

OOOOHHHH I didn't know that about whipworm eggs!!!! I did treat my yard with diatomaceous earth after Pip was diagnosed. My other dog Newman did not have it, as I recall.

[inn8]

Re: My Dog Pip

Hi Pam!
I haven't been posting on the forums for a while but I saaaaawwwwww your post, what is going on girl?

I've read back a little on your thread but I'm not seeing what exactly he is experiencing that justifies a liver biopsy. His blood work doesn't look bad, especially for a senior. Are his poops good?

You win the prize for having the worst vet support. Anything they'd want to do I would question and question and question. What exactly is the expectation from the liver biopsy? And when is it scheduled?

HTH Carla

[pgcor]

Re: My Dog Pip

Hey Carla - did you hear the hysterical crying in your neck of the woods? LOL. I have to say that I was so confused today that I cancelled the biopsy for tomorrow. I just couldnt go through with it being so confused.

I don't even know where to begin with Pip. He's had problems for about a year with rising liver levels. He always does better on an antibiotic. By better I mean his liver values go down and so does his insulin. This past summer though he couldn't seem to do without the Baytril for even a couple of days. So our regular Vet just sort of washed her hands and said I can't prescribe any more. Actually she won't even run curves for us anymore.

So, we had to go to the Specialist and that's where we are now. Pip has never had much of an issue with his poop - which we told her but she doesn't think that's always indicative of inflammatory disease. I told her about the whip worms and she didn't think much of that either.

The problem is that the Vet thinks Pip's liver enzymes will continue to rise as will his need for insulin. She can't treat him for something she doesn't know. She believes Pip has a number of things going on. Mostly inflammatory. He's had two ultrasounds and they show a thickening in his liver and various parts of his digestive tract.

Actually, after today, I bet mine do too! I hesitate to post here because I know I always come off hysterical! And poor Natalie! Anyway, for now the biopsy is off!

Boy, what would the board be without my hysteria! Pretty dull I think!

[pgcor]

Re: My Dog Pip

I wanted to post that the Specialist called this evening and said that based on Pip's coagulation test his fibrinogen levels were twice what they should be. 443 actually instead of 250. Not sure what that means as my husband spoke with the Vet. She said it could be just diabetes related.

[pgcor]

Re: My Dog Pip

Well, I just was not comfortable with the biopsy being done today. So I cancelled it. They were very nice about it. I can always re-schedule.

Little Pip has no idea what happened. Just watching out the window this morning for his nemesis, the squirrel.

[Patty]

Re: My Dog Pip

Pam,
One question I wasn't clear on with the plan for biopsy, were they planning to do a needle aspiration or use an incision to slice a larger piece of the liver? What did they tell you the recovery time would be like?
Patty