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    Liver Issue - feedback please!
    tomortlieb posted:
    Hey everyone, [br>[br>Just recently my pug, Hank, who is 6 1/2 years old, has been diagnosed with some form of liver disease/damage. My heart it completely broken, as he is the sweetest and most loving dog. For the past few days he has been at the local vet overnight (Friday night through Monday night - I will be picking him up on Tuesday). He is receiving a multitude of antibiotics that are meant to kill any potential bacterial infections, as well as support the liver. His test results from the most recent blood work are as follows: [br>[br>Bilirubin: 5.3 (up from 5.0 when he was first brought in) [br>ALT: 3100 down to 2500 [br>ALP: 2700 (up from 16 when he was first brought in - the vet explained that this is a normal reaction, as the liver is attempting to overcompensate). [br>[br>Hank has an ultrasound on Friday before being admitted and the vet did not see any damage to the gall bladder, liver, or any signs of cancer. I have been warned, however, that the cancer could potentially be cellular and thus a biopsy would be the only way of actually finding out if he does or does not have cancer. The vet also is unsure what has caused the damage and thinks it could have been the ingestion of a toxin (which I find highly doubtful because Hank next to never eats random things from the floor) or potentially cancer. But, the vet really has no clue and is focused on treating the liver currently. Again, as the vet stated, only a biopsy will tell for sure. [br>[br>Also, Hank is yellowish, which was explained by the high bilirubin levels, but he is active, alert, happy, and his appetite has returned. Currently, the plan is for Hank to come home tomorrow, take a number of antibiotics, and then have his blood work tested again in a few days. If his numbers decline then we will proceed with the medication. If not, I will have the biopsy done. [br>[br>Has anyone had this experience? Or, does this sound like a good course of action? [br>[br>Sincerely, [br>[br>Tom
    Sandy Willis, DVM, DACVIM responded:
    Sorry for the delay. Actually it does sound reasonable. The liver can look normal on an ultrasound exam, we generally would see cancers, but it does take a biopsy to determine if they problem is cancer, or infection, or inflammation, so we can treat more specifically. We do think toxins but rarely do pets get into toxins. Any sago palms around the house? And do you have leptospirosis in your area, a liver disease caused by an infection? Anyway, it sounds like your veterinarian is treating the liver disease with antibiotics, perhaps some liver support, and if on the right track, liver enzymes should decrease and icterus, high bilirubin should resolve. If the don't then a biopsy is a good idea. Perhaps your dog will have a disease that needs steroids. Some liver diseases are treated with steroids, but a biopsy helps to determine this. Again, there are liver cancers but there are also many liver diseases that are not cancerous. I hope your pug Hank does well. Dr. Sandy

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