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Ask Dr. Michael Salkin Your Own Question
Dr. Michael Salkin
Dr. Michael Salkin, Veterinarian
Category: Cat Veterinary
Satisfied Customers: 23824
Experience:  University of California at Davis graduate veterinarian with 44 years of experience.
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Almost 2 years ago we adopted an older dog from a shelter.

Customer Question

Almost 2 years ago we adopted an older dog from a shelter. Within the first week he was limping and wouldn't walk even a block. We took him in and while x rays didn't reveal anything wrong with his joints, we found out he needed surgery as he had calcified stones, and an infection in his teeth. Fast forward a year and cough started every now and then, almost like he had a hair ball. Within the last month, any time we pick him up and sit him down the cough, gagging starts. Last week he began throwing up. I took him to the vet today and they found a 2.6 lb weight gain (he's 12.6 lbs) since October, heart murmur that wasn't picked up before and a heart on the high end of normal. His liver was also enlarged and his enzymes are in the 700 & 900 range. He was put on blood pressure medicine, a diuretic and we go back Monday for bile acid testing. He is 12-13 years old and I feel like the vet today was side stepping what she really wanted to say. How bad is all of this when combined?
Submitted: 6 months ago.
Category: Cat Veterinary
Expert:  Dr. Michael Salkin replied 6 months ago.
I'm sorry to hear of all this with your dog but I can't prognosticate accurately with what you've told me so far. A heart murmur usually indicates myxomatous valve disease (leaky valves) in miniature dogs which usually can be well managed with the heart drug pimobendan, an ACE inhibitor (to manage high blood pressure) such as enalapril, and a diuretic such as furosemide. The fact that the heart size is still within normal is a positive prognostic finding. The elevated liver enzymes ALT and AP are quite elevated but much of that elevation in the AP is due to the heart disease rather than pri***** *****ver disease. The serum bile acid testing will tell us how well his liver is functioning - the most important prognostic factor of all. The severity of the liver enzyme elevations doesn't correlate well with the seriousness of the hepatic disease. I would be pleased to review all of his test results for you if you wish. Can you upload a copy of his test results to our conversation? I understand that you might not have a copy at home but his vet can give you one which you can scan into your computer and then give me file link or you can photograph the pages and upload them by using the paperclip icon above your message box (if you can see the icon) or by using an external app such as
Expert:  Dr. Michael Salkin replied 6 months ago.
Hi Ellie,

I'm just following up on our conversation about your pet. How is everything going?

Dr. Michael Salkin

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