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Doc Sara
Doc Sara, Veterinarian
Category: Dog Veterinary
Satisfied Customers: 952
Experience:  I am a dog and cat veterinarian with a lifetime of experience in our family veterinary hospital.
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My dog is being treated orange in color in her ear and

Customer Question

My dog is being treated for turning orange in color in her ear and stomach area. Treated by vet liver biopsy fine being treated with an antibiotic
Submitted: 1 year ago.
Category: Dog Veterinary
Customer: replied 1 year ago.
It's been 2weeks she was recently treated for heart worms she's on 3 antibiotic blood work white cell a little elevated I need an answer as soon as possible
Expert:  Doc Sara replied 1 year ago.

Good evening! I'm Dr. Sara. I'm a licensed veterinarian who works exclusively with dogs and cats. I'm sorry to hear that your pup isn't feeling well - I'd like to get more information on him/her so that I can provide the most complete answer. Could you please give me a longer description of what's been going on, starting with the first thing that you noticed that was "wrong" up through what your vet has done so far? Has the vet checked any blood work at all? Is he/she acting sick? Eating and drinking OK? Have you noticed any improvement with the vet's treatments so far? Is he/she only on an antibiotic? Any other medicines?

Turning orange is likely indicative of jaundice, which indicates significant liver impairment or possible bile obstruction. Jaundice by itself is a very nonspecific problem, meaning that there are a lot of things that can cause it. The answers to the above questions will help me provide you with the most complete info for your specific pet.

Thanks and I look forward to your reply :)

~Dr. Sara

Customer: replied 1 year ago.
about 4-5 months ago her blood work came back positive for heartworms she was treated and seemed fine. Than about 3-4 weeks ago she experienced a loss of appetite they did blood work and the liver and blood work was fine she was put on steroids and antibiotics stayed in vet care for 5 days released and back in 5 days blood work white cells a little elevated but liver biopsy fine white cells a little elevated more antibiotics steroids and milk thistle appetite better but still not feeling well and still the orangish tent in her eyes, ears and stomach area
Expert:  Doc Sara replied 1 year ago.

Oh my, there could be a lot going on here - there are multiple issues that she's got going on. How was she treated for the heart worm disease? Typically heart worm disease treatment takes a few months to complete from beginning to end starting with an antibiotic called doxycyline and eventually progressing to immiticide injections. Does that sound familiar? You say her liver blood work was fine? In that case, what led them to take a biopsy of the liver, and how was it acquired? Did they gather a noninvasive sample with ultrasound guidance perhaps or did they do an abdominal exploratory surgery? Sorry to keep asking you for more information, but this seems to be a complicated problem and I need to make sure I've got all my ducks in a row ;)

I'll await your reply :)

~Dr. Sara

Customer: replied 1 year ago.
the liver biopsy was done by ultra sound. I'm so worried about her she was fine until she was treated for heartworms. I know when she was treated for heartworms they kept her overnight on a drip
Customer: replied 1 year ago.
She was very active and supposedly on heartworm prevention when this took affect she's an 8 yr old dashaund
Expert:  Doc Sara replied 1 year ago.

Thanks for the additional info, that's very helpful.

Something just isn't adding up for me on the description here. Her liver enzymes shouldn't be normal if she's icteric (jaundiced). Icterus can be caused by pri***** *****ver disease (sclerosis, portosystemic shunting, drug reactions, infections), but this should have showed on a biopsy. It can also be caused by hemolysis, which is destruction of red blood cells, but this would have caused a severe anemia on blood work. It is possible that her liver biopsy could be normal if she's got a bile duct obstruction - which is usually but not always detectable on ultrasound examination by an experienced vet or tech. but again, with a bile duct obstruction I would expect more than just her WBC ct to be a little high. Bile duct obstructions can be caused by masses (tumors/cancer) or by inflammation associated with pancreatitis, which, again, would likely be detectable on ultrasound or through blood work. I've also seen icterus with gall bladder abnormalities like stones and mucocoeles - these are fairly easy to diagnose with an ultrasound. Mucocoeles do require surgery to correct, stones may require surgery or sometimes are treated medically.

If she's not already in the care of a specialist like an internal medicine specialist, this would probably be your next step - to get a second opinion from a specialty hospital. If he's already in the care of a specialist, I would stay the course with the recommendations made by your specialist. This is a complicated problem and I'm not going to be able to get a full picture of what's going on here third hand like this - there are too many variables, unfortunately.

I will say, though, that it's reasonable to cover with antibiotics for an icteric dog as well as support with milk thistle or better yet sAME - a product called Denamarin has both- this is what I use for my liver patients. It's also important to continue symptomatic and supportive care by treating individual symptoms like nausea, diarrhea, dehydration, etc as they come up. Unfortunately when I have older pets who have mystery illnesses that the diagnostics aren't sorting out, I start to worry that there's something cancerous process going on. There's no one specific test for cancer, so until the pet is improving or we find an answer, I usually keep hunting.

Please let me know what other questions I can answer for you :)

~Dr. Sara