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I am sorry to hear that Lilli is having this problem.
I will need a little bit more information to better help you.
When was the last time she ate a full meal?
Does she normally eat prescription food for liver disease? What is her normal diet?
Any vomiting or diarrhea right now?
Liver disease that has progressed to jaundice is very worrisome. This could be related to her liver failure or this jaundice could be due to something else. Regardless she needs to see a vet. Her bloodwork should be rechecked to ensure there is no hemolytic anemia causing the jaundice, appetite loss, and vomiting. She could also have severe gall bladder disease causing these same signs. Typically liver failure patients are kept on a liver specific prescription diet such as Hills L/d. These diets are low in protein which is what these dogs need. You can try feeding a cooked egg white to see if she is able to tolerate that, however I doubt she is going to hold anything down without prescription medication for vomiting. Most likely, she will need to be kept on IV fluids to flush her system.
It may be best to avoid giving her any other food tonight so she doesn't just vomit it back up. I would try the egg white and if she can't hold that, don't give any more food.
I would take her to the vet tomorrow at the latest for further care and workup.
If she has not yet had an ultrasound that would be highly recommended. A biopsy is needed to determine the exact cause of the liver failure (blood vessel abnormalities, cirrhosis, tumors, inflammation, copper issues, etc.) and that can potentially be done via ultrasound. Knowing the exact cause can help guide treatment further if that is the route you would like to go.
I am sorry to hear that.
I think her best bet is seeing the specialist. You need to figure out what is going on.
High bilirubin can be due to many things as can very high liver enzymes, not always specifically due to liver failure. The best thing is to have the consult with the medicine specialist and then decide where to go from there. They can give you all of your options and potential diagnoses based on the exact lab results that have already been done. Most likely they will start with an ultrasound.
Without knowing exactly what is going on you don't know that for sure. Most of the acute liver failure dogs we see undergo IV fluids and antibiotics for a few days until the values go down and the dog is doing better. The bilirubin can damage the kidneys, so you want to make sure you are flushing that out as best as possible with IV fluids. If this is a hepatitis, it can often resolve with antibiotics and IV fluids. We just need more information at this point.
Liver failure can be acute or chronic. Sometimes this can be reversible and no longer be a problem. Other times there is an underlying disease or too much damage and it will be irreversible.
There are many things that can cause these levels to be high: inflammation of the liver, different infections, blockages of the gall bladder, inflammation of the gall bladder, gall bladder stones, hemolytic anemias, different tumors (both benign and aggressive), and other diseases.
Without treatment or further diagnostics you just don't know what is going to happen next.
It might be helpful to see your regular vet tomorrow to get some medication to help stop vomiting and increase appetite. They can also start her on IV fluids and medications then transfer to the specialist the next day. Another option would be to go to the specialist tomorrow as an emergency. That is the way most see a specialist when they don't have a specific appointment available. It's worth calling the specialist tomorrow to see if they can get you in sooner since she is worsening. They often make exceptions in those cases.
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