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Dr. Andy
Dr. Andy, Medical Director
Category: Dog
Satisfied Customers: 30031
Experience:  UC Davis Graduate, Interests: Dermatology, Internal Medicine, Pain Management
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I have a 10 yr old lab with an enlarged liver, as indicated

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I have a 10 yr old lab with an enlarged liver, as indicated from an xray. Vet could see no tumors or other reasons for the enlarged liver. I also had some blood work done. These are her abnormal stats... RBC 4.78, HCT 32.8, ALB 2.1 and ALT 152.
The vet prescribed Denamarin.
Lily seems to be getting worse not better... just wondering your thoughts... what I might consider...
Welcome! My name isXXXXX am a 2003 graduate, and currently a Medical Director of a veterinary hospital.

I am sorry to hear about this concern for LilyPearl.

By far, the next recommended test would be to get an abdominal ultrasound so look at the architecture of the liver much better!

Abdominal Ultrasound in Dogs

I would also ask the vet if it is indicated to do a bile acids blood test, which helps to assess the "function" of the liver. But, fortunately, that is a rather low increase in the ALT liver enzyme.

Now, a albumin level can drop with decreasing liver function, so I definitely think assessing liver function and that ultrasound are critical next steps.

Love Denamarin. Excellent liver support supplement.

Remember, small tumors, infections, or inflammatory conditions of the liver will not be visible on x-rays. That is what the ultrasound will help to diagnose.

I hope that information has been helpful.
Please remember to select Reply to Expert, if for any reason you need further clarification, have more questions, or were expecting a different type of answer. Prior to leaving a feedback rating, which I greatly appreciate so I am recognized by Justanswer for responding, my goal is to provide you the best answer possible.
Dr. Andy

Customer: replied 3 years ago.

My vet suggested going to specialist for an ultrasound for further insight. I have not (yet) decided to take her for fear of the costs and having truly no beneficial difference in the treatment course, any thought???
Last Nov LilyPearl had a cancerous tumor removed with clear margins, then was put on chemo for approx 5 weeks. As you well know this was thousands of $. Just can't do that again, and if all they are going to suggest is more n more tests that would still lead to the same treatment, do you really think there might be some other treatment she might need? My vet did not think there was any infection as per blood work...
I would not want any surgery done, so???


 

I agree with your vet 100%.

It's worth the cost of the ultrasound to at least get a rough idea on what the primary issue can be. An ultrasound, even without expensive biopsies, can help dictate if medications like anti-inflammatory or antibiotics are necessary.

Yes, I do think alternative treatment could be suggested based on ultrasound findings.

Understood if you are not electing to do surgery again, but having some confidence to know if surgery was even appropriate really helps.

I agree with your vet in this situation.

Dr. Andy
Customer: replied 3 years ago.

OK... thanks.


Had tried to add this but you had already answered will send along now...


Lily's liver is enlarged enough to push her stomach back and up... not giving her much room in there. I have been feeding her fish/potatoes as opposed to her Earthborn Hollistic Prim Ntl dog food... maybe that food is too hi protein long term? I had just started feeding it to her after the cancer. Lately some diarrhea/loose stools and some throwing up mostly nothing. She only at the fish combo mix a couple times and then refused to eat... one day w/o much food... yesterday. Today she agreed to eat some hamburger meat, and tonight more hamburger meat w/some of her EHPN food. I am feeding much smaller amts more X per day as directed.


 

Yes, the diet may need to be modified to a liver (hepatic) friendly diet. May not make much of a difference in the long run, but worth discussing with your vet.

I run into a lot of digestive problems with these holistic diets. I do strongly feel you would be better off on her original food, at least for now, over this other formula.

If you are needing to feed things like hamburger because her appetite is falling off or poor, that is a serious concern.
Careful with hamburger. If not prepared with lower fat/oil in it, definitely can exacerbate some issues.

Here is a bland diet recommendation:
Boiled boneless, skinless chicken breast OR low-fat cottage cheese
And
Cooked white rice
*Never add on salt, pepper, oils, butter to any of the above
*Ideally, give 1/3 chicken or cottage cheese, and 2/3 white rice
Veterinarians will often prescribe some prescription bland diets as an easy alternative including
Science Diet I/D
*It is important to remember that if improving on a bland diet or prescription food like I/D, when you transition back to the old diet, do so gradually over 3-5 days.

Hope that additional information helps. Definitely, reply to me if there is any other way I may assist you. I hope my responses have been satisfactory?
Dr. Andy
Customer: replied 3 years ago.

Yes, you have helped... thanks!
Now, if I rate your answers will I still be able to continue this discussion with you? I did accept the 1 week free trial but not sure how all this works... Susan

 

YES about the slow change in foods... I did not do that with the fish/pot diet... forgot... sure that probably caused some of her probs... sighs...

 

My reg vet wanted to try that pill as mentioned and a retest of blood etc in 2 weeks... it's been about a week on that pill... now to wait and see if better diet helps... or just go for ultrasound?

Hello Susan,
Yes, please select a feedback rating, otherwise, I am not compensated at all by Justanswer for any replies. I would be more than happy to continue answering a few 'related' questions. Of course, if you were to ask unrelated questions or about a new pet, than even with a trial a new question box should be opened.

Thanks
Dr. Andy
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