How JustAnswer Works:

  • Ask an Expert
    Experts are full of valuable knowledge and are ready to help with any question. Credentials confirmed by a Fortune 500 verification firm.
  • Get a Professional Answer
    Via email, text message, or notification as you wait on our site.
    Ask follow up questions if you need to.
  • 100% Satisfaction Guarantee
    Rate the answer you receive.

Ask Dr. Andy Your Own Question

Dr. Andy
Dr. Andy, Medical Director
Category: Dog
Satisfied Customers: 28135
Experience:  UC Davis Graduate, Interests: Dermatology, Internal Medicine, Pain Management
Type Your Dog Question Here...
Dr. Andy is online now
A new question is answered every 9 seconds

I have a 10 yr old lab with an enlarged liver, as indicated

Resolved Question:

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...
Submitted: 10 months ago.
Category: Dog
Expert:  Dr. Andy replied 10 months ago.
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 10 months 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???


 

Expert:  Dr. Andy replied 10 months ago.
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 10 months 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.


 

Expert:  Dr. Andy replied 10 months ago.
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 10 months 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?

Expert:  Dr. Andy replied 10 months ago.
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
Dr. Andy, Medical Director
Category: Dog
Satisfied Customers: 28135
Experience: UC Davis Graduate, Interests: Dermatology, Internal Medicine, Pain Management
Dr. Andy and other Dog Specialists are ready to help you

JustAnswer in the News:

 
 
 
Ask-a-doc Web sites: If you've got a quick question, you can try to get an answer from sites that say they have various specialists on hand to give quick answers... Justanswer.com.
JustAnswer.com...has seen a spike since October in legal questions from readers about layoffs, unemployment and severance.
Web sites like justanswer.com/legal
...leave nothing to chance.
Traffic on JustAnswer rose 14 percent...and had nearly 400,000 page views in 30 days...inquiries related to stress, high blood pressure, drinking and heart pain jumped 33 percent.
Tory Johnson, GMA Workplace Contributor, discusses work-from-home jobs, such as JustAnswer in which verified Experts answer people’s questions.
I will tell you that...the things you have to go through to be an Expert are quite rigorous.
 
 
 

What Customers are Saying:

 
 
 
  • You are a light at the end of scary tunnel when $ are tight, but people need professional help to turn to for help with their dear pets! Linh Charleston, WV
< Last | Next >
  • You are a light at the end of scary tunnel when $ are tight, but people need professional help to turn to for help with their dear pets! Linh Charleston, WV
  • $1,000 spent at his vet, and I finally get the correct diagnosis from Nancy Holmes for $15 Carol Cedar Hill, MO
  • I think this is the greatest web site in the world. Thanks to all! Judy New Haven, CT
  • I have referred several friends to your web site. I'm impressed with how easy it is to use your site, the Experts available and the quickness of answers. Nina USA
  • I am completely pleased with the quick response that I received in our time of need for our dog, Jasmine. I couldn't believe how quick the response was and I thank you. It's good to know you're there!! Jasmine's Mom USA
  • Please let everyone involved with your site know that your Expert, Dr. Lucy, has saved my dog's life. I will recommend your site to all my pet loving friends. Thank you again for simply being there! Sonya G Easley, SC
  • Last night my Expert spent close to 3 hours working with me on my dog's illness. Thank you so much for this opportunity to share in her care and knowledge! Cathie M Pompano Beach, FL
 
 
 

Meet The Experts:

 
 
 
  • Dr. Gary

    Dog Veterinarian

    Satisfied Customers:

    2534
    DVM, Emergency Veterinarian; BS (Physiology) Michigan State Univ
< Last | Next >
  • http://ww2.justanswer.com/uploads/RY/rydergar/2012-6-6_192240_IMG0328.64x64.JPG Dr. Gary's Avatar

    Dr. Gary

    Dog Veterinarian

    Satisfied Customers:

    2534
    DVM, Emergency Veterinarian; BS (Physiology) Michigan State Univ
  • http://ww2.justanswer.com/uploads/JA/Jav917/2012-2-20_54059_201221802254JoananddavidArchuleta3.64x64.jpg Joan's Avatar

    Joan

    Vet Tech

    Satisfied Customers:

    4544
    Vet Tech for over 30+ years working w/Dogs/Rescues
  • http://ww2.justanswer.com/uploads/JA/jadedangel57/2011-11-8_193134_janenewsm.64x64.jpg Jane Lefler's Avatar

    Jane Lefler

    Breeder,Behaviorist, formerVet Asst

    Satisfied Customers:

    13847
    Former vol Vet Assistant.Breeder 16+ years Dog trainer / behaviorist
  • http://ww2.justanswer.com/uploads/ER/ERPetNurse/2011-11-7_1293_b.64x64.jpg Candy's Avatar

    Candy

    Veterinary Technician

    Satisfied Customers:

    7108
    Practicing Veterinary Technician for 26 years.Former Veterinary Practice Owner, Technician Trainer
  • http://ww2.justanswer.com/uploads/BA/babybloo/2011-3-10_62613_DavidandI.64x64.jpg Theresa's Avatar

    Theresa

    A Voice for Your Pet

    Satisfied Customers:

    4704
    19+ years experience in small animal medicine
  • http://ww2.justanswer.com/uploads/VE/vetforyou/2012-6-20_33122_PearlPhoto.64x64.jpg Dr. Andy's Avatar

    Dr. Andy

    Medical Director

    Satisfied Customers:

    4430
    UC Davis Graduate, Interests: Dermatology, Internal Medicine, Pain Management
  • http://ww2.justanswer.com/uploads/VE/VetAnswers/2013-4-5_8257_prof10.64x64.jpg Scott Nimmo's Avatar

    Scott Nimmo

    Dog Veterinarian

    Satisfied Customers:

    3977
    BVMS, MRCVS.