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Ask Dr. Michael Salkin Your Own Question
Dr. Michael Salkin
Dr. Michael Salkin, Veterinarian
Category: Dog
Satisfied Customers: 24415
Experience:  University of California at Davis graduate veterinarian with 44 years of experience
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Dear Dr. Scarlett, My 9 1/2 years old chihuahua has

Customer Question

Dear Dr. Scarlett,
My 9 1/2 years old chihuahua has encreased ALT (881) and blood in his stool. His symptoms began this autumn ( blood in his stool and dry skin) . First the ALT was 621 and the vet prescribed a hepatic diet, antibiotics and Samylin. The vet also took x-ray and everything seemed to be ok in them. After a month took my dog to the vet for blood tests to see if the ALT has decreased and it was 131, the other symptoms were gone also so the vet said I could give treats other than the diet food for my dog.
However, now about 2 months after the symptoms ( blood in the stool) are back. I took my dog to the vet and the ALT was 881. I'm feeding him with Trovet hepatic diet food and Samylin. Is there anything else I could do rather than wait and see? My dog is acting normal.
Submitted: 11 months ago.
Category: Dog
Expert:  Dr. Michael Salkin replied 11 months ago.

Yes, but you're looking at invasive testing in the form of an ultrasound-guided needle biopsy of his liver. To be more accurate, I need to see all of his test results. Can you upload a copy of his test results to our conversation? I understand that you might not have a copy of the results at home but his vet should be able to give you one which you could scan into your computer and give me the link or you can photograph the page(s) and upload the images by using the paperclip icon in the toolbar above your message box (if you can see such an icon) or by using an external app such as dropbox.com.

Customer: replied 11 months ago.
Thank you for your answer. I took pictures of the results, hopefully they can be seen. I have been thinking about the biopsy but is there a chance that it might actually make the situation even worse considering the dog's age? And could the blood in his stool mean that the liver is bleeding?
Sincerely,
Mari
Expert:  Dr. Michael Salkin replied 11 months ago.

Thank you, ***** ***** received a normal complete blood count but no biochemistries. Do you have more information you could upload for me?

A needle biopsy is quick and safe even at his age. The only significant drawback to biopsying in that fashion is that a diseased portion of the liver may be missed when the biopsy is taken. Exploring the abdomen and taking a biopsy of visually abnormal tissue is preferable but entails a much more invasive procedure. No, the bleeding arises from his gastrointestinal tract and perhaps from an inflamed pancreas.

Customer: replied 11 months ago.
Unfortunately, those are the only documents I got from the vet.
Expert:  Dr. Michael Salkin replied 11 months ago.

I understand. I'm handicapped by not being able to see all of his test results. I not only review the test results but also note which tests should have been performed but weren't. Consider the ultrasound +/- biopsy and see if a specCPL blood test were performed - the most sensitive of the blood tests for detecting the presence of pancreatitis which can also elevate the ALT.

Customer: replied 11 months ago.
Ok and thank you so much. I live in Finland and there is not really any information about liver disease or pancreatitis in Finnish so this really helps me to figure what to do next. I will call the vet tomorrow and ask about the specCPL. I was wondering if there is any way to prevent the blood in the dog's stool ?
Expert:  Dr. Michael Salkin replied 11 months ago.

You're quite welcome. You'll need to determine the cause of the hematochezia (blood in the stool) in order to prevent it. The most common risk factor for hematochezia is colitis of any cause.

Nonspecific trial therapy can be attempted in an animal without systemic signs:

  • Dietary modification as dictated by underlying disorder
  • Broad-spectrum anthelmintic (e.g., fenbendazole 50 mg/kg PO q 24h × 3 days)
  • Trial course of metronidazole (e.g., 7.5-10 mg/kg PO q 12h × 10 days), or tylosin (10 mg/kg PO q 8h for 21 days as treatment trial if suspecting inflammatory bowel disease, or 20 mg/kg PO q 12h for clostridial colitis), sulfasalazine (dogs: 20-40 mg/kg PO q 8h for 14-21 days, then taper by 25%-30% q 14-21 days.

I can't set a follow-up in this venue and so would appreciate your returning to our conversation with an update - even after rating - at a time of your choosing.

Customer: replied 11 months ago.
Sure, thank you for the advice. I have a checkup on the 7th of January so they are going to check the ALT and possibly the specCPL and do the ultrasound as well if needed. Happy holidays!
Sincerely,
Mari
Expert:  Dr. Michael Salkin replied 11 months ago.

Sounds good. Happy holidays!