Dr. Rosol : Hello, I will be happy to help you today
Dr. Rosol : looking over the blood work we are dealing with dehydration (elevated rbc aka red blood cells and elevated hct aka hematocrit). This is a minor issue corrected with blood work.
Dr. Rosol : My bigger concern is the following....
Dr. Rosol : the alt and alkp are elevated. These indicate liver dysfunction
Dr. Rosol : The next step is to find out why
Dr. Rosol : A few questions......
so should I delay the anesthesia?
Dr. Rosol : how is her appetite? Water intake ( has it increased)? Weight (increased or decreased)? Any vomiting or diarrhea?
Dr. Rosol : Not necessarily......I have performed surgery including dentals on dogs with higher liver values, however, it's important that she be placed on IV fluids while under anesthesia
ok. Is she a risk patient?
Dr. Rosol : If you are unable to have further diagnostics to determine why the liver is elevated then I would place her on milk thistle. This is a wonderful over the counter antioxidant for the liver. She would need 100-150 mg once per day. You can purchase at cvs, Walgreens, rite aid, etc
Dr. Rosol : Very sma ridk
Dr. Rosol : All of my liver patients have done extremely well
Dr. Rosol : cushings diease can cause elevated liver enzymes but so can age, chronic onion ingestion, toxins, and sadly cancer
so you suggest making sure that she is being given iv fluids during the procedure? What could possibly happen if that isnt done?
Dr. Rosol : An abdominal ultrasound is the best in terms of figuring out a diagnosis, however, this can be expensive $300-400
I'm fine with further diagnostics but should i have those done prior to the dental or can i get dental first and then have further testing done
Dr. Rosol : Yes, IV fluids during will help to support her liver since mostly all anesthetic agents are filtered through the liver. If she does not receive IV fluids then her liver can become more affected (the liver enzymes will go higher).
Dr. Rosol : It depends on how badly she needs the dental. If she has severe dental disease then yes do the dental ASAP. If she can wait on the dental then I would determine why the liver is elevated and then perform the dental if the ultrasonographer says its ok
ok just one more question. I will suggest that vet give IV fluids, however, just so I am aware, after the anesthesia are there any signs that I should be looking for to make sure liver enzymes did not go up.
Dr. Rosol : Yes. Look for a decreased or increased appetite, increased thirst, increased urination, change in weight (up or down), pot bellied appearance, yellowing of the gums/eyes/ears/skin, vomiting or diarrhea
Dr. Rosol : she will be unlike her self for about 24-48 hours after surgery so don't take this as worsening liver enzymes
i just noticed that her gastrointestinal is abnormal too. Doesn't state a number just says abnormal. Is that anything to worry about?
Dr. Rosol : Where do you see that?
Dr. Rosol : Was that on the veterinary exam form? Any other notes with it?
Dr. Rosol : If this was on the exam form this could mean a number of things. I would ask your vet specifically about that because a physical exam would have to be done for me to tell you exactly what was meant by that.
Dr. Rosol : Perhaps the vet wrote this because of the elevated liver enzymes
it is in a list of cardiovascular, ears, eyes, lymphatic, nervous, respiratory, etc. all say normal next to them except the gastro