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Dr. Gabby
Dr. Gabby, Veterinarian
Category: Dog
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Experience:  DVM for 19 years. Compassionate, Caring, Experienced.
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my dogs sgot, sgpt liver enzymes are extremely

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my dog's sgot, sgpt liver enzymes are extremely high-3000, put him on bactrim, sam e, they improved, switched to baytril,now they are extremely high again, albumin normal, wbc normal, bili normal. rads showed enlarged liver? mass-no us done,Due to cost. assumed it is cancer. drinks alot, appet now decreased w/ some lethargy.should i put him back on bactrim? try milk thistle? why did enzymes respond to bactrim if it is cancer? Could we have misdiagnosed cancer. he is not jaundiced.Help-my dog is dying,Is it tool late for u/s & tx for chronic liver disease? 9yrold brittany/beagle mix

HelloXXXXX/p>

I was wondering if your dog has or has had a fever at all?

What made you bring him to the vet in the first place?

The baytril can actually cause the liver enzymes to increase.

I do not think bactrim is a good choice either as that medication is not recommended in patients with liver problems.

Customer: replied 10 years ago.
yeshas temp of 104, took to vet for increasee thist & urinaton-no n/v/d.What would you suggest to tx him?

I would not just randomly treat him.

Your best bet is to have an ultrasound done and then a ultrasound guided biopsy done at the same time. This will give you the most answers. I would do this as soon as you can.

It will tell you if it is cancer or inflammation.

I also think a bile acid test may be helpful. This is a blood test that helps determine if the gall bladder, bile duct, and liver are performing as they should. It is an easy test.

I would also tun a tick titer blood test to make sure it is not Lyme's, Rocky Mountain Spotted Fever, or Erlichiosis.

For antibiotics, I would use Meteronadazole and clindamycin or a cephalosporin for now. If they took a biopsy they could also take a culture of the liver tissue to see if they could culture bacteria from it. If they did, they could see what antibiotics it was resistant and sensitive too.

The milk thistle is more for hepatic toxicity like poisoning. It would not hurt.

If it is chronic active hepatitis he will need to be on medication for the rest of his life to help the liver cells function and last longer.

There is no point in treating it as hepatitis if it is cancer. You need to have a biopsy done to figure out which one it is.

 

Customer: replied 10 years ago.
would cancer of responded to antibiotics (bactrim)& sam e-his enzymes went from 3000 to 300 on meds.? then they climbed up after baytrill & he was not on sam e at that time either.how do you tx hepatitis? what harm would it do if is is cancer & are tx for hepaitis? the u/s w/ bx is $600 -we can't afford.doesn't it seem more of an infectious process as opposed to cancer?

The reason it does not seem infectious is the normal white blood cell count.

If you are short on money, instead of sending out tick titers, try doxycycline 10mg/kg for a few days. If it is a tick disease you should see a rapid improvement.

It would not hurt him at all if you treated him for chronic hepatitis.

Treatment for chronic hepatits:

Vitamin E 10 IU daily

SamE you already know that one

Zinc This is for fibrosis of the liver. We don't know if he has that so hold off on this for now.

Prednisone You will have to get this from your vet

Ursodeoxycholic Acid This protects the liver cells and is an antioxidant. Helps with gall stones and acute hepatotoxicity. You would have to get it from your vet.

I am not sure why he responded to the sulfa antibiotic and not the baytril. The baytril is less harsh on the liver cells too! If he had an infectious hepatitis I would expect to see a high white count. Maybe the white count would be higher now?

That ultrasound is expensive where you live.

By the way, run a urinalysis too if you have not and see if there is bilirubin in it.

Customer: replied 10 years ago.
dr.gabby-you are helping me struggle w/ making right decision. his lung rads were clear. he only ate rice today, his gums are pale pink, he sleeps alot, depressed. the reg vet thought we should put him down soon. she also put him on pepcid.The specialist discharged him 3 weeks ago after we declined u/s.am i pulling at straws to try to save him -does it sound like cancer. is it too late for u/s? we started all this end of november,does cancer move this fast

If his gums are pale then he could be anemic. That would go along with both cancer and chronic hepatitis.

This is the problem I see. Lets say you do the ultrasound and it is cancer. Then what? Are you going to do chemotherapy at $1000-$2000 a month or have part of the liver removed? Probably not right? Maybe it is a type of cancer that can not be treated. Will it drive you crazy if you don't know for sure if it is hepatitis or cancer?

That is why the ultrasound is so expensive, because the specialist is doing it right? It should be a little over half that if a regular vet did it.

Maybe what you could do then is antibiotics, prednisone, pepcid and samE. When he refuses to eat and drink, can not get up and around, loses bowel or bladder control, can't breathe well, or has bad vomiting or diarrhea then it is time. That is what I would do. I have never had good results with cancer and chemotherapy. I would not do it on my own dog.

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