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Dr. Bruce
Dr. Bruce, Veterinarian
Category: Veterinary
Satisfied Customers: 18799
Experience:  15 years of small animal veterinary medicine
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My dog has liver disease. She was suffering from hepatic encephalopathy

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My dog has liver disease. She was suffering from hepatic encephalopathy but Lactulose seemed to take care of that. She also takes Marin every day. She started vomiting so the vet prescribed Reglan and told me to slowly reduce the Lactulose. Now she won't eat and reacts to my touch as though she has pain in her abdomen. She's lethargic and losing weight. I"m at a loss as to what to try next.

Welcome to Just Answer. I'm very sorry to hear that your girl isn't feeling very well. The fact that she's not eating and painful in her abdomen has me worried that there is inflammation going on in her abdomen. The pain is the big sign of that. This inflammation could come from her pancreas, an organ that produces digestive enzymes. It could also come from her intestinal tract if there was something there that was blocking it up. As far as what to try next, honestly, I would have your vet do some blood work and take some x-rays of her to evaluate what is the underlying cause. She sounds pretty sick and this should be started up as soon as possible to help her through this.
Customer: replied 7 years ago.
I should have also mentioned that she's had an abdominal ultrasound and there was no indication of other affected organs. She had more blood work done and saw the vet on Monday, 3/29. Her liver had actually improved, but she was vomiting and I was worried. This is when the vet prescribed Reglan, which did stop the vomiting. She's taking vitamins, Marin, and Reglan so this morning I used ground beef to get them down her gullet. Do you think that may have upset her system because of an amonia affect?

Sure would be nice if she could talk!
It would be nice to be able to ask them exactly where they hurt and why! Having patients that don't speak just makes us more attentive to our physical exam findings and test results. I'm glad to hear that the abdominal ultrasound was done and it didn't indicate other organs being involved at that time. But, I will say that sometimes things can change. If that ultrasound was done over a week ago, the current vomiting could be due to something that a repeat study might pick up on.

If the vomiting seems to be responsive to the Reglan, that is good. The ground beef being used to get her to take her medications definitely could have been something to upset her intestinal tract. It usually is considered a bland food when the grease is taken off or it is boiled. But, certain dogs can definitely have issues with it. Could it have caused blood ammonia levels to go up? Maybe. But usually when this happens they act lethargic, weak, and possibly stuporous. A post prandial rise in ammonia levels doesn't typically cause nausea. I would be more suspicious that the food itself just didn't sit well.

If the Reglan is loosing its potency, another antinausea medication can be tried - it is called Cerenia. Your vet may want to try a trial of this.
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