I got Sadie in January this year. She is a rescue. She's been sick since February. We've (my Vet & I) have had a long battle with her liver, gall bladder & white cell count. To make a very long story short, Sadie had surgery in August to remove a very enlarged gall bladder that meds just didn't help and a liver biopsy noted a rare form of hepatitis. After more rounds of anti biotics and liver meds (metrizindonol ? & Denimarin) we checked her blood work hoping to see all levels back to normal. Unfortunately, her liver counts were still as high as they were pre-op. Now the Vet's are scratching their collective heads and I'm really worried. We're into this nearly $7,000 of tests, surgery and ICU hospital stays for a very sick pup. She's feeling much better. Eating & drinking well. Not a sustained energy level that I would expect to see in a 2 year old. She goes in spurts then poops out. :). She is the dearest, sweetest personalitied , little thing I've ever seen. An angel. She was found in a ditch, abandoned, ragged and alone. She is about 40lbs. He DNA panel came back Plott Hound/ German Shepherd /Swedish Vallhound but she is blonde and looks like she is more lab / border collie mix. Go figure.
So, my question is. With liver counts up near 500 still. She cannot tolerate the Denamaren any longer (she vomits). The Vet is going to now try Milk Thistle supplements. Do you have any OTHER thoughts?? I didn't think it could hurt to throw another intelligent brain in the mix. I'd be happy to pay the $15 if this more complicate a question than the $8 one.. Any help I can get for Sadie or suggestions for my Vet & I might be able to turn. There is no cancer (thank God) seemingly no other disease that they can find. I'm scared to death that they are missing something and may find it too late..
Thank you in advance for your input.
Dr. Marie replied:
Oh, poor Sadie. It sounds like you have done so much to help her. Cases like this are so difficult.
It's unlikely that I'll be able to add much more, but I'll give you my thoughts.
First of all, do you know the name of the rare form of hepatitis that she has? If so, then I can do more research for you. But again, most likely your vet has been researching this a lot as well.
One thought I had was, if not already done, to talk to your vet about giving Sadie a course of Fenbendazole which is a broad spectrum dewormer. There are some unusual parasites that can affect the liver. Whenever I have a patient with a liver condition that I can't figure out I always do this just to be sure. There's really no harm in it.
Milk thistle is a good idea. It's not likely to be a cure, but it has been shown to help support the liver.
Do you think that you can find out the name of the rare type of hepatitis? If so, then reply and let me know. This will give me much more to go on.
Please let me know and I'll see what else I can add.
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Yes, I will find out the name of Sadie's hepatitis. Her Vet is gone for today so it will be tomorrow. Thank you very much for your input!!
Dr. Marie replied:
You're very welcome! Hopefully I can help you some more once we get the diagnosis.
I apologize for the delay in getting the information you requested. I've had a family health emergency. Believe it or not, my Mom is now scheduled for gall bladder surgery this Friday which Sadie just had removed. Bizarre!
Anyway, I've gotten a copy of her liver biopsy report from the Vet and the hepatitis she has is Portal Hepatitis, generalized, subacute, lymphoplasmacytic with pigment granules. How's that for a mouth full? In the comments the Pathologist wrote:
"Histologic changes are non specific and may indicate an ascending inflammatory process from gastrointestinal tract or other causes of chronic antigenic stimulation. Further correlation with the clinical exam findings and other diagnostic assays is warranted."
I hope this might shine a light for you. :). Thank you again for looking at this information. Sadie & I truly appreciate any and all eyes and brains willing to take a look.
Dr. Marie replied:
Oh I am sorry to hear about your mom. I pray that all goes well. It is strange but I have seen things like this often where a family member and a pet both have the same illness.
The histology results actually don't tell us a whole lot. This is the frustrating thing with liver problems - often it is really difficult to pinpoint what the problem is. The biopsy really says in layman's terms that the liver is inflamed but we don't really know why. It could be because of an intestinal issue or it could be a number of other possibilities.
I wish I could offer more in the way of a diagnosis. When we have cases like this we do what we can in the way of supporting the liver - so milk thistle is not a bad idea. It is unfortunate that she can't handle the Denamarin as this medication usually is quite helpful in supporting the liver.
My one other thought is that if there is antigenic stimulation (as per the biopsy report) it's possible that a small dose of steroids may help. It may be worthwhile to ask your vet about this. It's a tough call though.
Sorry that I can't offer much more. I hope things improve soon.
Thank you for taking a look at Sadie's issues anyway. I really appreciate just having another set of eyes and knowing we at least haven't missed anything obvious. I was pretty sure that hadn't happened as I do have faith in Dr Tyler but it is frustrating knowing that something else is wrong and not being able to pinpoint it. I just don't want this pup to suffer or be sick. She is priceless to me.
Dr. Marie is a veterinarian who practices in a busy animal hospital in Ottawa, Ontario. She created Ask A Vet Question as a resource for good, accurate veterinary advice online. Dr. Marie treats dogs, cats, hamsters, guinea pigs, and rats. She has been a vet since 1999.
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