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Jaundiced dog.

Species: Dog
Breed: Labrador
Age: 8-11 years
Hi, I have an 8yr old female labrador that on the 30th December, 2013 evening stopped eating. We tried changing food brands more than once, she would eat one or two times and them turn her head away but she kept eating treats and human food without any problems, we were assuming and also our vet after checking her that she was being picky about food since she was eating other things. This went on for about 3 weeks when suddendly she started vomitting bile few hours after eating. We returned to our vet to visit her and he immediately diagnosed her with jaundice, so we run a full blood count and she has also lost weight but there were no clinical findings. The blood test results for the liver were very high, ALP 1531 and ALT 1000 (U/L), GGT 0.26, Amylase 480 (U/L) and Billirubin 40 and he told us that he will do an ultrasound to examine the liver and surroundings. The ultrasound showed only 3 bright small spots near the spleen and nothing wrong with the liver. So he suggested to perform an biopsy full anesthasia to be able to diagnose the disease. In the meantime she was given Zentonil Advanced and Destolit to help her with the liver. Two days later we were back at the vet's clinic as she had stopped eating, so we were given Hill's L/D which up to today we still force-feed as she keeps losing weight, she already lost about 8kgs. Every now and then she would eat a piece of apple or carrots and last two days strawberries but nothing else. We have tried every kind of food, there is nothing she will eat on her own. One week after started meds (this was last week) we returned to the vet's clinic for revaluation and the jaundice cleared and orange urine had returned to normal and so we decided to re-do the blood tests and decide on the results whether to perform the biopsy, results are not out yet but should be later on today. But since Sunday Bailey stopped drinking water on her own, we are syringing water into her. We have noticed that she is hungry and thirsty, but as soon as she lowers her head in her bowls, her mouth fills up with bile and now I am wondering if she still has nausea and this is stopping her from eating and drinking. When we give her water by syringe, she accepts it and won't move away until basically satisfied. Another thing we have noticed is that the last 2 nights she wakes up sneezing alot, I have no idea if this is related or not. Anyway, all the way through this ordeal her stool remained of a normal colour and although very weak she still looks forward to go out and is happy to be around us, not lethargic, no vomitting. Vet has checked her mouth, nothing found. Now vet advised that he will give her IV Fluids since she is not drinking and eating. Sorry for the long post but so many things have been going on, that I wanted to give you a clear picture of what we are experiencing. We would also like to know if we can give her an appetite stimulator or atleast an anti-nausea, she was on cerenia for 3 days. Also would like to have your views about her condition.

Thank you
Josianne


Online vet, Dr. Marie

Dr. Marie replied:

Oh I am so sorry to hear of Bailey's ordeal. Any time a lab refuses to eat, you know that there is a serious problem.

I am thrilled to hear that the jaundice is going and that things are improving somewhat.

Liver disease is very frustrating because we often don't get a distinct answer even though we can do a whole pile of tests. It sounds like your vets are being very thorough and doing an excellent job.

The fact that the jaundice is resolving and that there were no obvious findings on the liver ultrasound makes me lean towards some type of toxin affecting the liver. Unfortunately you will likely never know what that is. One example would be xylitol which is a sweetener in gum that is very toxic to dogs. (However, dogs with xylitol poisoning usually have very low blood sugar.)

The spots on the spleen could be a concern but they could also be something very normal. Some animals have little pockets that form on the spleen and they are nothing at all to worry about. The other concern would be if they were tumors such as hemangiosarcoma. Logically though, if hemangiosarcoma was in the spleen and was affecting the liver (but not big enough to be seen by ultrasound) then I would not expect the jaundice to go away. This makes me think more of a toxin of some sort.

The IV fluids sound like an excellent idea. Not only will this help to rehydrate her, but if there is a toxin present they will help to flush the toxin out of her system. An anti-nausea medication is a good idea as well. Cerenia is a good one, but officially it is not meant to be used long term. I have used it for longer than 3 days though. However, when the liver is impaired, sometimes we are cautious about using too many medications as many of them are processed through the liver.

I don't usually recommend an appetite stimulant for dogs. Going without food will not harm a dog. (In a cat, it can cause fatty liver.) The lack of appetite is not hurting Bailey, but it is more of an indicator. When she starts to eat well again then we know that she is feeling better.

Here are a couple of things that you can ask your vet about. You may want to ask if leptospirosis is a possibility. This condition more commonly affects the kidneys, but I have had cases where it has caused severe liver disease as well. Lepto is usually a treatable condition but can be very serious.

Does Bailey eat chicken jerky treats at all? If so, you may find this article interesting: Is Glycerin the toxin in Chicken Jerky Treats?.

At this point, by far the best thing that you can do is get Bailey on some IV fluids. The vets will likely give injectable medication to help with the nausea and hopefully the liver is repairing. If this is a toxin then the liver usually is very good at repairing itself once the toxin is cleared.

I hope things improve soon!

Dr. Marie.



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Disclaimer: Although Dr. Marie is a qualified veterinarian, the information found on this site is not meant to replace the advice of your own veterinarian. AskAVetQuestion.com and Dr. Marie do not accept any responsibility for any loss, damage, injury, death, or disease which may arise from reliance on information contained on this site. Do not use information found on this site for diagnosing or treating your pet. Anything you read here is for information only.

Customer reply:

Hi Dr Marie,

Thank you for your reply. Just spoke to our vet and will be starting IV Fluids tomorrow morning, re-test results believe or not they have been misplaced and are trying to contact the lab to have another copy sent by email, so hopefully we will get them tomorrow.

She used to eat the Kong Chicken Liver biscuits and cooked stips of chicken, although we have always been very careful not to give to much due to allergies.

1 week before all this started, we called at the vet's clinic for her yearly vaccinations and check up and left there with a clean bill of health.

If this is due to toxins, could have it been from fresh fruit, as that day, apart from her usual breakfast, she had an apple (no seeds), some chicken strips, some beef and veg (special sunday treat), 1 mandarin and then that's it, in the evening she refused her food.

I will check about Lepto, although we do get vaccinations for it.

One more question, can we use any natural herbs to stimulate her appetite and as mentioned she wants to drink but her mouth fills up, can it be due to nausea?

Thanks alot your reply.
Josianne


Online vet, Dr. Marie

Dr. Marie replied:

Well that is frustrating that the results have been misplaced! I have had issues like that with laboratories as well sometimes, but not often.

It doesn't sound like any of the things that Bailey ate could have been toxic.

You did mention, however, that she had vaccinations a week previous to this. There are some very rare cases where vaccinations can trigger an autoimmune condition. You may want to ask your vet if this is at all possible. If so, then the vet may contact the vaccine company and discuss this with them. Most vaccine reactions do not cause liver disease, but it does seem coincidental that these problems happened a week after the vaccinations.

I would stay away from any natural herbs. Even though herbs are natural for many of them we don't know how the liver processes them. You have the potential to do more harm than good.

And yes, I think if she is getting a lot of saliva in her mouth when trying to eat or drink this is probably nausea. Most likely the vet will be able to prescribe something to help with this, or when in for IV fluids administer something by injection.

Dr. Marie.



Customer reply:

Dear Dr Marie,

Just got the result and we are very pleased (vet included), ALP down to 1173, ALT 352, billirubin 22. He is still worried about the eating & drinking issues but hopefully iv fluids will help.

Thanks alot for you kind assistance
Josianne


Online vet, Dr. Marie

Dr. Marie replied:

Yay! This is good news. I pray that things continue to improve!





Customer reply:

Dear Dr. Marie,

Just wanted to give you a quick update on Bailey. Yesterday Bailey had about 2 hours of IV fluids and was sent home to return for more fluids on Monday. Yesterday evening she ate fruit and today she had an apple and some real food too. Drinking water is still a problem but sure that we will get there too. I have to say that IV Fluids really helped alot, she is happy, even barked this morning and is wagging her tail more. Her nausea seems alot better too. Hopefully she will continue to improve and get better.

Thank you once again
Josianne


Online vet, Dr. Marie

Dr. Marie replied:

This sounds like great improvement. Don't worry about the fact that she is not drinking water. That is often common after having IV fluids.

Thanks for the update!



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Dr. MarieDr. 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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