Dog's hepatitis symptoms are back, worried about vet bills. What to do?

The next logical step is liver biopsy. Please, discuss it with your vet. If they are not able to take a biopsy (not every veterinary practice is capable to perform this procedure) you should ask to be referred to specialists in internal medicine. They will be able to offer much wider range of investigation and treatment.

The bilirubin is a bit high, as is the ALP (alkaline phosphatase) but neither of these values is super specific in terms of what the cause or the best treatment is. We can see the ALP be elevated with stress, age, and sometimes even normal cell regeneration within the liver. The bilirubin can be slightly elevated when the blood sample is what we call "hemolyzed," which can sometimes happen when blood is spun down for a blood test to be run. Therefore, if he is still showing symptoms of illness, I would echo what Dr Ana said; it may be time to consider imaging. Either X-rays or an abdominal ultrasound maybe helpful in identifying the problem and therefore identifying the best way to treat it. Take him back to the vet if he's still having troubles, as he probably is in need of some more fluids as well. Thank you for asking Petco Pet Education Center, formerly Petcoach, I hope he's feeling better.

Hello and welcome to Petco Pet Education Center, formerly Petcoach. Hepatitis (infection and inflammation of liver) is a very serious condition and is very hard to treat. If there is an internal medicine specialist in the area I would recommend having Nala seen by them. Otherwise I would be talking with your vet about testing for infectious diseases. However, it looks like they have treated her with broad spectrum antibiotics as well as IV fluids. I would recommend continuing treatment. She may need a feeding tube placed to try to keep her protein up during this illness. Unfortunately, with how severe this is, she may or may not pull through it, but the best chance of her making it through is to be aggressive with her treatment. I would suggest continuing to monitor her liver and white cell count, and to have imaging done and possible samples of her liver to try to determine the cause of the infection. Otherwise I would be talking to your vet about the parasites and infections present in your area and get covered with certain antibiotics. The white cells have increased however not that much, and the liver enzymes are actually improving if I can read the dates right from your picture. This is very hopeful. I would continue with antibiotics (IV if you cannot get them in orally), as well as IV fluids and I would think about syringe feeding or placing a feeding tube. Best of luck with Nala, I hope she makes a good recovery.

Hello, I am sorry to hear about Ginger. Based on the recheck liver values I would be concerned that Ginger has a problem in her biliary system, such as a GB mucocele or potentially a biliary duct obstruction. I would recommend rechecking the ultrasound to look for either of these developments. One thing that is interesting is that the other values are improving. Did your vet have any concerns about the blood sample when he ran/submitted the bloodwork. If there is a large amount of hemolysis (or breakdown of red blood cells) secondary to a traumatic blood draw or mishandling of the blood tube, this can lead to a false elevation of bilirubin. Although this value seems quite high to be due solely to sample error, I wonder if it may be contributing somewhat. If Ginger has a repeat ultrasound it might also be wise to recheck her total bilirubin level. Hope this helps, good luck!

I'm sorry to hear that Duchess is so sick. She is likely vomiting and experiencing jaundice secondary to the liver disease you mentioned. Dogs can also experience jaundice if their red blood cells are being destroyed. She will likely need to be hospitalized again and further diagnostics perfromed (repeat bloodwork, urine sample, chest x-rays and an abdominal ultrasound). These tests can give you more information on the potential cause of her symptoms and a prognosis for her. I would take her to the emergency hospital. I hope this information helps. Good luck!

Your dog needs to be seen by a veterinarian right away. This jaundice is a strong indicator for liver failure and this can only be treated properly with intensive veterinary intervention. If you are in financial difficulty, there are ways of still getting your pet treated by a veterinarian. Ask if they take Care Credit and apply online. This is a credit card specifically for medical, dental, and veterinary expenses. Call a local animal shelter or college of veterinary medicine in your area and ask if they have a low- or no-cost veterinary care program. GiveForward and Youcaring.com are crowd funding websites that help you raise money to help take care of your pets Harley’s Hope Foundation is an organization that ensures low income pet parents and their companion or service animals remain together when issues arise. Many breed rescues and groups have specials funds available for owners who need financial assistance, such as the Special Needs Dobermans, Labrador Lifeline, and Pitbull Rescue Central. Banfield Pet Hospital has its own programs for owners that can’t afford their pet’s care. God's Creatures Ministry helps pay for veterinarian bills for those who need help. IMOM is dedicated to insure that no companion animal has to be euthanized simply because their caretaker is financially challenged. The Onyx & Breezy Foundation has many programs including helping people with medical bills. They are a good resource for information. Brown Dog Foundation provides funding to families with a sick pet that would likely respond to treatment, but due to circumstances, there is not enough money immediately available to pay. Some groups help with specific disease, such as Canine Cancer Awareness, The Magic Bullet Fund, Helping Harley Fund, and Muffin Diabetes Fund. The Pet Fund and Redrover.org are great sources for help to care for your pet. The Humane Society website has many links to other organizations that help with veterinary expenses.

Poor Hera! It is possible that her lethargy and vomiting are indicative of a persistent infection, but could also indicate a new gastrointestinal illness (virus, stomach upset from eating something abnormal, etc.). If she is actually vomiting bile, this is coming from her stomach and is not fluid in her lungs. Since this is her third course of antibiotics for the same bout of pneumonia, I recommend calling your vet today to address these new concerns.