My dog has liver damage and high blood sugar. What are my options?

Mild increases in liver values can be seen for a number of different reasons, and sometimes it can be very difficult to determine what the underlying cause might be. Infections like leptospirosis, migrating parasites, congenital diseases like a portosystemic shunt or some toxins can cause liver values to increase. It seems like Leo is on supportive medications for the liver - it would be helpful to know if his values are increasing or decreasing since trends are most important. An abdominal ultrasound might be the next step, or you could also ask about referral to a specialist if available in your area.

Hi there and thank you for using pet coach to address your concern. I am sorry to hear that Lio is suffering from liver and kidney disease at such a young age. The most helpful treatment Lio could receive right now would be IV fluids for hydration. This will also help diurese him to flush out any potential toxins from his blood. With his age I would be concerned that the cause is a toxicity from him eating something possibly. Denamarin is a good liver supplemw t and getting him to eat a critical care formula food such as Hills A/D is good. If an abdominal ultrasound has not yet been performed, I would consider having that done for more information. I hope this helps and that Lio improves soon. Please let me know if you have any other questions or concerns. I am also available via consultation if needed.

Hello. Without the bloodwork, I can not address her overall condition to say whether surgery is appropriate or not. I would highly recommend that x-rays of her lungs be done to see if there is any evidence that the mass on her liver has metastasized to her lungs. If this has happened, then I would not put her through surgery. An ultrasound of her abdomen would also be very useful in looking at the liver, gall bladder & kidneys, & would give much more information about what is going on. In the meantime, I would start her on insulin to try & regulate the elevated blood sugar. Talk to your vet to see what the next best steps for Layla are. Thanks for contacting Petco Pet Education Center, formerly Petcoach.

Hi, Oscar needs to be hospitalized and treated with IV fluids, antibiotics, and gastrointestinal protectants. Additionally, he should be tested for infectious diseases such as leptospirosis and ultrasounded to determine if he has any problems in his liver or kidneys.

It looks like he is suffering from some liver and kidney values elevations and he also is anemic. (Low red blood cells). Since I do not not his current condition and how long this has been going on, it is difficult for me to give you a survival time. If this has happened quickly and could be a toxin then with aggressive therapy (hospitalization and IV fluids), then these values could go back to normal and stay that way as long as there wasn't any permanent damage. If this has been chronic and his urine is very dilute then this could be permanent damage to the kidneys which is a much poorer prognosis long term. I would still recommend hospitalization and IV fluids if possible. I would talk to your vet about whether he needs fluids, antibiotics, appetite stimulants, anti-nausea medicine etc. I hope this helps and your sweet baby gets well really soon!

I assume when you say liver enzymes you mean ALT? There a few enzymes we look at and elevation in 1 value makes us consider different causes then elevation in another. ALT elevation is caused make liver cell injury and leakage of enzymes in to the bloodstream. As the liver sees all the blood of the body it can be quite a reactive organ. So the question is whether the liver enzyme is up because of something wrong with the liver/vessels to liver themselves (such as an infectious or inflammatory cause (hepatitis) or a shunt (more common in younger dogs)) or something the liver is responding too (toxicity, disease of over organs). Unfortunately all parts of sago palm are toxic to dogs with the seeds (nuts) being most toxic. And it can be quite challenging to know if this is the cause. If it is sago it depends on the degree of ingestion as to how severe the case is. Unfortunately the treatment for this is supportive as you have been doing. The values may continue to increase or hopefully may plateau off and remain mildly elevated or decrease again. Ultrasound will help to rule out other things going on in the abdomen, assess the liver for changes in texture (although a liver can appear normal on an ultrasound and not be functionally normal), and sometimes identify a portosystemic shunt. After the ultrasound then sampling either first by fine needle aspirate or with a biopsy (needed for many cases of hepatitis, some other issues) can be performed. Checking platelets and clotting times should be performed prior to liver sampling in patients whose livers are not normal to decrease the risk of bleeding from sampling. As shunts are more common in younger animals , if this is suspected, additional imaging may be recommended prior to sampling as ultrasound will not identify all shunts. There is also a disorder called microvascular dysplasia that can be found in the liver. This is best diagnosed by liver biopsy and the sample sent to a pathologist who specializes in liver pathology. I hope this has helped and not confused you more. It sounds like your vet has taken the appropriate steps thus far and has recommended the next best steps to try to rule out some other causes. Thank you for using Petco Pet Education Center, formerly Petcoach!

It is difficult to state exactly what would be the next step if I do not have the actual blood work but if the liver values are elevated I would agree with your veterinarian that an ultrasound is not a bad idea for Tiny. With the ultrasound they will be able to see if it is generalized enlargement and damage or if there are lesion that would be a good thing to biopsy. I would recommend having an internal specialist perform the ultrasound (and biopsy if they feel it is needed). I would not change Tiny's diet yet until they find out what is going on with Tiny's liver. Thank you for using Petco Pet Education Center, formerly Petcoach.