Is vecchiola degeneration serious for my senior Shih Tzu?

Hello and thank you for contacting Petco Pet Education Center, formerly Petcoach. Elevated liver enzymes and abnormal liver appearance on ultrasound scan does not necessary mean liver tumour or liver failure. Older dogs often have abnormal liver appearance, which is not related to any serious underlying problem. Liver enzymes level is a measure of 'damage' to liver cells but it is not directly related to prognosis. Again, older dogs often have mild elevation of liver enzymes I would think that the specialist will perform full abdominal scan and possibly take liver samples through a needle - this is commonly performed procedure in dogs with signs of liver disease. Based on the findings of the aspirate, the doctor will recommend further testing or prescribe treatment for Mars.

I hate to hear this is happening. I recommend to have a frank discussion with your veterinarian about what they suspect is happening. Coco may need more diagnostics to determine the cause. Here is a link about Hepatic encephalopathy including the causes: https://www.merckvetmanual.com/digestive-system/hepatic-disease-in-small-animals/hepatic-encephalopathy-in-small-animals If this is due to a single large liver shunt, surgery may be an option. If this is not, medical management may help which includes a special diets, lactulose and medication life long. You may want to seek a second opinion as well if your vet does not seem up to date on current information. Thank you can make an informed decision. I hope this helps.

Hello. There are many underlying causes for high liver values, some more serious than others. The beauty of our livers is it is the only organ that can heal & regenerate once an insult is removed. I am not sure what your veterinarian hoped to accomplish keeping Lucy over night, but if she is otherwise feeling well, use of the Denamarin & prudent monitoring of the liver values is a good start. It would be helpful to obtain a bile acid assay & abdominal ultrasound to try & get as much information as possible about the liver, but the Denamarin can protect the liver from further oxidative injury. It will not help much if this is cancer, or an active hepatitis or infection, but it has helped to bring the enzyme levels down in some patients. Once you can obtain more detailed information about the liver can you determine how absolutely serious this might be. Stay in contact with your vet & try to follow their recommendations as closely as possible. Hopefully, Lucy will do very well. Thanks for using Petco Pet Education Center, formerly Petcoach.

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!

Hello, and thanks for your question on Petco Pet Education Center, formerly Petcoach. I would classify those liver elevations as mild to moderately elevated. Liver values can be quite fluctuant - those elevations are somewhat nonspecific and simply indicate that there is higher liver cell turnover than what would typically be normal. This can be due to anything inflammatory, infectious, cancerous, or otherwise disturbing to the liver. A blood test alone cannot usually say exactly why the liver values are elevated - to have more information, a liver function test such as bile acids could be run, or the liver could be evaluated via ultrasound to make sure it still has normal architectural appearance. If these results are 8 months old, then the best next step would simply be to repeat a liver panel of bloodwork, and see if those values have remained elevated. It's very possible they may have normalized by now; if they haven't, your vet can discuss the best next step with Bear's other history and exam findings. If the values are still elevated but you choose not to pursue further diagnostic testing, there are liver protective medications that your vet may recommend to help protect the liver from oxidative damage. Hope this helps!

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!

Poor Lucy! This could be a few different things. The most common things would be geriatric vestibular disease, an inner ear infection, a cerebral vascular accident (stroke), or a brain tumor. A lot of times it is geriatric vestibular disease which is a disorder they get when they get older that causes imbalance, but it improves with time. Unfortunately, they usually need supportive care to prevent dehydration. If she were mine, I would take her to your vet for an exam. Your vet may want to run some blood work to ensure her organs look okay and there is no toxins involved. Your vet will likely recommend supportive care and possibly antibiotics or steroids to cover all the possible problems. They may want to keep her there to watch her closely. I would give her a few days to see if she improves. I hope this helps!