Liver Disease (AutoImmune)

[Millie82]

In January my pony had raised GGT flagged on a blood test, most horses on the livery yard were getting tested as a few had raised GGT. I didn't think much of it but wanted to check she was ok. Unfortunately she had GGT of 250, I immediately started her on Milk Thistle and Vit B as per the vets advice and a week later I had full bloods run. Her GGT had dropped to 224 in a week but worryingly she had Bile acids of 30. She had a liver biopsy done a couple of weeks later as I suffer from anxiety and was concerned that I didn't know the cause. It came back showing portal areas generally expanded by fibrous tissue and some portal-portal bridging. She had moderate lympoplasmatic inflammation so was diagnosed with lympoplasmatic portal hepatitis, my understanding is this is also known as chronic persistent hepatitis and Autoimmune hepatitis. Information on this condition in horses seems almost non-existent and so anyone who has experience of this condition I would love to hear from. The vet prescribed a 10 day course of steroids 125mg a day (she is 445kg so a low dose), bloods were re done 10 days after the steroid course finished and approx 5 weeks from the full blood test. Her bile acids dropped from 30 to 12 but I am concerned that her GGT has increased 343 from 224, AST increased 495 from 409, ALKP increased 403 from 296, LHD increased 1,119 from 763. The vet says the steroids would have caused the increase. I can see the logic behind that, a drug would cause the liver to be under stress, but I thought the steroids were supposed to shut down the auto immune response and improve her results. Has anyone else had increased Liver enzymes after steroid treatment? The vet has advised to continue Vit B and Milk Thistle and retest in 6-8weeks. I suffer from anxiety as previously mentioned and this doesn't sit right with me. I hate the whole wait and see approach as she seems to not be getting better. Any advice?

 

[millmo]

Hi Millie82,
Don't know if this will be of any help but if nothing else it might help with your anxiety. At the age of 7 our little gypsy mare was finally diagnosed from a biopsy with Liver disease and severe Liver damage. She was on 5 different drugs a day and her GGT was through the roof. Like you we were worried sick and this diagnoses was after months and months of treatment that failed to work.
You might by now be thinking how is that helping you. Well with nothing really helping she went under a specialist, who immediately took her off all medication and told us to take her home stop worrying and enjoy her.
And that's what you need to take from this stop focusing on the illness and enjoy your pony. Worrying won't help you or your pony and when we chilled out and enjoyed Millie we found that she was better and more chilled out which in turn helped her liver.
That was 10 years ago and yes Millie is still with us and in very good health that people have trouble believing she is ill.