Liver problems in 12 yr old lab (long sorry)

[atlantis]

We have a beautiful black lab who we took on as a 3 yr old. He is now 12 and has been the perfect dog.

But if history. He was 48 (yes 48) kg when we got him. It took about a year to get him down to a healthy 30kg. He is a tall lab and vet was always happy with that. Been on serequin since we got him as he moved terribly behind especially with his right hind do wewete expecting bad joints. His hips and stifles have been getting worse this last year (although still bounding around quite a bit) and we started him on a non-steroidal anti-inflammatory called Onsior 5 weeks ago. It worked really well and we had our bouncy dog back.

Last Tuesday he started to become unwell. Threw up his dinner. Then gradually deteriorated and went off his food. Stopped onsior on Wednesday. Still not right Thursday so rang the vet and went to vets Friday. Possible abdominal problems. Started on antibiotics, anti sickness and antacid.

Further deterioration Saturday, still not eating and then passed yellow stool and started drooling and shaking, back to vets urine and bloods show liver damage. Kidneys good. Everything else good.

So started on Denamarin (active ingredient from milk thistle is in this, plus other bits) steroids, another liver med that helps with bile flow and amoxicillin.

Then stopped drinking Sunday morning. I started syringing fluids and then after talking to the vet watery food too. Still peeing quite a bit so vet was happy.

Took him back to vet Monday morning. Steroids dose higher and more antisickness meds and different antibiotic. Continue with liver meds.

He started drinking again last night. He is still drinking loads. He has shown little interest in food but has eaten a few mouthfuls of food out of my hand. I am still syringing rehydration fluid wizzed up with some food a few times a day.

Has anyone had experience of liver disease that their dog has recovered from. I am quite prepared to camp out by his side and make sure he gets nutrition until his liver picks up and his appetite returns. He is more himself today, more attitude and a bit more active, but still far from normal.

However I'd like opinions on whether this is futile. I don't think he is suffering. He is currently settled sleeping by my side and dreaming as he normally does. He is happy for me to syringe the food and has never put up a fight at all, although he lets me do anything to him that doesn't involve his feet. He was playful with his toy today and doesn't have the vacant look he had on Sunday.

Just wanting knowledgable opinions on how quickly we should expect an improvement. Vet is supportive but realistic lady. We are going together (hubby hasn't been with me yet) to see her in the morning. My general feeling is he is improving, but very very slowly. His pee is still pretty dark and his eye balls are still yellowish, but maybe not quite so much (or maybe I'm clutching at straws).

Thanks in anticipation.

Jx

 

[Umbongo]

Liver problems can be caused by various things, such as infection, disease, tumours, drug use, diet etc etc. So without finding out exactly what is causing it, it's hard to say I am afraid. This would require further diagnostics such as further blood tests, ultrasound/x-ray, biopsy etc.

Good luck with your boy, I hope he will be ok xx

 

[atlantis]

Liver problems can be caused by various things, such as infection, disease, tumours, drug use, diet etc etc. So without finding out exactly what is causing it, it's hard to say I am afraid. This would require further diagnostics such as further blood tests, ultrasound/x-ray, biopsy etc.

Good luck with your boy, I hope he will be ok xx

Thank you. We've ruled out biopsy too much for him at his age. Vet mentioned ultrasound and I think we should give it a go. Hubby in particular needs to know the cause. I do too to make decisions I think.

The denemarin is supposed to protect against neuro damage and he is definitely less confused. For eg he comes to me to ask to go out where as on Sunday he was staggering to the door and staring vaguely at the wall. Also he wasn't strong enough to hold himself up when weeing but now he is squatting properly. Info on it says to look for improvements in appetite, attitude and activity. We've seen a definite improvement in the latter two.

I take your point entirely thank you.

 

[sheep]

I am terribly sorry that your beloved old boy is unwell. Sadly my 13 year old Labrador exhibited more or less identical symptoms back in March this year and while we had a few "pick up" moments, his condition deteriorated and we made the heart breaking decision to let him go. He was always a real foodie and he just lost interest in everything. From the beginning of his illness to saying goodbye was around 3 weeks in total. Like your boy, he was absolutely perfect and never put a foot wrong. Even typing this is making me well up.
I truly hope your boy improves but be prepared that he may not recover from this. Sending you lots of positive thoughts and well wishes to your dog.xx

ETA I hope you don't think my post was insensitive, I know just how awful it is to be confronted with illness in a much-loved member of the family.

 

[Umbongo]

Thank you. We've ruled out biopsy too much for him at his age. Vet mentioned ultrasound and I think we should give it a go. Hubby in particular needs to know the cause. I do too to make decisions I think.

The denemarin is supposed to protect against neuro damage and he is definitely less confused. For eg he comes to me to ask to go out where as on Sunday he was staggering to the door and staring vaguely at the wall. Also he wasn't strong enough to hold himself up when weeing but now he is squatting properly. Info on it says to look for improvements in appetite, attitude and activity. We've seen a definite improvement in the latter two.

I take your point entirely thank you.

No worries. I work in a veterinary practice and we sometimes see liver issues....but without the go ahead for further diagnostics we can only treat symptomatically and hope for improvements. If biopsy is not an option, ultrasound may be a good next step, however you may still not get an answer. If you can get him on to a veterinary specific hepatic diet (royal canin, hills, specific) that may also help. But as Sheep says, there is always the possibility that something is causing this that he may not overcome, however the liver is an amazing organ and can regenerate depending on the cause.......I do hope he gets better! The fact you are seeing some improvements already is hopefully a good sign.

 

[atlantis]

Thank you for your reply Sheep. I'm so sorry about your dog. It hurts so much to see them poorly. I am prepared to loose him and have psyched myself up 3 times now for it. My gut says that we will loose him if I'm totally honest. However there is a part of me that doesn't want to stop yet. If he's making improvements, however small, then I can't pts yet.

He doesn't seem to be suffering, in pain or unable to settle (he was Saturday night) he's just not himself now. However I won't leave him not eating for too much longer. It's not fair on him or me. He lets me syringe the food in but then he lets me do anything. He's so good.

Thank you for your reply. It helps it certainly does. Even if it's just that 3 weeks is s decent length of time to try. 1 week since start of symptoms so far. We've been treating for 4 days now.

Sending lots of love.

 

[SusieT]

If he is in liver failure you either need to treat conservatively and expect a poor outcome at this stage, or get referred to a more advanced vet to see if there are any more options.

 

[atlantis]

No worries. I work in a veterinary practice and we sometimes see liver issues....but without the go ahead for further diagnostics we can only treat symptomatically and hope for improvements. If biopsy is not an option, ultrasound may be a good next step, however you may still not get an answer. If you can get him on to a veterinary specific hepatic diet (royal canin, hills, specific) that may also help. But as Sheep says, there is always the possibility that something is causing this that he may not overcome, however the liver is an amazing organ and can regenerate depending on the cause.......I do hope he gets better! The fact you are seeing some improvements already is hopefully a good sign.

Thanks for your reply. I think US will be a good thing to try. I'm a physio so very comfortable treating symptomatically and seeing how people (or my dog) respond to that. I am hopeful that he will continue to make improvements. This time yesterday he wasn't drinking, today he is weeing and drinking at least every hour. Flushing the system through hopefully.

You say seeing improvements already... is that a decent time scale then. He's had 4 days of the liver meds... I don't know if we need to wait a week or if he should be charging around by now...

 

[atlantis]

If he is in liver failure you either need to treat conservatively and expect a poor outcome at this stage, or get referred to a more advanced vet to see if there are any more options.

Well he has some jaundice but it may be slightly better, (might be clutching at straws with that one) but seen a difinite improvement in his confusion and activity levels. He is more steady, less erratic in his gait, able to turn quickly better and ran to the door earlier today. He doesn't have any ascities (sp) and his liver isn't enlarged that our vet could tell.

Would the referral be to a specialist centre? Do you know of one in the midlands? We are with a senior vet at the practice.

Thank you for your reply. I am being realistic in my expectations, or I think I am if I'm honest I don't know what to expect.

 

[sheep]

Thank you for your reply Sheep. I'm so sorry about your dog. It hurts so much to see them poorly. I am prepared to loose him and have psyched myself up 3 times now for it. My gut says that we will loose him if I'm totally honest. However there is a part of me that doesn't want to stop yet. If he's making improvements, however small, then I can't pts yet.

He doesn't seem to be suffering, in pain or unable to settle (he was Saturday night) he's just not himself now. However I won't leave him not eating for too much longer. It's not fair on him or me. He lets me syringe the food in but then he lets me do anything. He's so good.

Thank you for your reply. It helps it certainly does. Even if it's just that 3 weeks is s decent length of time to try. 1 week since start of symptoms so far. We've been treating for 4 days now.

Sending lots of love.

We did the same, we tried to treat the symptoms but sadly it wasn't to be for our boy. It was just his time, if we hadn't PTS then I think he would have been gone within the next 48hrs or so anyway. He was still in control of his faculties to an extent but he was refusing all food and barely drinking, he had just had enough.
But I sincerely hope your boy rallies round and has some more happy time left with you. I feel so grateful for the time we had with our boy. Back in April 2016 he had a bit of a health scare and then we thought it was almost his time. Fortunately he recovered and gave us almost another year before he went. The first week of him being unwell, he was still reasonably bright but lost his appetite significantly and was vomiting intermittently. Week 2, he improved a bit due to treating of symptoms but he went downhill again in the 3rd week and despite our best efforts, just wasn't interested in life anymore. At that point we knew it was time and so said goodbye to our darling old boy. Still haven't managed to move all his toys from his little corner under the stairs! I miss him every single day and after 13 years, sometimes still forget he's gone.

But back to you. Best of luck to your and your boy. I really, really hope you see some improvement soon. x

 

[Umbongo]

You say seeing improvements already... is that a decent time scale then. He's had 4 days of the liver meds... I don't know if we need to wait a week or if he should be charging around by now...

Again, depends on the cause. I have seen patients who are being treated symptomatically without a known diagnosis....some do well and improve, some show no improvement and continue to deteriorate, and some may rally for a bit after a few days on medication, but then go downhill again. Sorry I can't be of more help.

 

[atlantis]

Again, depends on the cause. I have seen patients who are being treated symptomatically without a known diagnosis....some do well and improve, some show no improvement and continue to deteriorate, and some may rally for a bit after a few days on medication, but then go downhill again. Sorry I can't be of more help.

It is helpful to hear. Thank you 😊

 

[SusieT]

Yes probably - I don't know of one but I'd ask your vet who they would refer this to - I'd also consider a second opinion before I gave up. Have fluids been offered?

 

[Boulty]

I would say whilstever he's improving and is still for the most part happy with life then it's worth carrying on for the moment. Definitely worth discussing an ultrasound scan with the vet if they're offering that as an option. It may not give you an absolute diagnosis / cause but may be able to give you an idea of how damaged his liver appears to be and aside from having to give him a dodgy haircut is non-invasive and if he's a good boy generally then they may not need to sedate him for it either. Can totally understand you not wanting to go for biopsies under anaesthetic if it's unlikely to change what you do / if you're wanting to avoid anything invasive although depending on what they find if they did scan him they may be able to take aspirates with a needle (not always diagnostic or appropriate but sometimes an option). Other options may be a stay at the vets for a few days on fluids to give him a bit of extra support (there are also things like feeding tubes that can be useful in the short - medium term for dogs that aren't eating but the vibe I get from your post is that this isn't the road you're really looking to go down and it may not be deemed appropriate for him anyway). You could also ask for referral to an internal medicine specialist if you wanted all the options as to investigations but if your main aim is to manage him conservatively for as long as you can with minimal disruption to his daily life then doing as you are doing and following the advice of your normal vet who you trust and get on with is a perfectly fine and valid option also. I guess his increasing stiffness and how to manage that alongside his liver also has to be a consideration.

 

[sheep]

OP how is he now? Hope you've seen an improvement. X

 

[atlantis]

OP how is he now? Hope you've seen an improvement. X

Hi Sheep.

Just coming on here to update actually. He is much much better.

He is playing and interacting with us very much close to his normal. He still doesn't have much of an appetite, for him anyway, but has eaten the most he has had so far tonight. His jaundice appears better, difficult to tell on an all black lab with black lips but his eye bells are definitely better. Urinating less and it's not a horrible dark colour now still more than normal for him.

I'm pleased with how he is getting on, every day he makes slight improvements. He is now only on Denemarin, Destolit and amoxicillin. He has finished his course of steroids and metronidazole. Fingers crossed he continues to improve.

 

[sheep]

So pleased to hear that, long may the improvement continue!