Howdy - sweet Peeves has passed

[peeves]

I got here looking for info on my 'rescue' dog with elevated liver enzymes. Simple diagnosis is 'disease'.



I got here ( I suspect like most),looking for info on liver disease since our rescue dog has elevated enzyme on test and ultra sound.

He acts and behaves perfectly normal, but, with test finding Vet has indicated a diseased liver. So far with the initial 'emergency' visit and tests and subsequent ultra sound, repeated enzyme tests, a spell on vet prescribe Zenotil, we are no further along since Dec. 0f 2012.

Dog still behaves completely normal, yet ...
Benji
2o+ pounds
probably 7 years.
Mostly Maltese.

Latest enzyme. (if I'm reading them correctly, not a mavin by any means)* high per vet interpretation.

GLU .......8.07 mmol/L * high
TP ...... 84 g/l *
ALB ....... 41 g/l*
ALT ........ 128 /l*
ALKP .......1057 U/L *
GGT .........3211U/L
TBIL .............32
CHOL..........11.80 mmol/L


May ultra sound (truncated for brevity)
Urine creat/cortisol ratio was M1 above normal dog 'asymtomatic'
"rounded hepatic margins present presumed right side of liver."
"liver is mildly hyperecoic and finely echotextured."
"mild to moderate heterogeneity oif the parenchyma is also present"

lobes ...normal

"conclusion:"

mild to moderate diffuse hepatic changes consistent with steroid or other vacuolar hepatopathy, regenerative change, hepatitis , or infilitratrive neoplasia .

Small splenic nodules consistent with lymphoid hyperplasia, extramedullary hematopoiesis , or , neoplasia

Say what?

Vet would like biopsy of liver and maybe a life on SAM-e, .milk thistle...also came up.

Looking up suggests 90 mg capsule 2 x day.

I'm thinking he may have a fatty liver since he's over weight.

Looking at suppliers of food supplement (S-Adenosylmethionine), several supplier. If my vet is on board for putting him on it for life, there must be something

Any advice or opinion is welcome.

[mytil]

Hi and welcome to our site.

I have a second, but wanted to confirm that your little guy has just been diagnosed with Cushing's, right?

Let us know the results of the tests performed to come to this diagnosis. (LDDS, ACTH?). I see an ultrasound was done to check on the liver, were the adrenal glands checked as well?

From the panel I see you indicated the glucose is high. I do not have any direct experience with this but I know the normal blood glucose in a dog is between 80 and 120 mg/dl and your's is approximately 145 mg/dl. (conversion math = 8.07 * 18 = 145 mg/dl).


ALT ........ 128 /l*
ALKP .......1057 U/L * These are associated with the liver and function and the notes indicate some liver problems to put it in layman's terms.

Is your pup on any medication right now (other than what you mentioned)?

Is the 90 mgs you mentioned referring to the liver support meds (SA-me)? or is this Cushing's medications?

Sorry for all the questions, but the more we know the better we can offer advice.

Terry

[peeves]

Hi and welcome to our site.

I have a second, but wanted to confirm that your little guy has just been diagnosed with Cushing's, right?
Thanks mytil,
No definitive diagnosis to date, "cushings not ruled out" per vet.
So far simply high enzymes found after a stomach problem..emergency x ray and enzyme tests.
Some liver surface indicators? Then follow up with family vet, more tests, and now lastly in May, the ultra sound.
Let us know the results of the tests performed to come to this diagnosis. (LDDS, ACTH?).
Neither LDDS nor ACTH are referenced on the (three ) enzyme tests. ?? Could they be assigned other lettering/code??
Just those are marked high in my post.
I see an ultrasound was done to check on the liver, were the adrenal glands checked as well? Yes nothing abnormal in adrenal glands

From the panel I see you indicated the glucose is high. I do not have any direct experience with this but I know the normal blood glucose in a dog is between 80 and 120 mg/dl and your's is approximately 145 mg/dl. (conversion math = 8.07 * 18 = 145 mg/dl).

These are associated with the liver and function and the notes indicate some liver problems to put it in layman's terms.

Is your pup on any medication right now (other than what you mentioned)? Not on any meds or supplements at this time, was briefly put on Zenotil by vet.

Is the 90 mgs you mentioned referring to the liver support meds (SA-me)? or is this Cushing's medications?
the '90' was the prescribed amount of Zenotil..by vet but it was only for a couple of months. No longer.Was on antibiotics for two months or more. not now.Vet suggested we may go the SAMe -Denosyl route We haven't yet, are others using that supplement touted for liver problems is my question ?? Vet thinks it might help.

Sorry for all the questions, but the more we know the better we can offer advice.

Terry

Actually no definitive cause for the elevated enzymes has been assigned, just liver disease.

Not on ANY meds. currently. Was on Zenotil briefly (couple months)

NOT to further confuse, but those indicated as within normal range are:

UREA
CREA
PHOS
CA
GLOB
AMYL
LIPA
Na
K
CI.

Report from may 24th Ultra sound which I summarized, indicates "Hepatic aspirates or biopsy may be helpful."

Since dog is asymptomatic, we are hesitant to have a biopsy and are considering the supplement route suggested by the vet.


Thankfully, our Maltese both play and act physically healthy.
NO symptoms.That one dog, Benji, has liver disease indicated through enzyme elevations is verrrry concerning since we have no definitive diagnosis, no meds prescribed and know nothing about the effectiveness, if any, of Denosyl, SAMe, milk thistle or Zenotil.

We will gladly get the supplements if any here can vouch for the use, or, advise against.

[mytil]

Thanks for answering the questions.

Here is a link from our Resources section about SAMe (S-Adenosyl) etc - http://www.k9cushings.com/forum/showthread.php?t=192 (sorry to repeat if you have read through this already.)

Many here use this to great success.
Terry

[Budsters Mom]

Hello and welcome to you and Benji:)
I am sorry for the reason that brought you here, but so glad you found us.You have come to the right place! There are many K9Cushing's angels standing by to help and stay with you every step of the way. They love details, test results, any information you can get your hands on. The more the better. We will do all we can to help. It look like you are already off to a good start. Others will be popping in to welcome you also. So again welcome to you and Benji

Hugs,
Kathy

[molly muffin]

Hello and welcome from me too.
I was wondering if you could post the normal range, next to the value on the test results that are high.
I'm using a hepato support supplement which has the milk thistle, sam-e included in it. Many here use it or have used it.
Do you have a copy of the ultrasound report and does it mention the adrenals?
I'm also very curious about thyroid, T4 on test, and the high glucose result usually means that you want to check further into diabetes.
The GGT is high enough that I wonder if this is the reason they put Benji on antibiotics, thinking there could be an infection somewhere, was this mentioned?
As long as there is any possibility of anything else wrong, cushings testing would not be reliable. So these other possibles need to be ruled out first.
Again welcome to the forum
Sharlene and Molly Muffin

[peeves]

Thanks for answering the questions.

Here is a link from our Resources section about SAMe (S-Adenosyl) etc - http://www.k9cushings.com/forum/showthread.php?t=192 (sorry to repeat if you have read through this already.)

Many here use this to great success.
Terry

Thanks I did read it. The supplements all indicate they are effective, but I'm asking, Has anyone here ever used a supplement and later found the high enzyme liver tests show an improvement?

Any objective findings that can be ascribed to the supplement???

We are on a small pension and willingly take any reasonable route to keep our dogs healthy. (so far about $ 2,000 on Beji treatments tests ultra sound meds, etc. over the last year.)

We are inclined , with hope of improvement, to buy the supplements as Denosyl etc. but has anyone had any proven success?

[peeves]

Hello and welcome from me too.
I was wondering if you could post the normal range, next to the value on the test results that are high.
I'm using a hepato support supplement which has the milk thistle, sam-e included in it. Many here use it or have used it.


Do you have a copy of the ultrasound report and does it mention the adrenals?

I'm also very curious about thyroid, T4 on test, and the high glucose result usually means that you want to check further into diabetes.

The GGT is high enough that I wonder if this is the reason they put Benji on antibiotics, thinking there could be an infection somewhere, was this mentioned?

As long as there is any possibility of anything else wrong, cushings testing would not be reliable. So these other possibles need to be ruled out first.
Again welcome to the forum
Sharlene and Molly Muffin


Thanks.
Yes, but have there been improvements on any high enzymes? Using is one thing, objective findings after using are another ball of wax. I want to use supplements, but I wonder IF they've been proven to work by any here?

All organs (adrenal, gall bladder, kidneys, normal, liver surface finely echo textured, and right portion of liver slightly 'rounded."

check further into diabetes.
Good advice thanks.


Was on anti-biotics, no improvement in test.

[molly muffin]

Some of the others who have used it can tell you if they saw liver enzymes come down or not on the supplement. I'll be able to tell you if it goes down for me or not when we have the next blood test done. Probably within this month. We've been on it since, hmm. last last summer. I saw a bit of a decrease in December blood work and we'll know more with this next one. I'm not overly worried about the ALP coming down as Molly's started to go up when she first got crystals which was many years ago and since that is always an ongoing issue with us, I doubt it will come down. I would like to see the ALT come down a bit though for us. So we'll see. Our GGT is within normal range so far, but that again is something liver related. Any steroid use would also cause that to go up.

Not sure if that helps you or not, but I have always read that any kind of liver support is a good thing, as even if the values don't go "down" they may not continue to go up on it either. Cushings dogs almost always end up using liver supplements.

hugs,
Sharlene and Molly Muffin

[peeves]

Some of the others who have used it can tell you if they saw liver enzymes come down or not on the supplement. I'll be able to tell you if it goes down for me or not when we have the next blood test done. Probably within this month. We've been on it since, hmm. last last summer. I saw a bit of a decrease in December blood work and we'll know more with this next one. I'm not overly worried about the ALP coming down as Molly's started to go up when she first got crystals which was many years ago and since that is always an ongoing issue with us, I doubt it will come down. I would like to see the ALT come down a bit though for us. So we'll see. Our GGT is within normal range so far, but that again is something liver related. Any steroid use would also cause that to go up.


again thank y'all.

I have ordered a supplement Denosyl since my vet mentioned that one and milk thistle. Hope for positive results and not just a waste and false encouragement. On the other hand, unless we get a definitive diagnosis/prognosis, not many alternatives.


Not sure if that helps you or not, but I have always read that any kind of liver support is a good thing, as even if the values don't go "down" they may not continue to go up on it either. Cushings dogs almost always end up using liver supplements.

hugs,
Sharlene and Molly Muffin

backatcha, thanks. If you get encouraging results I'll be happy to hear about same.

[]D eeves
I called a supplement vitamin/supplment store for humans and checked a few others. They bad mouthed SAMe as having been discontinued, as too many complaints and returns.

[frijole]

I used milk thistle on my Haley when her alk phos went up to 1800+ - I had no idea if it would work or not. The next time we went in for a blood panel it was down to 800. This is fantastic. A cush dog's alk phos will remain elevated so just getting it to that point to me was a win so I continued to use it.

I didn't purchase anything expensive - just capsules from the local drug store, Walmart, wherever it was on sale. She weighed 17 lbs and I split a capsule and put 1/2 on the food in the am and the other 1/2 at night on her food. She didn't notice it and loved her food so it was painless and easy. Kim

[Roxee's Dad]

Our Roxee was on Milk thistle and Trilo ... her ALKP came down to within the high normal range. after being in the 1800 range. :)

[peeves]

Our Roxee was on Milk thistle and Trilo ... her ALKP came down to within the high normal range. after being in the 1800 range. :)

Good to know. I went with Denosyl for now. Want to see how that works then might add milk thistle if indicated. Here's hoping for lowered enzymes on next test.

If I use both I won't know which is effective.

[]D eeves

[molly muffin]

Hi again. I told you that I'd let you know what Molly's test showed after her next blood test, which she had on Saturday. I just have the preliminary until I get the results copy from the vet tomorrow, but basically it shows that the ALKP came down around 300 units, the ALT is up about 7 units, but the vet said that is pretty good. The Albumin is back to normal range and everything else seems to be in normal range. The vet and myself, both think that the Hepato Support supplement she has been on has helped. I started her on it, on 08/20/2012.
Hope that is of some help to you.

Sharlene and Molly Muffin

[peeves]

Kenny:
I can't tell you how glad I am to see you are posting again. I thought something had gone terribly wrong and we were all worried about you and sweet Gracie. Glad to hear the mucocele is smaller and she is doing well. Boy that was some break you took, scared me to death!!! Blessings
Patti

Hi, been away a while.

I was here for advice about our 6 year old Maltese Benji (rescue dog) a while back
Liver conditions.
Have him now 4 months on Denosyl, will have a test done soon hoping improvement.


BUT
Sadly we lost the battle with Peeves 8 year old Maltese who had heart problem. He died in July. I've been too upset to do much.

Here's the thing though. Our vet thought to relieve some heart strain a
A prescription would help. Vetmedin was prescribed, @ 2 x a day. I'm cautious, so I first tried 1 x a day. On the second day he went into a seizure and recovered in minutes but a few hours later the second seizure killed him. Of course there is no proof the drug caused the seizure, but I looked it up sadly maybe too late. Here's the caution I found.



What are the possible side effects of Vetmedin: If any of the following serious side effects occur, stop giving Vetmedin and seek emergency veterinary medical attention; an allergic reaction (difficulty breathing; swelling of the lips, tongue or face; hives), scratching, sudden onset of diarrhea, vomiting, shock, seizures, pale gums, coma. Continue giving Vetmedin and contact your veterinarian if your pet develops; poor appetite, drowsiness, diarrhea, labored breathing, weakness, incoordination, fainting, accumulation of fluid in the lungs or abdomen, and cough. Other side effects may also occur. Talk to your veterinarian about any side effect that seems unusual or bothersome to the pet.


Now I'm passing it on FYI. Consider b4 administering.
Now I must add he did have a seizure from Epilepsy a year or so before that which complicates defining cause of his death.
However it's more than a coincidence I think though I'm not blaming the vet. Wish I had looked it up before giving it to him.

[molly muffin]

Oh I am so sorry to hear that you lost your precious Peeves. :(
I know it is suspicious for that side affect to be one of seizures and then for a seizure to do him in.

It is a good reminder for all of us of two things, 1) every drug will affect every dog differently and anything Can happen and 2) always look up medicine before administering it.

We'll never know if this was the cause of what happened to Peeves or just a very bad coincidence, but it never hurts to have a reminder of possibilities.

I hope that Benji's numbers are good at the next test and that the liver values have come down some. Remember it took us almost a year to get Molly's to come down on the liver support supplement.

My sincerest condolences to you and your family on the lost of precious Peeves.

Sharlene and Molly Muffin

[Budsters Mom]

My deepest condolences for the loss of Peeves. I know that your heart is broken and only time will help to mend that. I know this because I lost my Buddy in July also. Sending you tons of love and many warm hugs.

[peeves]

Thx. all. Peeves was attached to me and followed everywhere, whined if he couldn't see me. Obviously as we all do, it leaves a hole when one passes. The thought of losing (possibly) Benji with liver problem is horrible.
We hope next test is showing improvement with supplement.

The Vet has contacted the drug manufacturer passing on the anecdotal evidence. I think that was professional of him.I hope he passes info to other vets as well.

[Squirt's Mom]

I am so sorry to hear about your sweet Peeves. It's awful when the very meds we count on to help harm instead. My Squirt had a very bad reaction to Proin, resulting in a seizure and she has not been the same since. I know only too well how you feel.

Your sweet Peeves has been added to the In Loving Memory thread for 2013. For now, he is simply listed as passing in July with no date given. If you would let us know the date, I will be glad to correct that for you. We would also like to include a photo of Peeves in the In Loving Memory album for 2013 so if you would send a copy of your favorite photo to k9cushings@gmail.com we will upload it for you.

Please know we are here to listen any time.
Our deepest sympathies,
Leslie, Squirt, Trinket, Brick, Sophie and our Angels, Ruby, Crystal, Tasha, and Josie


I Haven't Left At All

I saw you gently weeping as you looked through photographs
You paused for just a moment at one that made you laugh;
But as you turned more pages the tears began to flow
You whispered that you missed me but I want you to know;
I softly licked those stinging tears that down your cheeks did fall
I want to help you understand I haven’t left at all.

On those days that you are overcome with sorrow, pain and grief
I rest my head upon your leg to offer some relief.
When you take our walking path I’ve seen you turn around
Because I know you surely heard my paws upon the ground.

At night while you are sleeping I snuggle at your side
You stroke my fur as you touch that place where I used to lie.
You said it’s just your heart playing tricks upon your mind
But rest assured I’m really there, my spirit’s left behind.

I know your heart is hurting; it’s like an open sore
You think my life has ended and you won’t see me anymore.
But for those of us bound tight by love, death is not the curtain call;
It’s really the eternal beginning that waits for us all.

So, dear Master, as you live your life I patiently await
For us to be together when you pass through Heaven’s gate

[goldengirl88]

Sorry to hear you baby has passed, may God watch over you at this time. Blessings
Patti

[peeves]

Peeves,aka Peevie died July 6th/2013 .

I keep his favorite toy next to where I sit evenings.

I wrote this.


Dog-gedly Cat-erwauling




A pet is the rubbing at your knees
A floating hair that makes you sneeze.
Licking tongue, liquid eyes .....
'say'..... pleeeease ?
‘Mistakes’ and surprises and ...
sometimes fleas .
A clawed up chair, a gnawed on shoe
A chewed up sweater, litter box..
.. Oh pee yew!
A lump of fur invades the bed,
A purring thing beside your head.
Constantly wanting out or in
Woofing or mewing-a raucous din
Pleading and whining for a walk
or,
Patiently waiting a bird to stalk
“Not that again” she seems to say
Though gobbled down the other day.
What a job that dreaded bathing
and,
then he rolls in something rotting
Hair balls gagged on carpet floors
Scent glands used on exit doors
But then........
Years by 7’s pass so quickly
Beloved pets become old and sickly
Sad consultation with the ‘Vet’
Consider though the suffering pet

........Ah geeze..... the ache, tears flood the eyes
......Alas our heart breaks...
..........and In part too .....dies.

[Squirt's Mom]

Nice poem! I wanted to let you know the date was corrected.

http://www.k9cushings.com/forum/showthread.php?t=4794

[molly muffin]

Love the poem. Peeves was so very cute. I'm so sorry he is gone. :( They just break your heart when their time is so short with us. It is the love though that lives on forever in your heart.

Sharlene and Molly Muffin

[scoora]

I'm sorry to hear about your loss of your sweet Peeves.
My thoughts and prayers are with you.

[doxiesrock912]

My sincere condolences for your loss of Peeves. Your poem is wonderful!

[Little Britches]

So sorry for your loss, they leave such a void behind. Take care. x

Run free at the beautiful bridge sweet boy, playing in fields of gold forever. xx

[peeves]

Thanks again all. It 's some consolation that Benji is still at our side. If we hadn't had him we'd have suffered the loss even more. His days and nights have been affected by losing his buddy as you may well imagine.
He still looks behind him after exiting the 'doggy door'. He was always first with Peevie shortly behind him. Benji seldom goes out now.

Hope the Denosyl Benji's on brings down the liver readings.

My best to all here and the pets health.

[peeves]

backatcha, thanks. If you get encouraging results I'll be happy to hear about same.

[]D eeves
I called a supplement vitamin/supplment store for humans and checked a few others. They bad mouthed SAMe as having been discontinued, as too many complaints and returns.

6 months now on Denosyl
No improvement in enzymes from test 6 months ago.
ALP 1,352 up from 1,095
ALT 126 essentially the same.

Benji still active with no indication of any problem.

Vet advises continue supplement Denosyl

We were hoping for at least some improvement.:(

[molly muffin]

It took me a long time to see any difference. How is his blood work? Anything else abnormal besides the ALT and ALP?

hugs,
Sharlene and Molly Muffin

[doxiesrock912]

My sincere condolences on the loss of your Peeves!

[goldengirl88]

I am so sorry to hear about the loss of your Peeves. I will say a prayer for you and your sweet baby in heaven. Blessings
Patti

[peeves]

Everything else is fine. I guess we just continue as we are for another 6 months and test again.
I've read where it was a year before the supplement showed any enzyme improvement.

Ron



It took me a long time to see any difference. How is his blood work? Anything else abnormal besides the ALT and ALP?

hugs,
Sharlene and Molly Muffin

[gatorgirl_bama]

So sorry to hear about Peeves. I lost my Tia is August and it's a heartache like no other.
In 2010 Tia was diagnosed with Auto Immune Hemolytic Anemia. A long with her other meds, the vet started her on Denosyl 90mg. and she did good until she got sick in April of this year with Cushings. I'm not sure what her reason was, but she refused to take the Denosyl after that. I would put it in peanut butter or cheese, but she would spit it out. Funny little girl...
Anyway, I hope Benji does well on it. I'll keep y'all in my prayers.

Donna and Angel Tia