Killian/Liver Disease ?

[Sudilar]

Again, Killian has unusual symptoms and ailments that just don't fit with the text books. His eonsinophylic gingivitis is common in cats, not dogs and now this.....

Here goes...ask questions, if you have any...make corrections.....give advice if you have it....

The doctor (ultasound Dr. gives his opinion and diagnosis and recommendations) said that Killian's liver is very small. His veins were very dilated so if he would have done a biopsy, he could have hemorrhaged to death. He found high blood pressure in the liver, not all over his body, just in the liver.
Possible causes for this are:
1.Vascular shunt- when you eat, the toxins pass through the liver to be detoxified, his liver was being by-passed and the toxins are going into his blood stream throughout his body.
How do you get a shunt? Born with it. No, because shunts are usually in small dogs, with neurological problems, seizures, etc. symptoms that show up as a pup. Many times they die very young. Killian is large and used to weigh a lot and never had a seizure or any neurological problem.
Acquired shunts. Come on later in life. High blood pressure could cause a shunt and a shunt could cause high blood pressure. What came first and why?
An aquired shunt can be caused by cirrhosis of the liver (none) or tumor (none evident).

2.Vein disorder or clot

3.Scarring from chronic hepatitis from a low grade bacterial infection.

In Nov. of 2000, Killi's liver enzymes were still normal. In April of 2001, they were 220 (elevated), then came the crash you all know about.
He does not exhibit the signs of most of the problems listed. However, #3 may fit a bit if his gingivitis was caused by a bacterial infection (I'll have to ask the vet) or way back when we first got him, could the unknown infection that he had , could that have been bacterial and has it slowly been working on him since? Must ask that question.

The options:
1. Go to U of I for a technizium (sp?) enema (an enema with radioactive dye) and see if the dye goes to the liver or to the heart or wherever. All this test will tell you is that he has a shunt. It will not locate it, it will just tell you that there is one. He'd have to stay overnight until he's no longer radioactive!

2.The dreaded Exploratory Surgery with two specialists. This would be a mesenteric (sp??)venogram. They would inject dye and then xray where the shunt was and then the surgeon specialist would open his liver and tie it off. HOWEVER in MOST acquired shunt cases (if it is what he has and a big IF it is) there are multiple shunts and when you tie them off it can cause more damage, even possibly death.

3. Diet and medicine. Put him on a low protein, high fat and carbo diet and administer amoxicillin 5 days out of the month. Monitor him regularly and see how he keeps doing.

The u/s doc said that maybe the bad breath is caused by the ammonia toxins in the bloodstream. The next time his breath gets really bad, there's an ammonia test we can take. Why did the mouth biopsy come back eosinophylic gingivitis then??? Just my question.

So there are the options. The enema will tell you only that it is a shunt not where or how many. The surgery is extremely invasive with it's dangers and Killi's liver can't handle many anesthetics. His liver blood vessels are very dilated with a hemorrhage risk.

I chose diet and medication and monitoring. I asked my vet what she would do if it was her dog and she thought for a while and agreed with me. All we can do is pray that we have him for a few more years.

Any thoughts or suggestions or ideas are welcomed. Thanks, guys, you've been great through all of this.

Sue

[Cinder & Smoke]

Good Choice, Momma Sue!

The meds/observe course of action should buy some time... Spend that time surfing the net and talking to any Vet Specialists you can reach.

And don;t be afraid to ask the loaded question: "If he was YOUR FurKid, what would you do?"

Continued prayers for You, Killian, and of course Shiloh, too.

[jackiesdaisy1935]

Sue, I am so sorry Killi has to go through all this, I guess I wonder why it always happens to one we love so much.
Of course you need to decide yourself what you feel is the best coarse of action.
I can tell you honestly, if it was Perry or Daisy and I had to make that decision, it is difficult to make but I would go with the diet and medication and hope that would do it.
I would do the technizium and the exploratory surgery as a last option.
I know this is a difficult decision for you to make, I'm just saying if it was my dogs
I would go the same route that you have decided on. Please give Killi a hug and a few smooches from Daisy, Perry and me. He is very brave to go through all this, Bless him.

[ September 21, 2001: Message edited by: Jackie ]

[lizbud]

Sue, I agree with your conclusions.
The first number #3 was probably the original cause, and the second #3 is the best course to take(given Killian's physical state given by your Vet's evaluation).
Sue.. I know that you are very 'in tune'
with your babies and will instinctively choose what you feel is the best course to take. You have my complete support and continued prayers. All the best. Liz

[Logan]

Sue, you and your husband are the ones closest to the situation, and I know you will give long thought to your decision. I tend to agree with your first assessment, based on what you said in your post. There are too many unanswered questions, and is it worth putting him (and yourself) through the trauma of an exploratory operation and the recovery, as well as the risks associated with surgery? I think I would side with meds and diet, and research, research, research to see if there are other options or ideas.

You know we love you and are all praying for many more years of happiness with Killian. I am so, so sorry for this latest news. But I sure do believe in the power of prayer when it comes to our family, human and pet. And whatever happens, my biggest hope is that Killian can be comfortable and continue to enjoy his family.

I'm thinking of you often.

Logan

[4 feline house]

This has not been a happy night to browse Pet Talk. First I read that sweet little Charlie is gone, only five months after Thelma learned he was ill. Now brave Killi is very ill and the good news we were praying and hoping for will not be forthcoming.

Everyone, give your little guys extra hugs and skritchies, because they are here way too short a time. And in the meantime keep praying for Sue and Killi for healing, and Thelma for comfort.

[KYS]

I am so sorry for you and Killi.
My heart goes out to you.
I hope the medication and the change
of diet does the trick.
Poor baby.

[Eudora]

Poor Killian... first his liver and now this... the medicine should buy some time so go find the best vet you can! This seems to be a really special case....

[Daisy's Mom]

Poor Killi! This wasn't the news I was hoping for Sue I would have chosen the medicine too. Daisy and I are praying with our paws and fingers crossed for you both. Good luck with everything.

[Angels3]

Sue, I agree entirely with everything Cinder & Smoke said. I shall keep looking out for any further info that might help. And loads of prayers will be coming your way...

[joycenalex]

dear sue, i am so sorry to read such news. i would like to make a few suggestions. since you live in llinois could you have the ultrasound reviewed by one of the board certified vet radiologists at the university of illinois at champaign to see if there is a concurring opinion. yahoo groups has a chat group for dogs with liver disease, i encourage you to join us, its' addy is groups.yaho.com/groupcanineliver-d.
what recommendations did the vets/nutritionists make specifically for food for killian? it sounds as though commercially prepared food is not a good option, would it help killian if you were to prepare foods for him?
since my dog has a chronic disease(epilepsy) i am taking advantage of the talent at my state university, i am very glad i did, and i would HIGHLY recommend it to anyone, at least getting a second opinion. i was also very surprised at how reasonable the costs were.
i wish you, killian and the rest of the pack the best. joyce and alex the wonder dog, columbus ohio

[RachelJ]

I think Joyce has an idea that may be worth pursuing. After all you have been through, it may not hold out any solutions but certainly worth the effort to confirm what you already know or the chance that there may be some other explanation or options.

This is one of those situations where you are learning more than one ever wants to know. I am so sorry you and Killian have to go through this ordeal. He is so lucky to have a Mommie who tries to hard to help him.

[tatsxxx11]

Oh Sue, This is not the news we were all hoping for. But now, knowing what the cause of the problem is, we can all brainstorm and help and support you to do what is best to get Killi back to full health. He WILL be here for many years to come; I just know it. I agree with Phred and Logan and Rachel and Joyce. I don't think Killi's system is up to the surgery or enema right now. I would start with the diet and medication, close monitoring, ask every question you can think of your vet, especially, as I always do and like Phred would. "What would YOU do if it were your furkid?" The more invasive options will still be there if necessary.
And if you can, Joyce's recommendation of a university/teaching hospital would be ideal. They are usually the ultimate resource for cases like Killi's. Here in Mass., we are lucky to have Tuft's U. and Angel Memorial Animal Hospital as major teaching hospitals for furkids. If you can, try and get any info. you can from U. of Ill./their opinion. The Yahoo group Joyce mentioned has a wealth of info. about liver disease in doggies. Like Phred says, being armed with as much knowledge as possible is your first line of attack.

Sue, I can't begin to tell you how much we all here are thinking of you, praying for you and sending you all our support to help get you through this. We have come to know and love Killian so. I wish there wasn't the great distance there is between us all. You know we would all do anything and everything in our power to help you and Killi. If only to be there as friends who truly care and love you. Please give Killi, the bravest, most beautiful boy, all our love. We'll be waiting to hear from you. Sandra

[Karen]

We will all, of course, keep Killian in our thoughts, I agree with your decision for diet and monitoring being the best option of those you were given. Are there any foods/activities you should avoid or anything? I have never dealt with liver disease in a dog, so I can't do anything but keep you all in our thougts and prayers.

[Sudilar]

Hi, I've been researching liver disease and shunts, etc. and talking to people who have something similar maybe..... My head is spinning. Killian just sits there very content and happy! He has to eat less protein and more fats and carbohydrates. This morning I made him American Fried Potatoes without the onion and salt. My husband asked why I never cook for him like that. LOL Killi ate half of it and I asked my husband if he wanted the rest. He declined. Could it be he didn't like the little pieces of dog food stuck to it??? Ha-ha. Gotta laugh or else I'd cry. I'm going to check out that Yahoo group, too. One minute I think that I should do the surgery and the next, I don't. One person I talked to said her dog went through that and they didn't find anything conclusive just that her immune system was attacking her liver. I'm waiting for more info on that cause maybe that could be happening to Killi, too with all his immune system problems. If anyone comes across any more leads, please let me know... I want to know everything about this, but I don't know if we'll ever know for sure...
Thanks, everyone....again and again!!

Sue, Killian and Shiloh