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Pet Forum / Miscellaneous / Animal Health / February 2007Need Advice... Keko - 9yr old Alaskan Malmute very sick...
I really need some advice here... a little history... Last Sunday (Jan 29th) late evening my buddy/son (Keko) began vomiting, I wasn't too alarmed at first because he often licks his fur as most dogs do which will on occasion make him hack-up. Over the following few days I noticed he wasn't eating his food and late in the week he completely started to act very lethargic and tired. I made an appointment for him with his vet but he started to vomit again late in the evening so I rushed him to the emergency. He was put on an IV with Reglan and antibiotics. His blood tests revealed... ALKP = 3096 U/L; ALT = 3207 U/L; AST = 247 U/L; TBIL = 12.3 mg/dl. The next day the same type of tested showed significant improvement ALKP = 1800 U/L; ALT = 1836 U/L; TBIL = 11.0 mg/dl. Yesterday at his normal vet he showed even more signs of improvement... ALKP = 636 U/L; ALT = 640 U/L; TBIL = 11.0 mg/dl. While at the emergency room a biopsy was done on his liver and were currently waiting for the results, which should be Wednesday or Thursday for sure. During the week leading up to going to the emergency room and while at the emergency room he was having daily bowel movements which were normal. He is currently taking Cephalexin 500mg 2 capsules twice a day; Mentronidazole 500mg 1 1/2 tablets twice a day; and I've been giving him Pepcid AC Original Strength 10mg 2 gelcaps twice a day to help with his stomach. Meanwhile, while waiting for the biopsy results, I have him at home now but I'm having a real tough time to get him to eat. I've tried everything I can think of... Crushed his dry food so it's almost a powdery consistency Tried wet canned food Tried the two above mixed Tried mixing the two above with beef broth Tried every combination of the above Tried plain boiled chicken breast He will drink plenty of water and will drink a little plain unflavored pedialite. He does hold this down. He is urinating fine and the consistency is starting to thin out and lighten up. I can tell he wants to eat, he puts his head in the bowl but then lifts it out. It's almost as though he's afraid of vomiting again if he does eat. What else can I do to try to get him to eat? Any suggestions will be greatly appreciated...! Thanks, Anthony If he is hydrated which he is, I would not worry too much. We think people/dogs/etc. need to eat to recover, which we don't. Let him lay off the food, he will know when he is ready. I think you are doing a fine job w/ him. He also has a lot of meds/drugs in is system. Give him support and love, water and then when he is ready to eat, he will. He will not die of starvation. (my 2 cents worth.) Perhaps he ate something in the garden or outside to make him ill? His labs values will indicate this. >I really need some advice here... a little history... > [quoted text clipped - 43 lines] > > Anthony Thank you, I just got off the phone with the emergency clinic, they received the biopsy results; Keko has Cholangial Hepatitis (CH). I will be talking with his regular vet first thing tomorrow morning. I was told we'll need to put Keko on a strict liver diet, as well as meds from here on out. I'm on the net right now searching for as much as I can find regarding CH. Thanks again, Anthony > If he is hydrated which he is, I would not worry too much. We think > people/dogs/etc. need to eat to recover, which we don't. Let him lay off [quoted text clipped - 52 lines] >> >> Anthony <ajmnews@com.cast.net> whittled the following words: > Thank you, > [quoted text clipped - 67 lines] >>> >>> Anthony https://app.vetconnect.com/5min/data/04420443.htm >I really need some advice here... a little history... > [quoted text clipped - 43 lines] > > Anthony The bland diet of boiled beef and rice often works. Does he like yogurt? Hope he feels better soon. margaret > He is currently taking Cephalexin 500mg 2 capsules twice a day; > Mentronidazole 500mg 1 1/2 tablets twice a day; and I've been giving him [quoted text clipped - 3 lines] > What else can I do to try to get him to eat? Any suggestions will be > greatly appreciated...! .......I've had Hepatitis B from drinking contaminated water. You really don't feel like eating much! I'd think about getting him B12 shots. He'll have to be on a liver diet. In the meantime try small frequent meals. Boil that chicken breast to death, skim off the fat and give the broth only. The drugs may also be affecting his appetite. You could try feeding in the AM before giving pills. From your other post: >I just got off the phone with the emergency clinic, they received the biopsy >results; Keko has Cholangial Hepatitis (CH). This is for chronic hep, but you might find the discussion interesting. http://www.vet.utk.edu/continuing_ed/05decCE/denovo.pdf Everything about any liver disease: http://www.lbah.com/liver.htm As you indicated there's not much on Cholangiohepatitis in dogs, mostly cats. http://www.vetinfo.com/cchohep.html#Cholangitis%20or%20Cholagiohepatitis%20i n%206%20year%20old *Cholangitis is inflammation of the bile ducts, primarily. Cholangioheptatis is inflammation of the bile ducts and liver. I think that the results of your cat's tests probably indicate cholangiohepatitis. Suppurative cholangiohepatitis is diagnosed by the prevalence of neutrophils among the white blood cells present in the biopsy. Neutrophils are present when there are bacterial, viral or parasitic causes, usually. The bacterial infection is best diagnosed by culturing the bile or culturing the liver during biopsy (or a biopsy specimen after biopsy but this means taking more than one sample). In all honesty I think that obtaining and interpreting cultures is daunting enough that many vets won't try, but I could be wrong about that. I know that I don't do it very often. So I use the antibiotics most likely to be effective in a liver infection, which are usually considered to be amoxicillin/clavulanic acid combinations (Clavamox Rx), cephalosporins (Keflex Rx), fluoroquinolones (Baytril Rx, Orbax Rx) and metronidazole (Flagyl Rx). Metronidazole only works for anerobic infections. Many vets use metronidazole in combination with amoxicillin or fluoroquinolones to try to cover the possibility of both aeorobic and anerobic infections. Other antibiotics may be deemed better based on culture and sensitivity results and aminoglycosides, which have more toxic side effects than most antibiotics, can be used when the situation warrants it.* .......Has the dog been tested for Leptospirosis? This test can take a while to get back. I'd discuss the possibility with the vet. There's specific antibiotics needed in this situation. http://www.vet.uga.edu/vpp/clerk/noel/ .........Did they say anything about CAH - viral hepatitis? .....Denosyl may be a good supplement to protect the liver. http://www.nutramaxlabs.com/veterinary/denosyl.htm ........the liver is one organism that can repair itself if given a chance. Hope things improve for your pup. buglady take out the dog before replying |
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