Clin path - liver. Help!

Re: Clin path - liver. Help!

mariette asselbergs — Fri, 08 Feb 2013 16:55:54 GMT

Or is it the other way around? In humans for example, it is well known that gall bladder stones cause pancreatitis by obstructing and irritating the bile duct and simultaneously the pancreatic duct.

Mariette

Re: Clin path - liver. Help!

Nicola Lawlor — Fri, 08 Feb 2013 16:47:01 GMT

Last one I had similar to this turned out to have a chronic pancreatitis with apparent inflammation affecting the bile duct and causing the liver enzyme changes.

Re: Clin path - liver. Help!

Tom Ward — Fri, 08 Feb 2013 15:24:49 GMT

[quote user="Bob Russell"]

ACTH stim test sounds quite a reasonable idea. Panting is now considered a pointer to possible Cushings.

[/quote]

yeah, that's the reason I blood sampled it in the first place; a normal ALP put me off the scent, but it could still be! We've opted to monitor for the next few months with a view to repeating resting bile acids and if his panting worsens we'll ACTH stim him.

Thanks for all your help!

Re: Clin path - liver. Help!

Bob Russell — Fri, 08 Feb 2013 14:20:34 GMT

ACTH stim test sounds quite a reasonable idea. Panting is now considered a pointer to possible Cushings.

Re: Clin path - liver. Help!

James Laidlaw — Fri, 08 Feb 2013 12:56:50 GMT

Ultrasound ideally, maybe workup for cushings/addisons as well if pu/pd and electrolyte imbalances present.

Re: Clin path - liver. Help!

Kate Richardson — Fri, 08 Feb 2013 12:19:46 GMT

You can have normal liver enzymes in the face of liver failure if there is little functional liver tissue left but not in the face of an otherwise well dog. Terriers (IME) often have higher bile acid values than other dogs and in Australia I believe this has been documented in Maltese Terriers- my own little dog was a Maltese cross and she had bile acids values similar to your case for at least the last 5 years of her life (never tested before so don't know what they were prior to this) and was essentially fit and well (although progressively senile). She did have a a liver biopsy early on which showed mild degenerative changes, but essentially she ate and drank normally, maintained her weight and was a happy healthy dog.

So should you follow up- depends on how worried the owners are. Offer an ultrasound and repeat monitoring of bloods every 3 months initially. If everything remains stable then no need to be worried.