Help with case needed - 6yo MN Min Schnauzer with liver probs

Re: Help with case needed - 6yo MN Min Schnauzer with liver probs

nikki — Wed, 17 Aug 2011 22:18:54 GMT

We have steered clear of steroids so far. Lepto titre could take another week to come back according to the lab. Got a vague answer of 2-7 working days turnaround and they received it last Fri. Owner has decided cant possibly make a decision until spoken to the boss (who's been off all week) so will wait and see what he persuades her to do tomorrow.

Re: Help with case needed - 6yo MN Min Schnauzer with liver probs

Alasdair Hotston Moore — Wed, 17 Aug 2011 17:14:27 GMT

BAST will not add anything here: the raised bilirubin tells you the same thing. Biopsy will be reqd if your continued supportive care doesn't see an improvement.

Re: Help with case needed - 6yo MN Min Schnauzer with liver probs

Michael Woodhouse — Wed, 17 Aug 2011 15:18:00 GMT

In a cooperative dog you should be able to do a biopsy with sedative and a bleb of local.

Re: Help with case needed - 6yo MN Min Schnauzer with liver probs

Edward Jones — Wed, 17 Aug 2011 14:36:23 GMT

Give Nick Bexfield at QVSH in Cambridge a call.

Has it had any glucocorticoid yet?

Re: Help with case needed - 6yo MN Min Schnauzer with liver probs

nikki — Wed, 17 Aug 2011 11:10:32 GMT

thanks - we are trying to persuade the owner that liver biopsy is the way to go but she is taking some persuading.

If she does decide to go for the biopsies is there anything special you would do regarding it's anaesthesia - drugs to avoid etc?

Re: Help with case needed - 6yo MN Min Schnauzer with liver probs

Rob Loxley — Wed, 17 Aug 2011 09:50:24 GMT

If your pending results come back clear then I think you'll be unlikely to get much closer to a diagnosis without a liver biopsy.

Re GA risks remember that all dogs we're doing liver biopsies on we suspect have significant liver disease...

Otherwise if the dog is bright and eating I'd consider sending it home with destolit, SAMe, antibiotics and give it longer before repeating bloods.

Re: Help with case needed - 6yo MN Min Schnauzer with liver probs

Richard Carter — Wed, 17 Aug 2011 09:10:27 GMT

Aflatoxin/ green algae/ eaten the owners paracetamol?

Re: Help with case needed - 6yo MN Min Schnauzer with liver probs

Anonymous — Wed, 17 Aug 2011 07:54:11 GMT

I would have thought that a Bile Acid Stim test in the presence of hepatic jaundice would be a waste of time and money as doesn't really add any useful clinical information (going to be high as liver clearly not working; not helpful in assessing degree of damage or differential diagnoses)?

Re: Help with case needed - 6yo MN Min Schnauzer with liver probs

Clive Ansell — Wed, 17 Aug 2011 07:17:16 GMT

Bile acid stim test to get a handle on hepatic function, and lepto titres may be useful, then biopsy.