Hi there! Hoping for someone who has been through something similar. Back in early October, the wife and I had a scare with our 2 year old lab possibly getting some iburprofen pills. We immediately rushed him to the vet where they induced vomiting (no pills came up) and ran blood work. His blood work all came back great except his ALT liver level, which was up around 1100. The vet had recommended ultrasound/biopsy to determine if it was caused by the ibuprofen or an underlying issue. We got a 2nd opinion and everything came back the same. We went ahead with an ultrasound in middle of October and they informed us the liver was pretty inflamed. Basically active, chronic hepatitis. The vet doubted is from the Iburpofen and an underlying issue, possibly genetic. We were put on a double dose of Prednisone for 2 weeks then a regular dose for 2 weeks, as well as Denamarin. While the double dose was absolutely awful in terms of no bladder control, it appeared to work as his ALT levels were checked again and were down to 330 (normal is 18-121). We were pleased with the progress and vet said we should keep him on it for 2 more weeks. Well, we just got the results back from the blood work done last week, after being off it for 3 weeks, and his level is back up near 1100. She wants to put him back on Prednisone, but keep him on it until the level is where it should be and then he should be able to be off of it as the liver will then be able to repair on its own. We are really dreading the double doses again, but will do what we need to do. Has as anyone had any experiences like this before? Her hope is that if we keep him on the Prednisone longer this time and get hit ALT level back down to where it should be, the liver will then be able to regenerate. She also suggested possibly Denamarin daily for life, but I would rather not Have to spend the $65 monthly if something like Milk Thistle will work in the same fashion. I have included a recent email below from the vet. Anyone have any recommendation, advice, or previous experience? Thanks much! Good morning, Ibuprofen does not generally cause liver issues right away but ingestion of a large amount could cause liver inflammation which can lead to chronic hepatitis later on. The hope is that the prednisone will decrease the inflammation in his liver long enough to allow healthy liver cells to regenerate. This takes time and depending on how much inflammation there is, can be months to resolve. I would also recommend keeping him on the liver supplement Denamarin possibly life long or at least as long as he is on the prednisone. This will help his normal and healthy liver cells stay healthy and function better. I hope this answers your questions. Please let me know if I can help answer any other concerns or if you would like us to order him more Denamarin. Dr. Miriam
What an awful dilemma for you , I am sorry you are going through this . I haven't had the same experience as you but my dog who died recently was treated with a high dose of prednisolone , in his case to help his lymphoma , so I can thoroughly empathise re the awful side effects . I think, if it were me , and there was a good chance of reducing the levels in order to allow the liver to regenerate , then I would go for it , especially as he is so young . Welcome to the forum by the way and please let us know what you decide and how he is doing, good luck
I will certainly keep you informed. It's nice just to hear some varying opinions and people giving a little insight. It's so difficult because he never did or does show signs from this. The two weeks of Pred 2x/day with me sleeping on couch in the living room with hardwood floors, him waking up from a nap in a puddle of his own urine, his looking at me while urinating on the carpet 2 minutes after being outside wondering what the heck is going on was a challenge to say the least. I think i am leaning towards doing it all over again if it does provide a resolution to the issue. Thanks again!
Thank you, he was one heck of a lad ,missed terribly . I went through Sams endless tiddling too , and decided to stop treatment , because he had an incurable form of cancer , but in your case , hopefully it will all be worth while , good luck and come on here to chat any time x
It sounds like a tough situation. I’d go with the vet’s recommendation though, even though it means dealing with the side effects. I hope his liver can rebuild with the help of the steroid treatment and other medication. Is it the case that you and the vet still don’t know what has caused the liver inflammation?
Correct. She referred to it as chronic hepatitis,. I've done some research on it and it can be just as much genetic as a cause. I guess Labradors are predispositioned to it. http://todaysveterinarypractice.navc.com/canine-chronic-hepatitis-diagnosis-treatment/
Thank you for the article - an interesting read. I would definitely go ahead with the steroid treatment after having read that. Seems like just pure luck that you found this problem then (triggered by the ibuprofen scare).
Hi. I too would go with the vets recommendation, especially as it did decrease his levels previously. Its horrible watching our dogs when they are poorly. Hopefully he will improve quickly on the meds.
We are going to get him back on the Prednisone and Denamarin to see how those go. It seems as if she ruled out some major possibly underlying issues through the ultrasound and is just referring to this as "chronic hepatitis". I think we will need mixing in some Omega 3. We also rotate between the several available Fromm Four Star foods and wondering if some provoke his inflammation based off the main protein...
Sounds like your vet is doing a good job of working through it all. I hope that the treatment plan brings good results. Please do let us know how things go with your boy.
Welcome to the forum, I am really sorry you are going through this and hope the medications will help.
