Pit Diagnosed with AIHA

[Alyssa]

Gosh. I’m assuming ALP and ALT are her liver values. I knew they would be high. Is that like, dangerously high? I have just started her on milk thistle.

GLU – is that blood sugar? It says high. I am a type 1 diabetic myself. Should I monitor her blood sugar with my meter? Or is that something related to stress, food, water intake etc? I checked it the first few days she was sick before we knew what was really wrong and I believe it was in the 70s.

[Vally]

Alyssa, I’m not great with blood results, but ALP and ALT are up because of the prednisone. That’s quite normal for now. Sorry I forget everything, is Sassy on Denamarin? That’s really the best you can use to get the numbers down. The milk thistle is good too but make sure it’s a really good quality milk thistle though. I use a quality human brand.

Vally and Bingo
xxx

[Alyssa]

She is not on Denamarin. I decided against that in the past due to the cost and my vet insisting her liver values were “normal” for the treatment and it wasn’t necessary yet when I talked to her about it. I AM starting to question most of the advice from her, though.

She being given quiet a bit of milk thistle in powdered form. This one here:
http://www.amazon.com/gp/product/B002DXU0TI/ref=oh_aui_detailpage_o01_s00?ie=UTF8&psc=1

I just started it when it arrived Monday.
Do you think those levels deem using sam-e as well? I know that’s the thing with the pills. It has both.
The question I have then is; if she is on these:
http://www.amazon.com/Nutramax-Denamarin-Tabs-Large-Dogs/dp/B0011XHGR0

Is that ONE tab a day for her 75lbs, or will I have to use more? One tab a day is only a little more expensive than the other option I have. If I have to use more than that, I may try this to add with the milk thistle powder instead:
http://www.amazon.com/Lumina-Health-Cellfood-Liquid-Formula/dp/B0019K99OI/ref=sr_1_9?s=hpc&ie=UTF8&qid=1431732266&sr=1-9&keywords=sam-e

Sorry, that’s a lot of links!

[Patrice]

Alyssa,
The two values you are looking at that are above normal are ALT Alanine Transaminase and ALP Alkaline phosphatase, both values that are usually recognized as liver enzyme values. However, they can also sometimes reflect inflammation in other organs as well.

But in general, when a dog is on prednisone these two values will tend to rise and can often be extremely high. The liver is the organ that must process the prednisone and as it performs this function liver cells are destroyed. The enzymes are the byproduct of that cell death. The liver is highly regenerative and can recover, if there was no organic liver disease prior to AIHA, from this insult very quickly once the dose of prednisone is lowered and discontinued.

When Chance was being treated for non-regenerative anemia, both his ALT and ALKP were extremely high, he had been on prednisone for several months at that point. The ALKP was nearly 38x higher than normal. The ALT was also similarly high. These values indicated that his liver was highly inflamed and they needed to come down quickly for his health. I used Denamarin and considered it one of the most important parts of his treatment. Very shortly after starting Denamarin the values began to drop and eventually got down to about 1x normal. It is expensive, but he was in serious trouble and it helped him immediately.

Your chem screen, however, only shows a mild elevation in both ALT and ALP, not even 2x normal. You don’t need to worry at this point too much. Use some high quality milk thistle as a supplement. This supplement is not regulated so it is important to find a manufacturer that ensures the quality.

The glucose values is just barely over the normal high value. Unless this value has been a bit high consistently for a number of chem screens I would say this is probably because she may not have been fasted properly before the blood was drawn and you are seeing the result of a recent meal.

Make sure that she is fasted for 8-10 hours before the blood test, but make sure she has plenty of water. Blood glucose is a dynamic value. Our body is constantly adjusting it throughout the day in response to our food intact and numerous other stimulants like stress.

Talking about stress… Please take some time for yourself tonight, please. A nice hot bath with a good book or if you can get away for a movie. It’s Mommy’s night to reward herself for doing such a good job.

The only other values I see are some indications she may have an infection. Something to discuss with the vet the next time you are there.
my best
patrice

[admin]

Hi Alyssa

I love the photos – Sassy is a real cutie pie! It’s good to hear she’s a happy girl. I was just asking my husband if he remembered Worzel having a saggy, baggy neck on the pred – he said he definitely did. But it was never “fluidy” like that as far as we remember. I left his collar off as much as I could, in case it was uncomfortable or restricting him – maybe try that? There are so many side effects, unfortunately.

I couldn’t get Denamarin here in France, so I used high quality organic certified milk thistle from the UK – the Soil Association certifies it there, but I don’t know if you guys have an equivalent? I also bought Sam-E tablets. His enzymes soon dropped, so well worth doing. Here is a site which Dr Dodds has put information on dosing:
http://www.canine-epilepsy-guardian-angels.com/milk_thistle.htm
So you can work out exactly what Sassy needs according to her weight.

Worzel also had high glucose levels until we reduced the pred – then they dropped back into normal & have been fine ever since. Again, the pred does do this. It does raise glucose levels in people as well unfortunately. As Patrice rightly says, this also varies according to food & need throughout the day. I’m sure you know that glycaemic index tests are done 1st thing in the morning after a fast to get correct results being a diabetic – I hope YOU are OK too – the stress does get to us when coping with this disease. I lost quite a lot of weight when Worzel was ill – shame I’ve put it all back on again!

Hoping you will get the vet to check her out for infection soon – looks like there may be something going on, so this needs to be kept an eye on as they have little resistance to infection when they are on these drugs – please let us know how she’s doing.

Sheena x

[admin]

Hi Alyssa,
I said it before, and say it again, Sassy is such a sweetheart! Just love the picture with the towel over her head! Sorry I will not give you any input on the cbc or the chem panel, our experts have covered that. Sassy’s neck looks definitely different from before and I would get it checked out, mention it to the vet rather sooner than later. I seem to remember that an other dog had something similar, but can’t remember specifics. When I look at the pictures, to me (remember I am not a vet) it does not look like the right location for lymph nodes. They should be higher up under the ears and jaw. Sassy’s swelling looks more like on her neck. But of course it is hard to say. Could it be just fluid retention? One thing I remember from my dog being sick is that when I touched him, he just felt different. His skin, his whole body felt softer and more like pudding. It is hard to describe sorry. I am just thinking all this could be is water retention and side effects from the steroids. Their whole endocrine system is totally our of whack. This is just a gut feeling of mine and I would certainly show it to your vet. How is Sassy feeling, behaving? That would be a very good indicator how well she is.
Best wishes,
Brigitte

[Vally]

Alyssa, just checked the photos. I don’t have any real knowledge about such things, but Googling neck swelling photos, it does look a bit like an allergy reaction to me. Is she in her collar? I think I’d probably keep that off for now.

Love Vally
xxx

[Alyssa]

her collar is only on when we go outside, its off inside.

her neck hasnt changed since i mentioned it. would it be changing if it was something? sassy seem incredibly happy today also, even after bad storms this morning.

She just tore through the house playing with her toy like she used to do. I was so shocked. I knew she was happy today but I didn’t expect that at all. She was bringing the toy around to everyone, chasing it, ripping and pulling out stuffing. She’s played since getting sick but usually only a little tug o war and pulling out stuffing. This was the longest she’s played and the most.

all signs are pointing to her feeling better each day. i hate to stress her by going to the vet if she seems okay. i feel i would be seeing other signs if it was anything but fat/retention, not these vast improvements!