"DIAGNOSIS: Liver biopsies: Cytoplasmic swelling and vacuolar change in hepatocytes, diffuse, moderate to marked, with multifocal overt vacuolar degeneration, and multiple small lipogranulomes comprised by hemosiderin laden macrophages/Kupffer cells. Inflamination is not a prominent feature. Hepatocytes are swollen so that sinusoids are collapsed. They have fine to medium granular eosinophilic foamy cytoplasm with multifocal overt vacuolar degeneration. Fibrosis is not a feature.
COMMENT: The most common cause of vacuolar degeneration of canine hepatocytes is hypercortisolism, either endogenous or exogenous. Alkaline phosphate is usually markedly elevated in that case. Some other drugs (for example, Rimadyl, phenobarbital) and some environmental hepatic toxins cause a similar but often less dramatic change."
He's having a test for Cushings Disease Monday - BUT his bloodwork does not give any indications of a problem with his adrenal glands.
I'm going to have to check out what alkaline phosphate can include and then try to remember if he's had any contact with them - the vet said exposure to toxins is a real possibility. He may have had Rimadyl after he had the bloat surgery in September 2005, but I don't know if he had enough to do serious liver damage. He's never had phenobarbital. I'll also have to check out the environmental hepatic toxins.
He's currently taking: Ursodiol, Denamarin and just finished a course of Tetracycline. He's had some Tramado AFTER the biopsy. He didn't start taking the Ursodiol and Denamarin until he flunked his recent bloodwork with high ALT values. He's been off and on Tetracycline for about 19 months.
I haven't had any insect spray in the house in over 7 years. I get my yard sprayed maybe once a year or longer for ticks and fleas with malathion and an IGR. The last time I had it sprayed was probably in the Spring of 2006.
Any thoughts, suggestions, ideas will be greatly appreciated.