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Discussion Starter #1
Hope all are well....it's been a while!

Neb became quite ill last Thursday night and was hospitalized in the ICU from Thursday night to Sunday morning when we took him off the IV and home.

Suddenly on Thursday night he started throwing up (mostly clear bile-ish stuff) and then pooped in the hall (which he NEVER does) followed by him clearly starting to strain; I would take him out and having little blobs of diarrhea. He than became obviously in pain.

It goes without saying we took him to the vet.

(Note: The dogs are normally fed grain-free kibble as Luc can't have bones anymore due to his teeth. We rotate between a variety.)

The vet suspected pancreatitis or some sort of infection. Neb was admitted to the ICU and tests started (x-ray, blood work) along with antibiotics, pain killers, antacid, and a stomach protectant.

His temperature was low - 35.4C.

By the next morning his temperature had improved to 36.9C. It continued to improve through Saturday to pretty well normal.

The vet said his bloodwork showed the signs of a severe liver infection, a liver shunt, or I guess some sort of liver failure.

I didn't do as good of a job as normal asking questions because this was so sudden and scary I wasn't thinking straight. Still:

-vets all (3 at 24-hr clinic plus both vets at our regular clinic) ended up agreeing shunt was not the issue. He doesn't seem to present with a lot of the signs (small/runty, losing weight) plus his age makes it less likely
-Neb had the compromised liver values: ALP - lowered, ALT: 446 (normal 5-95), AST: 266 (normal: 5-71)
-test for pancreatitis came back normal - this includes a blood test and a cPLI test, so the good one
-Neb had blood in his feces Friday morning - they did a coaugulation test and if I recall correctly it was normal
-Neb had an effusion in his abdomen (largely receded by Saturday morning when x-rays repeated)

Neb had, on Tuesday I believe, gotten into the plastic bit that sits on meat styrofoam trays to collect blood (my partner left it in the recycling of all places). I know of several dogs who have eaten a number of those and been fine. The vets seemed to think it was theoretically possible that it had caused an infection but they didn't really seem to think so.

My mother-in-law is coming for dinner next weekend and we cleaned the bathtub with Scrubbing Bubbles cleaner - normally we would use baking soda (well, to be honest, normally we wouldn't clean it). I made sure to rinse off everything, but could he have somehow ingested a missed spot???????? I have been told (by a layman) this likely wouldn't be it either - ???

Neb was started on small amounts of food Saturday morning and kept everything down. Since that time he's kept all food down and finally Monday night pooped (no blood). He's still on the meds I mentioned earlier. No poop since Monday night.

We are taking him to the vet Friday (our regular vet) for follow-up bloodwork etc.

I honestly can't think of, other than the scrubbing bubbles, what Neb could've gotten into that could've caused this, and frankly, it was used 24hrs before he got sick and like I said, we rinsed it. He's always on-leash, so I can't think of anytime he would've accidentally ingested some antifreeze off the ground, for instance.

In the month leading up to this, Neb was obviously not feeling well Halloween day but he bounced back by the next day, and still hiked that day (we were on a backpacking trip). He threw up bile a couple of times, the first time I put it down to him getting a bit of the rabbit's hay, the second time, he'd had a smaller-than-normal breakfast.

But perhaps those were warning signs?

I've done some research but am still a little confused about how suddenly liver disease can onset. Is he presenting like a dog that could have liver disease, or does this appear more consistent with ingesting something toxic? Given that it's not pancreatitis, does anyone have some thoughts as to what is going on?

My only other comment is that Neb is hypoglycemic and I know liver function can sometimes cause hypoglycemia. Neb was dx'd through routine bloodwork but this is something I plan to ask the vet about when we see her Friday.
 

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What a frightening experience. Glad he seems to be on the mend.
 

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Have you talked to your vet about having an ultrasound done? I'm not even sure if it's appropriate given the situation, but oftentimes you can learn so much more about what's going on than by blood work alone.

I wish I could give more helpful info/suggestions. I hope your dude starts feeling better soon, and that you guys are able to get to the root of the problem.
 

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Wow, that is scary!

Far out thought - HGE - probably not but this gives a good list of other stuff too:
Canine Hemorrhagic Gastroenteritis (HGE) ~ Pawprints and Purrs, Inc.

I agree with the ultrasound thought. MOST of the time, something will show up, if there is anything there.

Also, while those numbers are not good I have heard of much higher - I am guessing you will be retesting those when you go back in?

Keep us posted!
 

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Discussion Starter #5
Thanks guys.

Jean, I'm checking out that link now. I hope not that but I'd like a dx.

I also read of higher numbers....so I don't know what to think.

PuffinGirl, we talked about doing an ultrasound; we decided to get through the initial hospitalization (which was horrifically expensive; $3000 for 2.5 days; we were very lucky to receive some money outside of this which is making this possible) first. Dependent upon the blood tests results (yup Jean, we're redoing) we will look at an ultrasound.
 

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How scary! I hope everything turns out ok. It's so hard to figure out what causes everything...if only they could talk!
 

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Thanks guys.

Jean, I'm checking out that link now. I hope not that but I'd like a dx.

I also read of higher numbers....so I don't know what to think.

PuffinGirl, we talked about doing an ultrasound; we decided to get through the initial hospitalization (which was horrifically expensive; $3000 for 2.5 days; we were very lucky to receive some money outside of this which is making this possible) first. Dependent upon the blood tests results (yup Jean, we're redoing) we will look at an ultrasound.
I completely understand - vet care is so expensive! We've spent tens of thousands in the last year and a half on our sick boy. :(

The (sort of) good news, is that ultrasounds aren't that expensive. I think the ones we've done have been around $250-300. So comparably, it's a bargain. :rolleyes:
 

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PuffinGirl, as soon as this happened, my bf said 'do we have insurance?' ....uh, I never got it for the dogs - I had it for the cats and never used it. Dear me.

We got quoted around $500 for an ultrasound, which is what I've seen before. Vet care here tends to be expensive unfortunately, well, it is everywhere.

Lisa, I've been reading about milk thistle but I'm hesitant to give him anything until we know more AND he's done the meds (four in total) he's on at the moment. I don't want any unexpected interactions.
 

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We haven't bothered with insurance either, and I don't think it would have covered the vast majority of Jones' vet bills. It's better for us to just save the money we would have put towards the premium and use that for vet bills.

That's more expensive than I would expect for an U/S...if you guys do decide to do one, I would maybe call a couple internists and see what they charge.

I hope he continues to improve!
 

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Discussion Starter #12
I'm not sure, we've had ultrasounds quoted for other things (sick cat) and it was actually more expensive! But we'll see.

We went to the vet today - she thinks for now until we get the results of the blood test and see what's going on we can't really guess what's happening.

I did find out though, the med I thought was a pain med (what I understood from the 24 hour vet) is for the liver actually. Ursofalk. But she said it shouldn't throw off the liver results like AST, ALT, etc, that it would change the bile acid if anything.

Thanks!
 

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So the blood tests look good - everything is normal except for the bile acid, which is slightly elevated, however my doctor attributes this to the Ursofalk and says it is a known side effect of it (it's a liver med). We're almost done it, and than in a few weeks we'll repeat the blood work to see what it looks like off the Ursofalk.

But PHEW!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
 

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That's excellent news! The liver is very resilient from what I've seen, so that's a good thing. I hope your boy continues doing great!
 
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