Liver Disease Cases

Each dog is different when unwell and what works - my girl with micro liver shunt has responded very well to amino acids - L carnitine- L- methionine- and thank you to this group I now have added L ornithine all with meal  

I am so surprised how well it is working 

And how settled she is. 

Hope this helps others and it won’t break the purse.

Dr. Steve's Advice -  thank you for the feedback. I'm glad your little dog's microvascular shunts are improving! 

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My beautiful 12 year old Jenny had an ultrasound Wednesday that revealed three cancerous tumours in her liver & one in her intestines.
The detailed report was not available but these were the initial same day findings.

I was told that maybe she might have 2 months & no treatment is available with potential results that would outweigh the pain she would endure.

She was put on pred.. twice a day to reduce inflammation.

She had been very picky with her food (raw fed since a puppy) . I have been cooking her brown rice/ cooked skinless boneless thighs. I had added heart and gizzards but changed it up to only the thigh after seeing her diarrhea wasn’t clearing up.

I read with intestinal cancer a diet higher in omega fats is beneficial? I was also wondering about products by Adored Beast Apothecary for her gut or pumpkin?

I am hoping for a miracle.
Dr. Karen gave us an additional 8 years with our Dodger who crossed the bridge at 16 and she saw Maggie Lab thru til we let her go at 15.
Jenny had been raised at the same clinic & am hoping…

Any advice would be very appreciated.

This is my beautiful girl.

Thank you

Dr.Steve's Advice - Did the diarrhea clear up with the diet change?

There are just so many things you can try that they really don't fit into one post. I would push for a final written ultrasound report that you can share here. What were the signs and symptoms that made you get an ultrasound done? If you can share the report and the specifics of exactly what is going on, I might be able to suggest a specific anti-cancer formula for your dog.

Meanwhile, omega 3s are theoretically helpful in all cancers. As long as your dog didn't get diarrhea from them, give the maximum tolerated dose. Add 1 clove of crushed garlic a day to help the body deploy those omega 3s more effectively in fighting cancer. 

Another couple of things you can use in virtually all cancer cases: Six Gentlepets by Kan Essentials, which helps fight cachexia while having anti-tumor effects; and the addition of turmeric to the diet. For a dog that size, probably half a teaspoon per meal

Regarding the diet, there's no real advantage to giving brown rice. You'd be better off using vegetables and beans that have more micronutrients that can stave off tumors and which are a more dilute form of starches, such that we don't run the risk of feeding your dog's tumors (since cancer loves carbs).

Probiotics and pumpkin are fine to add to the food to help support a healthier microbiome.

Hopefully this helps you make a start

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A question please now that I have my cavoodle girl all settled with her micro liver shunt issues, she back eating human grade quality raw and veggies she is just loving it - I must say
I am looking for advice on how to build up her immune system what could I add to her diet to build her up hopefully to prevent or minimize her summer allergy reactions with eyes & skin paws issues

Thank you kindly 

Dr. Steve's Advice - for dogs fed healthy real food diets that have allergies, I recommend Cessorex (https://goldstandardherbs.com/products/Original-Cessorex-85g-p647327434) from Gold Standard Herbs. You can read more about how it works at #cessorex and #skindiseasedogs. It has a balanced effect on liver circulation so the microvascular liver shunts should remain under good control. Hope this helps you out!

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I have a 9 year male that showed slight elevated liver enzymes at his vet visit.   I opted to do ultrasound & FNA in which ultrasound showed a mass on the left lobe.  Our vet said she feels it should be benign by the way the mass looks… ( I understand they can’t diagnose from the US without cytology) The FNA came back stating Nondiagnostic sample due to insufficient intact cellularity.  

He has zero symptoms and his ALT came down quit a bit and is somewhat close to the normal range. 

(Normal is 125 and his was 173). ALP is slightly more elevated.   

Mass is 5cm x10cm left lobe which is fairly large.. mass looks encapsulated 

My question is, what should our next steps be?  I hate that his test came back without a diagnosis.    How common is this to have the test come back with this result?  

All other organs and lymph nodes were normal.   

All other liver enzymes & blood test were normal as well.     

Any advice would be greatly appreciated!   

Thank you all for giving us your time and opinions.  

Dr. Steve's Advice - the result just means that the veterinarian didn't manage to get intact cells for whatever reason. You could repeat the test if you like. 

Another option is to monitor it if your dog has zero symptoms. Do another ultrasound in a couple of months. If there is no growth, then it makes it more likely it is benign. Or, do lab tests checking ALT and ALP every six or eight weeks. If they stay stable, then likely the liver mass is, too.

Herbs are available that can shrink liver masses. A safe one you can try is Dispel Stasis from the Middle Palace by Kan Essentials, often available online at Amazon in the US. Dose according to the guidelines at https://nphc.ca/using/dosage

Hope that helps!

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My senior Corgi has recently been diagnosed with liver issues. They are all on a raw food diet. But starting this time last month, Frostie started turning her nose to her beef, goat & lamb mix. Switched her to turkey & did good for 3 weeks. Then started rejecting it. Resorted to boiled chicken & rice. Something told me things were off. Had bloodwork done. Dr said her liver was not happy. Put her on a regimen of amoxitabs, prednisone, denamairn & omeprazole. She’s doing better but Dr is talking about keeping her on prednisone & denamatin permenatly. I don’t know what she got into to cause this problem. Everyone else is fine. I don’t want to see her on meds the rest of her life. She’s 12.5 years old. I need suggestions on holistic things i can use you help her.

Dr. Steve's Advice - if the liver enzyme elevations weren't too high (max 300s or so), then given the mid-spring onset, I would wonder about Liver Blood deficiency as the cause. This equates to either mild chronic active hepatitis or microvascular dysplasia, both of which are curable. 

To get there, I would source Kan Essentials' Happy Wanderer, often available online at Amazon if you're in the US. Dose according to the table at https://nphc.ca/using/dosage. If there are improvements, but not quite enough, there are other formulas to choose from that modulate the liver blood supply to help 'actively resolve' the inflammation there. 

Pred is not a long term solution, since it suppresses enzymes needed to help resolve inflammation going forward, and can actually predispose to animals getting inflamed in the first place, due to its metabolic impact. If the liver enzymes return to normal, I would certainly wean off the pred and then the omeprazole. Denamarin is just an isolate of Milk Thistle, so it's not a big problem and is not likely helping that much but not hurting either. 

Hopefully this helps you out! Let us know how it goes!

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My 4lb chihuahua has elevated liver numbers. Her ALT Zane AST are each double.  She is Asymptomatic. Her bike acid test was perfect.  I’m being told she can absolutely not give her raw anymore. Is that true. Is it still ok to suppliment her her with the mercola hormones to support her hormones because she is spayed?  I’ve started balance it suppliment (I’m not a fan because they are synthetic of course) with the recipes with low carb but I’m upset about no raw. Please tell me your thoughts.

Dr. Steve's Advice - there is no reason to stop feeding raw, as far as I'm concerned. Most dogs with liver enzyme elevations are eating kibble, not raw, so there is no scientific basis for the food change unless they gave you some specific diagnosis for which raw diets are contraindicated. I can't think of one.

Does your raw diet contain fermentable carbs and soluble fiber (i.e., an ample amount of vegetables and or fruit)? If not, then a lack of these ingredients can leave dogs prone to leaky gut or immune mediated issues. Sometimes this can lead to the transplantation of bacteria from the gut into the liver, or to things like chronic active hepatitis. To avoid that, make sure the diet has these items in it (making up about 1/6 to 1/10 of what is in the dish).

I'm not sure what hormone supplement you're using, but if it's this one (https://www.chewy.com/dr-mercola-canine-hormone.../dp/162981), compounds like the first ingredient have been associated with liver enzyme elevations in dogs. I'd suggest stopping it and seeing if that helps. Is there a specific hormonal problem with your dog? If so, let me know what it is, and we can try to address it another way, such as through plant sterols.

If this doesn't help, there are herbal formulas you can try that will probably work, but it might be as simple as just discontinuing the hormone product.

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 Hi Dr Steve

Just got my Ava's lab results. After her 1st vaccine at 2months, she got liver failure . Befor she was ok as i always check blood befor every vaccine (if i give )
She got 6 months to live, now she is 4,5yo.

Last week she started to pee a lot. In the house. As my male went crazy after her and as she had accidents with peeing i thought she is coming into heat. Because of liver issue she is intact

But on Saturday she peed on puppy pad and i saw blood and blood clots (not much).

I put her on antibiotics as she is very delicate, will describe later, and i could not go to vet till yesterday.

After taking antibiotics she stoped peeing into house.

She is sleeping a lot. And she is not as happy as she usually is.

She is not eating but she is drinking a lot. And long.

She is even when she is ok not good eater. Or let say she eats very unhealthy.
I feed my dogs with real food, raw, cooked, fruits, veggies  but she eats very limited: bread and butter, fat from baked pork ribs, kaki, apples, Sauer cream, soft salami from pork (like mortadela but i would never buy it for us even is for human of course),  shrimps, cake with cheese and raspberries, whipped cream... And i can't rotate these. She is eating 1 month something another something else

She is taking omega 3, milk thistle every day 

Do yes, her status is...complicated

Today i am taking her urine in, i will ad results later.

But i am worried because of her results : WBC, monocytes

We made US and there is something in her bladder but x rays did not show stones in bladder. 

What are your thoughts and suggestions?

***Updates: in urine they found blood , quit lot, for +++, leucocytes, proteins, but no sediments or crystals

Dr. Steve's Advice -  given her indulgent tendencies and the high ALP, she most likely has Damp Heat. That can be paired with Blood stasis, and both can occur in the bladder to create cystitis, mass lesions, etc.

I know you don't have access to Chinese herbs, but some western herbs that may help at least with the inflammation are Corn Silk, Arctostaphylos, Hydrangea, Collinsonia (Stone root) and Eupatorium purpureum. Corydalis, Frankincense and Myrrh can also be added to the mix. I guess see what you can find of those while you are waiting for final results

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 Good morning Dr Steve-

Kaiser, 8.7 years old had his yearly physical last week.  Going into that appointment he was being treated for arthritis with Deramaxx 75mg per day. Yesterday our veterinarians office called to report that his liver levels were high, which could be caused by the Deramaxx. They suggested lowering that dosage and add Denmarin to help his liver recover. My question to you all is first and foremost for any insight you may have into this. Also do you know of anything I can add to his diet to help his liver as  well.  Kaiser and I appreciate your input! 

Dr. Steve's Advice -  if you have to use NSAIDs to keep your dog comfortable, you can try add in something that will improve liver blood circulation. Denamarin is not likely to help in that regard. I would suggest something like Happy Wanderer from Kan Essentials, which you can source safely through Aleksandra Topic at aleks.topic1@gmail.com. Hopefully that will help.

If it does help a little, circle back. There are herbs you can use along with it that might help with the arthritis. For sure you should only use the drug if your dog needs it. If he's not painful, give him a day off like you would for yourself.

Lastly, look around for canine physio or rehab therapists, chirorpactors or acupuncturists. Sometimes their methods are more curative, allowing a reduced reliance on the drug

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 Hi Dr.Steve! 

I've finally taken the step to feeding only homemade meals for my senior boy. He was on antibiotics for 5 months for a stubborn UTI and he finally finished 2 weeks ago. I just got his blood tests 2 days ago after he finished, which showed ALP at 1211. 

On Jan 6,  right AFTER the first round of antibiotics, I did a blood test that showed 400 ALP. 

6 months before starting any antibiotics (before UTI), his bloodwork showed 263 for ALP.

I asked my vet if this increase can be related to the antibiotics and he said antibiotics don't impact liver enzymes, which was surprising to hear. Other than the liver enzymes, everything else was decent (lab work from this week below).

But I'm having a hard time finding recipes for senior dogs with high liver enzymes.

He is on:

Lumbrex
Glucosamine
Probiotic
Green lipped mussel
Myos Muscle formula
Lion's mane
Reishi mushroom
fish oil 

Today is day 2. So far, I've been rotating for each meal:

White fish/salmon/chicken breast 250-300g raw
Veggies mixed - 150g steamed
Sweet potato/quinoa/oatmeal - 150-200g raw 

Is this ok? I checked out your pinned post but it wasn't specific for senior dogs with high liver enzymes. I asked my vet but he recommended hill science and I don't want to do that. 

Also should I add other multivitamins? If so, can you recommend one for him that won't interfere with his condition and Thyrotab meds (levels were perfect with current dose).

Thank you so much!

Dr. Steve's Advice -   real food alone should put the brakes on a lot of causes of liver pathology. As for why this is happening, Chinese medicine would say it is reflective of whatever the problem was in the bladder. If the bladder wall was found to be thickened, they would say that the liver and bladder had Blood stasis, calling for a decongestant effect, using formulas like Harmonize the Qi and/or Dispel Stasis from the Middle Palace. If the bladder was completely normal, but the infection was refractory, then it's possible the liver was blood deficient, calling for more circulation using a formula like Lift the Qi (Galvanex from Gold Standard Herbs) If there were crystals or stones in the urine, then a formula that is anti-inflammatory to both the liver and bladder is called for, like Four Marvels Combination. All of these are Kan Essential formulas. Hopefully your veterinarian gave you enough information to figure out what might be most helpful. Meanwhile, though, the diet you have found your way to should help in all those situations 

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 Hi Dr. Steve, my four year old Bolo has had mildly elevated liver enzymes since I got her at six weeks and recently elevated bile acids. The post bile was 111 from a different lab and after two blood draws ten minutes apart. She was definitely upset with it. She is on supplements and no meds and the ALT hasn’t worsened since the beginning. A surgical biopsy was recommended during a spay even though two ultrasounds showed nothing alarming. What treatment would you recommend in the future for the liver? She’s been on Adored Beast Liver Tonic and recently RX Vitamin Hepatic. I just read here about Chinese herbs that helped so much. She whimpers occasionally when I pick her up and sometimes I have to hand feed her gently cooked rotated raw. She appears lively and happy. Just trying to avoid unnecessary surgical trauma. Do you recommend the Cornell protein test to definitively conclude hyperplasia? Many thanks for your help. 

Dr. Steve's Advice -  I personally think you have enough information to go ahead and treat on the assumption this is microvascular dysplasia. From a Chinese medical point of view, the weak appetite and discomfort when picked up (presumably from a twinge of pain along the ends of the ribs) suggests a Liver Blood tonic like Happy Wanderer will help. You can get that from Kan Essentials, which Aleksandra Topic is a distributor for. You can contact her at aleks.topic1@gmail.com

It should only take a few weeks for improvements to occur. As for added testing, if it is in aid of rendering effective treatment, then it's a good idea. I'm not sure what the plan would be for confirming nodular hyperplasia If there is none, then you might as well 'diagnose through response to treatment' and get started on Happy Wanderer

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Hi Dr. Steve. It's me again. Sorry for all the long posts. 

I just repeated my dog's blood test and his liver enzymes are very concerning.
Last May of 2022, his liver enzymes were 294. Then in Jan 2023, his liver enzymes were at 487. He was struggling with a UTI at this time. This is where we had to try amoxicillin, cefpodoxime, and finally doxycycline, which worked. But this took 6 months. He has been on denamarin since February 2023 after I got worried that he's been on antibiotics for so long. 

Despite this, in June 2023, after all the antibiotics, I got another blood test and his liver enzymes shot up to 1211. This is when I started him on a fresh (cooked diet). Daily, he gets 300-350g cooked protein + 250g of cooked veggies + 200g of cooked carbs with 1/2 teaspoon eggshell.

Yesterday (2 months later), I got another blood test and now, his liver enzymes skyrocketed to 2050. Also, now, his thyroid levels that were being treated with 0.6mg of Thyrotab 2x a day, skyrocketed to 3.5.

Is it the new food with eggshells? I try to keep a minimum of 2 hours before and after taking Thyrotab to give him his meals with the eggshells since it's so high in calcium. The next day, I started giving him just 0.3mg 2x a day as that was what he initially started with a year ago (we had increased it steadily to get it higher as 0.1mg x 55lbs wasn't enough). 

My questions are: 

1) do you think it was the calcium from eggshells that made the Thyrotab absorption erratic? And do you think cutting it down would help?

2) what can I do for his liver enzymes? He has increased thirst but his appetite is strong. 

One other thing that I saw in the blood work that I think might be related to his liver enzymes is that, for the first time, his RBC, MCV, Hemoglobin are slightly low. 

The first two pictures are the blood tests from January 2023, the 3rd and 4th pictures are from 

Dr. Steve's Advice -  liver enzyme elevations worse in summer generally indicate Damp Heat, or else Shao Yang disharmony. The high platelets suggests Shao Yang disharmony is more likely, calling for a formula like Voltrex (https://goldstandardherbs.com/products/Original-Voltrex-85g-p647327438) from Gold Standard Herbs.

Now if you're tying it to the big bump in dietary starch content, then it may be Damp Heat, calling for Four Marvels. If in doubt, you can try both together. You should expect to see appetite and thirst normalize. If you don't have Four Marvels, you can access it through Aleksandra Topic at aleks.topic1@gmail.com

As far as the calcium having a bearing on the thyroid, I don't think that is enough to explain the T4 increase. Glands hypofunction if they are inflamed. If the thyroid inflammation subsided for some reason, that would be enough to cause a hike in T4 levels. I'm assuming that is what happened here, and that it is a positive development.

Hopefully this helps you out!

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Hello Dr. Steve,

My now 1 year old Yorkie Luna had surgery for Congenital extrahepatic portosystemic shunt 7 weeks ago.  She also has a small liver and enlarged kidney. The only symptom she had was neurological back in April before she was diagnosed. We switched her to an all vegan diet and she has flourished. She’s full of live and energy. We did a 6 week post surgery bloodwork and bike acid test. Her bloodwork shows all her levels are now normal. She no longer had bilirubin crystals in her urine but her bile acid levels have not changed. They are the same as they were before her surgery. Is there anything I can do to help that?
She’s on on lactulose and a liver & kidney support supplement.

Dr. Steve's Advice -  

something that can support both liver and kidney blood flow to help them do their jobs better (resulting in lower pre- and post-bile acids) is Glehnia and Rehmannia from Kan Essentials. You can source that from Aleksandra Topic using the instructions she provides here: https://www.facebook.com/groups/1158575954706282/posts/1420037418560133/

It improves microcirculation in the liver, which the surgery can't really address.

Hopefully this helps you out! I'm so glad your dog is doing better!

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