Lymphocytic Portal Hepatitis aka Cholangiohepatitis?

[KimmyD]

Hello everyone,
I haven't posted in many months. Halo (6 y/o male, FIV+, diabetic since July 2011, Prozinc 4 units 2x day) has been doing fairly well all things considered.
However last month he had a dental and his ALT was elevated in the 300's, I just took him yesterday for and ultrasound & liver asipirate, his ALT is now in the 500's.
My internist is thinking that it's Lymphocytic Portal Hep but sent the slides for further testing as there were a VERY few suspicious cells & he wants to rule out Lymphoma (now THAT'S a word you really don't even care to have spoken).
For the past month, I've been sneaking some Milk Thistle into Halo's water (alas his ALT is obviously still rising). I won't know until Monday (way to spend a wonderful weekend) if lymphoma can be ruled out. The doctor put him on Simplicef so we can start treating as though it is the bacterial inflammation.
I'm just wondering if anyone has experienced this & has any further info, suggestions ect.
Thank you so much for any input.

 

[pamela and tigger]

Hello everyone,
I haven't posted in many months. Halo (6 y/o male, FIV+, diabetic since July 2011, Prozinc 4 units 2x day) has been doing fairly well all things considered.
However last month he had a dental and his ALT was elevated in the 300's, I just took him yesterday for and ultrasound & liver asipirate, his ALT is now in the 500's.
My internist is thinking that it's Lymphocytic Portal Hep but sent the slides for further testing as there were a VERY few suspicious cells & he wants to rule out Lymphoma (now THAT'S a word you really don't even care to have spoken).
For the past month, I've been sneaking some Milk Thistle into Halo's water (alas his ALT is obviously still rising). I won't know until Monday (way to spend a wonderful weekend) if lymphoma can be ruled out. The doctor put him on Simplicef so we can start treating as though it is the bacterial inflammation.
I'm just wondering if anyone has experienced this & has any further info, suggestions ect.
Thank you so much for any input.

You know Kimmy, it sounds like you and your vet are right on top of things. That is so important. Tigger had very high liver enzymes about five years ago and was diagnosed with Cholangiohepatitis in the spring of '07. He was much older than your Halo, and his liver values were very high, much higher than Halo's.

But Tigger is still with me and doing well in all areas. I think the one thing that helped him the most during his treatment period was giving him Ursodial (Actigall). This helps to improve the flow of bile. Your vet can get it compounded into a fish (or whatever) flavor and mix it into his food.

http://www.veterinarypartner.com/Content.plx?P=A&A=549&S=0&EVetID=0

Increased bile flow
When the liver is healthy, small amounts of toxic bile acids get reabsorbed into the liver and are dealt with promptly. When the liver is not healthy, these bile acids build up and damage the liver further. Ursodeoxycholic acid is what is called a choleretic, which means it improves the flow of bile through the tiny ducts into the gall bladder and improves the flow of bile from the gall bladder into the intestine. In other words, it helps the flow of bile, which in turn facilitates the removal of toxic bile acids as well as other toxins excreted in bile from the body.

Ursodeoxycholic acid also appears to have beneficial effects in normalizing immune reactions in the liver and may be useful in the treatment of cirrhosis and chronic active hepatitis.


Anyway, you can see what exactly we did in my Profile starting in the spring of '07 - Tigger's liver values were so bad that he didn't need any insulin at that time, which was really unusual since he had already been diabetic since 2003 and is still diabetic today.

I am sure Halo will be fine. Do continue with the Milk Thistle (Denamarin combo is what we use), and get periodic bloodwork done to recheck Halo's liver values. Work closely with your vet and ask lots of questions. If I hadn't suggested going with the Ursodial at the time, I don't think my vet would have gone that route. But now it is more commonly used.

 

[BJM]

Something to discuss with vet/consider:

His digestion may be a bit off with the liver issue - would adding some digestive enzymes to the food help or hinder? They do make pet specific ones available over the counter.

Digesting fats may go better if there is a bit of lecithin added to the food. This is naturally found in egg yolks or may be bought in supplement form. Lecithin helps emulsify fats, ie , hold them in little tiny particles suspended in digestive liquids that can then be absorbed through the intestinal tract.