Minou food trial failed, biopsies scheduled

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Karen & Angus(GA)

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Quick recap - known problems are seasonal allergies, FLUTD, and a life long history of vomiting an average of once/week. Her liver enzymes have been elevated for 15 months now. We tried a 3 month course of denamarin which did lower her liver enzymes some, but not into the normal range. She also lost a pound during those three months and had a low USG for the first time. My regular vet recommended an abdominal ultrasound because we didn't know what we were treating. We went to an internal medicine specialist for the ultrasound on 4/23. The IM specialist did not see any abnormalities with the liver or pancreas, but did see diffuse thickening throughout the intestines. She recommended bile acids and GI panel tests. Those were also done on 4/23. Bile acids, fPLI, folate, and B12 tests all came back normal. The IM vet said it could be IBD or lymphoma and that the intestinal problems could cause elevated liver enzymes by allowing bacteria and their toxins into the body that the liver would then have to filter out. We discussed "novel protein" diets and the possibility of a biopsy. She was leaning towards IBD and her recommendation was to try a 4 week "novel protien" diet trial with the success criteria being stable weight and no vomiting. We stopped the denamarin so that we would know for certain that it was the diet making a difference. She has been eating nothing but d/d vension since 5/1. Her weight was stable at the four week mark, though the vomiting was the same, so we planned to continue the diet trial a for another 4 - 6 weeks to determine if it was helping her liver. Well, she then scratched her forehead raw and had Tresaderm drops and chlorpheniramine for two weeks (and four doses of cephalexin, none of which stayed down). Last doses of meds were last Thursday morning. We had an ear recheck, blood work, and urinalysis done Tuesday. Her liver enzymes are much higher (ALT was 225, now 700; AST was 54, now 195). Kidneys were fine, USG back to 1.032.

So, talked to her internal medicine vet. They want to do exploratory with biopsies to liver and intestines and possibly stomach and pancreas. Surgical consult is 7/7. Surgery is 7/8. I am very worried. I lost Angus to lymphoma in March.
 
sorry you guys are going through this. I have no advise to offer but healing vines and whit light and snowflakes and hopes that it turns out to be something easy to treat. maybe jess can give you some insight into this
 
Ugh, I'm sorry Karen, it sounds like you've tried all of the non-invasive options. Is there anyone in the area that can do the surgery laprascopically? This is how I did my dog's liver biopsies -- a few teensy incisions and home the same day.

Keep us posted.
 
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