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Altered liver enzymes - cause for concern
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Rio de Janeiro, Brazil
Member Since:
17 May 2014
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24 May 2015 - 6:30 pm
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Johnnie has just completed 1-yr post-amp for OSA.  He handled 6 rounds of chemo (carboplatin).

The current protocol up to one week ago was K-9 Immunity (6 a day) and Apocaps (5 a day).

Two weeks ago he had a back injury, ended up at the vet for and was prescribed 5 days of Maxican (NSAID).  The day he was over the vet ran a blood test, and the liver enzymes were elevated.  His oncologist asked for a second blood test, which showed the same situation, and for an ultrasound of the liver.

Liver is clear, no clinical sign of any liver problems, but the alkaline phosphatase, which in January was 113, now is over 1.300.   I started giving Apocaps around Christmas, and last month increased the dosage from 3 to 5 capsules a day, in a single dosage around bed-time.

The vet prescribed some medication for the liver, and we agreed to stop the Apocaps for two weeks and then recheck the blood.  In Dr. Dressler's book there is a small reference to the fact that Apocaps has similar effects to NSAIDs, which are known to affect the liver.

Here is his blood exam:

https://drive.g.....sp=sharing

Anyone had similar issues?

Am wondering if it would be a good idea to rotate Apocaps with Artemisinin , and if Arte is less harmful to the liver.

Daniela & Johnnie

Our awesome Golden Boy was diagnosed for OSA in April 2014 in the proximal humerus, front-leg amp on 05/20/2014. Finished chemo (Carbo6) on 07/10/2014. Ongoing treatment: acupuncture + K-9 Immunity Plus ( 3chews) and home-cooked no-grain diet.   Stopped Apocaps because of liver issues.   Liver issues: controlling altered enzymes with SAM-e and Milk Thistle.  October 17:  started having seizures.  Taking fenobarbital for seizures.  April 18: started prednisone.


Member Since:
22 August 2008
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26 May 2015 - 1:25 pm
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I would not be too concerned with these results because the ALT is only 104 and the bilirubin is normal.  These two enzymes are specific for the liver.  The AlkPhos is an enzyme that is also present in bone and muscle and that is frequently elevated with non-liver issues.  I usually don't worry unless the ALT is over 2 to 3 times normal.  The fact that the ultrasound is normal helps rule out cancer of the liver.

I would give denamarin or some other liver support that contains milk thistle and SAM-E.  Recheck the liver panel in 1-2 months.  I have not used Apocaps myself so I can't comment on that but I would not be afraid to use NSAIDS in a dog with these values.

Pam

Virginia







Member Since:
22 February 2013
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26 May 2015 - 2:44 pm
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Hey Daniela and Johnnie.....Jist saw this and Dr. Pam's feedback. And I like her feedback!!

Don't have any insight I to Arte. versus Appcaps. Dressler and Ettinger used to have a website and you could ppst wuestions. I think they still do. The Dog Cancer blog. Although I did buy the Arte., I ended up just sticking with the Apocaps and the K9 Immunity Plus.

Sorry about Mr. Johnnie's back injury, but glad he healed just fine. So many tweaks and strains can happen ince they become a tripawd.

We sure go use a swimming video of Johnnie to help cool js off! Hint!

Love to all!

Sally and Alumni Happy Hannah and Merry Myrtle too!

Happy Hannah had a glorious additional bonus time of over one yr & two months after amp for osteo! She made me laugh everyday! Joined April's Angels after send off meal of steak, ice cream, M&Ms & deer poop!

Rio de Janeiro, Brazil
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17 May 2014
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30 May 2015 - 1:31 pm
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Thanks so much for the advice, Pam.  The vet has prescribed Milk Thistle and some other medication for 30 days, and then we are redoing the blood work.

The previous exam, dated May 13, had showed altered bilirubin and ALT 673!  One week later we already had ALT at 104 and normal bilirubin.  The vet is still questioning what caused this liver alteration, since there is no visible tumor (fortunately) in the liver. 

I am VERY scared of this rapid increase in the Alkaline Phosphatase, since at the time of the surgery it was around the 100s, totally normal.  

Anyway, I decided to stop Apocaps for two weeks to give his organism a break, but will reintroduce it starting next Wednesday.  

It has been a rough year for this furry guy.  Bumps in the road are expected, but we are never prepared.

thanks again,

Daniela

Our awesome Golden Boy was diagnosed for OSA in April 2014 in the proximal humerus, front-leg amp on 05/20/2014. Finished chemo (Carbo6) on 07/10/2014. Ongoing treatment: acupuncture + K-9 Immunity Plus ( 3chews) and home-cooked no-grain diet.   Stopped Apocaps because of liver issues.   Liver issues: controlling altered enzymes with SAM-e and Milk Thistle.  October 17:  started having seizures.  Taking fenobarbital for seizures.  April 18: started prednisone.


Member Since:
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31 May 2015 - 1:16 pm
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It sounds like there was some sort of acute liver inflammation or infection.  The good news about the liver is that it can heal by regenerating new tissue.  It seems like he is making a good recovery.

Pam

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