Biopsy Next Step for Dog’s Ailing Liver

Q. My 2-year-old Beagle, Smoke, was diagnosed with liver disease three months ago. The vet gave us some medication for the liver and thyroid medicine. I also put Smoke on milk thistle. We have been feeding him boiled chicken, venison, potatoes, intestinal canned food from the vets, and cottage cheese. He was doing really well until a week ago when he stopped eating cottage cheese. That was the only way I could disguise the canned food. Now his appetite is not good at all, and I noticed that his ears are yellow again. He won’t take his medicine, sleeps a lot and is not acting like himself. Is there anything else I can try? The vets didn’t even think that he would make it this long. Any help would be appreciated.

A. I am sorry to hear about Smoke’s liver failure. As a 2-year-old, he is way too young to have such a life-shortening disease.
 
You noticed that his ears are yellow. Jaundice is the yellow tint the skin acquires when the liver is not functioning well to clear bilirubin, a breakdown product from red blood cells, from the bloodstream.
 
Jaundice is most apparent in the gums, the white portion of the eyes and the inside of the ears.
 
Treatment for generalized liver disease, or hepatitis, usually consists of antibiotics, steroids (like prednisone), and other supplements such as milk thistle, SAM-e, and vitamin C. If your dog is not already on steroids, ask your veterinarian about adding that to the regimen.
 
To accurately diagnose liver disease and get a diagnosis more specific than hepatitis, a biopsy of the liver should be done and examined by a veterinary pathologist. A biopsy can be obtained by using an ultrasound for guidance, during exploratory surgery, or by laparoscopy, a noninvasive surgical procedure.
 
Ask your veterinarian about a liver biopsy, and adding other medications such as prednisone, and possibly a referral for a second opinion from a specialist.
 
Good luck to you and Smoke.