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Luna's Health (and possible liver issue)

1404 Views 14 Replies 7 Participants Last post by  PeggyTheParti
Our wonderful 11.5-year old spoo Luna hasn't been feeling too well and so I thought I'd get some thoughts on the forum. This is going to be a bit of a long post, so I just wanted to warn you now.

To give you a bit of background, Luna has always been like a "tank". Nothing gets her down! Ordinarily. she LOVES to play, she wolfs her food down at every meal (and stares/begs for a lot more as dogs usually do) and then licks clean our other dogs' bowls. She runs downstairs at the sound of a peeling banana, loves treats and she'll wake up from a deep sleep just to shower you with kisses. She wags her tail like crazy and is the sweetest and most loveable creature you could imagine! This all changed literally overnight starting on 12/20. I'll try to provide a general timeline as best I can.

12/20: This was when her behavior changed so suddenly. She slowed down. She would eat, but much more slowly than normal. Instead of grabbing treats with "gusto", she'd take them very tentatively and often drop them on the floor and leave them. At first we thought maybe she had a problem with her teeth or there was something in her mouth, but she appeared to have no dental issues other than some tartar. She also started going down the stairs very gingerly. Prior to this date, she was playing with our other two spoos as usual in our living room one afternoon. They like to gang up on one another in "play mode", so our male Samson and younger girl Zoey like to tease. At one point, Zoey cornered Luna near the stairs and while there was no yelping, we think Luna may have twisted her neck due to the roughhousing and there may have been some kind of event/impact or body slam that may have injured Luna. We also noticed that Luna's ears were a bit dirty. Most of us probably know that ear infections are common with spoos and Luna has had quite a few of them throughout her life. But she'd never exhibited symptoms like these due to an ear infection. When we cleaned her ears, we just found some of that very light brown muck/debris around the outside but didn't realize that the infection was deeper (this has since been treated with Claro meds to dissolve the infection over a couple weeks).

12/21-12/24: During this period of time, Luna remained stable but was rather lethargic. She would spend a lot of time standing with her head down and to one side while panting and didn't want to lie down. The panting could have been related to general malaise and discomfort. Eventually she would lie down and find a somewhat comfortable position to sleep in, but she just wasn't herself. Her appetite decreased considerably and she just had little to no energy. I'm sure she must have been in pain, too, due to both her ear infections and whatever happened to her neck. It was killing me! It was during this period that I was trying to get Luna in to see a regular vet before resorting to emergency, but it was impossible being so close to Christmas. While I made a regular vet appointment for the following week (12/30), I really felt she needed to be seen before then, hence the trip to the emergeny vet.

12/25: So we spent Christmas day at a local emergency vet where they ran a battery of tests on Luna, including an entire blood panel, X-rays, and a general ultrasound to see if they could find something. $1,100 later, the relief vet found very little with the exception of (what they thought were) slightly elevated liver enzymes. Her other blood levels were normal at the time. They supposedly cleaned her ears, but our regular vet had to subsequently treat them properly the following week, so I'm not really sure what the emergency staff did or why they charged twice what a regular vet would for effective treatment.

Between 12/25 and 12/30, Luna's condition remained the same and we were told by the emergency vet to watch her and take her into our regular vet if she didn't improve over the next few days. She didn't improve very much. The emergency vet didn't want to give her any anti-inflammatory medication due to her symptoms. She continued exhibiting:
  • Lethargy
  • Loss of appetite (she'll usually eat once a day but no more)
  • Weight loss (probably due to the lack of appetite. She is usually around 59 or 60 lbs, but is now only 51.9 lbs)
  • Panting on and off with some occasional heavy nose breathing, but it's very intermittent and happens more often at night. Other times, she breathes normally. The vet has already taken note of this.
  • Favoring one of her legs when going down the stairs (could be attributed to her previous roughhousing, not sure).
12/30: We took Luna to our regular vet and he ran the same blood tests that were done a week earlier at emergency. It was good that our vet already had a baseline test from the emergency vet from which to compare the levels. Her liver enzymes went down 23% from their previous value which was a good sign and he wasn't concerned at the time, but he noticed a lot of debris and puss still in her ears. Obviously the emergency vet didn't treat those ear infections appropriately. So his staff treated the ear infections (properly with Claro). He also put Luna on both Gabapentin (for nerve pain related to her neck) and Methocarbamol (as a muscle relaxant/pain medication). This visit was around $350. Better than $1,100, but still no diagnosis. We kept her on these meds for several days and scheduled a re-check just this past Thursday (1/7).

1/7: Upon Luna's re-check appointment this last Thursday, our vet again ran the same bloodwork, but this time both her liver enzymes and CBC counts were elevated (particularly her white blood cells). That freaked me out because cancer would be at the top of the speculation list for the increases. Obviously, this concerns us a great deal and our vet too. In addition to the Methocarbamol and Gabapentin, the vet also added Tramadol for additional pain management. While these all appear to be safe for use with dogs that have some kind of inflammatory issue going on, I'd be lying if I said it thrilled me for Luna to be so drugged, as it's hard to tell whether her continuing symptoms are due, in part, to this combination of meds or whether they're having little effect. The most common side effect for all three medications is just drowsiness. She has been exhibiting most of these other symptoms since 12/20, so it's hard to tell if the meds are even helping much at all.

At this point, our vet wants to perform a more extensive ultrasound of her liver to see if he can find anything that would explain the elevated liver enzymes and WBC (white blood cell counts), which I think is important. We've scheduled the ultrasound for this next Tuesday so I can keep you all posted. My terrible fear is that it could be liver cancer or some kind leukemia or other auto immune disease. The lethargy and loss of weight/appetite are symptoms of liver cancer, as are jaundice, bleeding, diarrhea, etc. but Luna has not exhibited any of those other symptoms (i.e. yellowing of the skin/eyes/mouth or any bleeding of any kind). Her bowel movements are normal. She urinates regularly but not excessively. She keeps herself well hydrated but doesn't drink excessively, either. I know that excessive thirst can be a sign of liver issues, but she normally drinks a good amount of water from her bowl 2-3 times a day and that hasn't changed throughout her life.

What's so frustrating about all this is that after all the vet visits and stressing, there's still no clear diagnosis and I'm running myself crazy with speculation. This is one time when I wish I had a super power to talk to my pets so they could tell me EXACTLY what's wrong.

If it's cancer, then what is the explanation for all of these symptoms coming on literally overnight? Wouldn't something like cancer develop over a period of time? And why would her liver enzymes show slight elevation one week, go down the next, and then up again? Could her liver have been bruised due to roughhousing and maybe she twisted her neck at the same time and the ear infections were just coincidental? I just don't know.

Anyway, I'm sorry for going on so long, but I just wanted to share the experience and see if perhaps anyone else has experienced something similar with their spoo. Luna has been so healthy and animated her entire life that to see her just change so dramatically overnight is so disheartening and scary. However, she is 11.5 years old and I understand as much as anyone that a spoo of this age is bound to start having some issues. All I can do is hope that her condition is something that can either be managed and/or perhaps even reversed with time. I just want my happy girl back again. It just makes so little sense to me that cancer would just appear out of the blue overnight with no explanation or prior manifestation, especially in an organ like the liver. If there is something that has been affecting her liver for some time without our knowledge (which makes very little sense because we're on top of our dogs all the time and immediately notice any behavioral change), wouldn't she have started exhibiting some of these symptoms earlier and over a gradual period of time? I'm not a vet, obviously, so I can't diagnose her correctly, but this whole thing just seems weird to me. Plus, you'd think the emergency vet's ultrasound would have picked something up back on 12/25, especially if it were cancer. I guess I'll just have to wait to get the results of her liver ultrasound next week...
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I’m so sorry to hear this. Poor Luna. :(

I can only speak from personal experience with my girl Gracie. I do see overlap in their symptoms, but I’m sure many are just universal pain symptoms.

For Gracie it was her teeth, first and foremost. She, like Luna, got a clean bill of dental health, but after x-days and under anesthesia, it became apparent there was a lot doing on under the surface. She had almost a dozen teeth pulled and was like a new dog after.

The teeth symptoms appeared abruptly: Dropping food from her mouth/reluctance to eat. Holding her head/neck low. Panting. Spontaneous yelping/trembling. “Drunken” unsteady gait. Lethargy/general malaise.

I truly thought she was dying and had to put full faith in our vet. I believe she was 11 when this happened.

Meanwhile, she was developing Cushing’s disease, which first showed up as elevated liver enzymes. But it wasn’t an overnight night thing. The Cushing’s symptoms came on slowly, beginning with increased appetite which eventually became almost frantic eating. She couldn’t get enough.

I’m not sure if any of this will be helpful to you. I hope others can weigh in. Just know that we’re here for you as you navigate this.

It’s so maddening not being able to ask them what’s wrong. They can suffer quite stoically without even letting on that they’re hurting, so it’s possible something was quietly going on for a while. Gracie’s teeth, for example, didn’t just suddenly get bad overnight. But the symptoms seemed to show up overnight. In retrospect, she’d been slowing down for a while and I just attributed it to normal aging. It wasn’t until the teeth were out and she was hopping around like a young dog again that I realized she’s been feeling bad for quite some time.

Sending hugs and hope.
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Hugs. I went through something similar with my boy Pogo. I knew he was feeling off, but I couldn't figure out why.

In his case an ultrasound revealed thickening of the stomach and intestinal walls: cancer.

Prior to the ultrasound I also (because I'm one of those annoying pet owners who spends too much time on the internet) asked my vet to run a blood panel for Addison's. Poodles, more than some breeds, have a relatively high rate of autoimmune issues. My vet was nice about it, and he was perfectly happy to accept my money, but I think he felt I should leave the diagnostics to the pros. He was right, as it turned out.
Poor girl, I’m so sorry she’s unwell. 😕
The only thing I have to add is my 14 year old dog has elevated liver enzymes, but they have been elevated since they started doing his senior blood work a few years ago and they don’t really mean anything in his case, we just watch them to make sure it’s not changing. I hope you have answers soon.
I’m so sorry to hear this. Poor Luna. :(

I can only speak from personal experience with my girl Gracie. I do see overlap in their symptoms, but I’m sure many are just universal pain symptoms.

For Gracie it was her teeth, first and foremost. She, like Luna, got a clean bill of dental health, but after x-days and under anesthesia, it became apparent there was a lot doing on under the surface. She had almost a dozen teeth pulled and was like a new dog after.

The teeth symptoms appeared abruptly: Dropping food from her mouth/reluctance to eat. Holding her head/neck low. Panting. Spontaneous yelping/trembling. “Drunken” unsteady gait. Lethargy/general malaise.

I truly thought she was dying and had to put full faith in our vet. I believe she was 11 when this happened.

Meanwhile, she was developing Cushing’s disease, which first showed up as elevated liver enzymes. But it wasn’t an overnight night thing. The Cushing’s symptoms came on slowly, beginning with increased appetite which eventually became almost frantic eating. She couldn’t get enough.

I’m not sure if any of this will be helpful to you. I hope others can weigh in. Just know that we’re here for you as you navigate this.

It’s so maddening not being able to ask them what’s wrong. They can suffer quite stoically without even letting on that they’re hurting, so it’s possible something was quietly going on for a while. Gracie’s teeth, for example, didn’t just suddenly get bad overnight. But the symptoms seemed to show up overnight. In retrospect, she’d been slowing down for a while and I just attributed it to normal aging. It wasn’t until the teeth were out and she was hopping around like a young dog again that I realized she’s been feeling bad for quite some time.

Sending hugs and hope.
Thanks so much for the reply, Peggy! I'm so sorry that Gracie had to go through that, but the symptom parallels are quite interesting. Our first thought was that maybe this was a dental problem, but you'd think that would have shown up on the x-rays. The weird thing is that she eats her breakfast and seems somewhat interested in the morning, though she likes a lot of softer stuff these days (e.g. cooked salmon, sweet potato). She'll eat the kibble too, but isn't as interested in that. If nothing is found on the liver ultrasound, maybe I'll ask my vet if a dental x-ray might reveal something. She had her teeth scaled in the last year, but we haven't been doing it every single year. The vet mentioned back in August that she does have some plaque buildup and should probably have her teeth scaled again, but he didn't mention anything other than typical tartar buildup that is common.

But this information was definitely helpful because I wouldn't have necessarily attributed her symptoms to that. I will definitely bring it up with the vet on Tuesday.
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I wonder if a cracked tooth and sudden onset dental pain could account for her behavior? I think it’s reasonable to continue to investigate dental issues.

Another less happy idea is a cancer related issue such as leukemia. As the immune system degrades from the impact of this cancer something eventually gives out and you see infections, skin breakdown, or other off the wall symptoms that can be traced back. But so far nothing has been traced back- so that’s good.

I am so sorry for you and Luna. She clearly is not feeling like herself, and I hope it is something easily addressed like a tooth or jaw issue. She is very fortunate to have your love and all the veterinary care you are providing for her. Many warm thoughts and hope for the best. Please keep us updated.
Thanks for the replies. So we're taking Luna back to the vet tomorrow for a liver ultrasound. The poor girl just hasn't improved much. We also noticed some dried mucous discharge around her nose this morning, which could definitely be related to an infection. She does have a loose tooth in between her lower canines, but our vet called today and said that he doesn't believe her issue is specifically related to a dental problem. Nevertheless, he will check her mouth anyway. I suppose I'll have to trust the vet that he's looking at these elevated liver enzymes from a different perspective. I just don't understand why these symptoms came on so fast, basically overnight. While she has not been getting worse, she isn't much better, either which has me really concerned. I really hope that we can determine what the problem is. These symptoms just don't scream cancer to me, but then again, I'm not a vet. It's just really unnerving, as I hate seeing her in any discomfort.
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I’m glad you’re pushing him to explore all possibilities. Does he know what caused the loose tooth? Could she have been injured somehow, maybe during play? I feel so bad for both of you. :(
I’m sure you’re googling like crazy right now, but in case you didn’t see this...

“Many dogs with dental disease have elevated liver enzymes. In this case, the bacteria have migrated to the liver, causing infection and tissue damage.”

Thanks again for your replies. Our Luna is doing better now. She's not 100% yet and still has some mild panting and minor neck stiffness, but she's definitely made significant improvement since my last post. Our vet has been keeping in touch with us every few days, which is much appreciated. Her liver ultrasound revealed nothing serious other than normal signs of aging, but we think her issues were due to a combination of things, including ear infections, some signs of dental disease (a couple of loose teeth), and the neck injury, which was most likely sustained during play. Just a lot of things happening at the same time.

We are going to schedule a dental scaling ASAP, but our vet has been really pleased with her progress. We still have her on Gabapentin and Methocarbamol for pain and inflammation, and we also have her on Rimadyl chewable tablets and Clindamycin to clear up infection. The vet also gave us some eye drops to help clear up the goopy eyes. She had some dried mucous around her nasal passages and goopy eyes before our last appointment. This has also improved a lot since. It seems like a lot of meds (which I don't like), but most are relatively mild and safe to use in conjunction.

Her appetite is also slowly returning, which makes me so happy. She's at least eating both of her meals again. Our angel needs to gain back several pounds and hopefully she'll be back to her normal self in a couple of weeks. But I don't want to rush it.

This just really threw me for a loop considering she'd been so healthy for so long and it seemed like nothing could get her down. It's hard to believe our girl is already 11 years old, since she usually acts like a 3-year old dog.
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Since you think she may have suffered from a neck injury, and the symptoms came on suddenly, maybe you should contact a vet chiropractor.
I’m happy to hear the pain medications are keeping her comfortable and that your vet has been so responsive. Will he be pulling those loose teeth?
So i I wanted to provide everyone an update on Luna's condition. We had her in for dental work about a week and a half ago. They pulled a few teeth, most of them very small ones and one premolar. The vet kept her on Clindamycin and Carprofen (Rimdayl), which she'd already been on previously before her surgery. For several days after her surgery, she seemed to be making some improvement, but now that she's been off the meds for 3-4 days, most of her initial symptoms are returning. This morning was the first morning in a while that she hasn't wanted to eat, she has once again started to pant a lot more, she often stands like a statue with her head down and slightly tilted, so her neck is obviously still an issue. When she drinks water, she'll stand over her bowl for several minutes, which means she's drinking quite a bit of water, but she doesn't do this all day. She'll go to her water bowl several times a day and drink quite a bit each time before stopping. So, I don't know whether to consider that "excessive" at this point or not.

The poor girl just isn't herself. While I know neck discomfort might explain her lack of appetite, the meds should have really helped that along over the last several weeks, but it's like she's made little improvement on that front.

Now, I'm starting to wonder whether she should have a pancreatitis and possibly a kidney test and/or benefit from some heat/laser therapy for her neck issue. We've already spent upwards of $3,000 since we first brought her to the emergency vet Christmas Day and she's been on meds constantly, which hasn't seemed to help much at all. So the answer shouldn't be just putting her back on meds. I just don't understand why she's not improving and why she should be completely dependent on pain medications after almost 2 months of treatment only to revert back to her previous decline as soon as she goes off them. I'm running out of ideas of what to try next.
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I'm really sorry to hear that you're going through this. It sounds like there's more going on than the neck injury, and I have no insight into what it could be or if it's treatable.

Some cancers develop quickly and are difficult to detect. A friend's spoo died of stomach cancer at age 11, and she wasn't diagnosed until after she stopped eating and underwent surgery to place a feeding tube. They spent several thousand dollars between the surgery and other diagnostic tests. The last week was rough for everyone.

I hope you and Luna aren't facing anything so dire.
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Poor girl and poor you. :( Sigh. These are the toughest puzzles to piece together.

Her pain meds weren’t increased at all after surgery? How strange that she briefly seemed to be improving.
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