Poorly Jack-Liver Disease

pulliptears

Well, he is not a Cushings dog.

I'm both relieved and saddened by this. He is now in for one last test next week (which involves bloods and feeding him apparently to test his liver functions) then they want to do an exploratory operation.

I have no idea what to do now, I plan on making some calls tomorrow to specialists and see if they can offer any inkling as to what is going on. In the meantime, Jack has an infection in the pads of his paws which is probably all linked in to this somehow. I can see him getting worse by the day and I don't know what to do now

Tulip

aw sorry to hear about Jack's prognosis Pupiltears

*hugs* to you and the family and of course Jack.

hotcookie101

pulliptears wrote: »

Well, he is not a Cushings dog.

I'm both relieved and saddened by this. He is now in for one last test next week (which involves bloods and feeding him apparently to test his liver functions) then they want to do an exploratory operation.

I have no idea what to do now, I plan on making some calls tomorrow to specialists and see if they can offer any inkling as to what is going on. In the meantime, Jack has an infection in the pads of his paws which is probably all linked in to this somehow. I can see him getting worse by the day and I don't know what to do now

I'm sorry to hear about your dog, he sounds like a very complex case! it does sound like the PDSA are being very thorough, which is good, as they have a limited budget for tests

I'm not sure if any specialists will talk to you directly though-as they should only do so via a referral from your vets (our code of conduct is quite clear we shouldn't see cases without informing previous vet, and specialists/referral practices generally only work via referral from a first opinion practice, and a lot of people would be very wary of giving advice over the phone, especially if not a client of theirs-blame the litigation culture coming over here ) You could ask your vets to ring a couple of people-where are you based? If you could afford a referral for a consult they would go through everything already done, but I don't know if you could then go back to the PDSA-I would check with them. Most specialist consults are approx £200+VAT

Is the skin problem scaly? The bile acid stim is a good idea, we can see skin problems with liver disease (hepatocutaneous syndrome) but thats pretty serious, so hopefully its not that
If they are thinking of a liver biopsy I would ask them if they are happy with his clotting, as we usually do a coag profile prior to sx (they may have already done an in house version of this-which is much cheaper and can give you a good idea if they clot properly) as liver disease can cause lack of clotting factors.

pulliptears

Hotcookie, after some research last night I discovered an article on heptocuteaneous syndrome and I was devastated to read that almost every symptom jack has is a match. My plan of action for today is to take a copy of the article to Kate our vet and ask for a skin scraping.

**edited to add**

He's having some tests on wednesday prior to the operation, however, my feelings at present are that a skin scraping will reveal heptocuteaneous syndrome. If this is the case then an operation is not something I would put him through and palliative care would be my choice. To be honest he's pretty low at the moment with scaly eyes and paws and not really moving around. We are facing up to the fact that we are probably going to lose him.

I've called our vet and she's reading up on the syndrome as I type. I'll keep this thread updated.

hotcookie101

pulliptears wrote: »

Hotcookie, after some research last night I discovered an article on heptocuteaneous syndrome and I was devastated to read that almost every symptom jack has is a match. My plan of action for today is to take a copy of the article to Kate our vet and ask for a skin scraping.

**edited to add**

He's having some tests on wednesday prior to the operation, however, my feelings at present are that a skin scraping will reveal heptocuteaneous syndrome. If this is the case then an operation is not something I would put him through and palliative care would be my choice. To be honest he's pretty low at the moment with scaly eyes and paws and not really moving around. We are facing up to the fact that we are probably going to lose him.
I've called our vet and she's reading up on the syndrome as I type. I'll keep this thread updated.

Unfortunately you need a biopsy to diagnose it-a skin scrape won't show it as it only looks at the surface. They may be able to do a punch biopsy with local/biopsy punch &skin staple if he's a VERY well behaved pooch, but they generally need sedation at least (local STINGS )

Is he having the bile acid stim test done on wednesday, or is that done monday, and potentially surgery wednesday?

Try to keep upbeat for him-I know its hard, but they really do pick up from us when we are worried. It helps to be prepared, but also try to keep positive.

I hope its not hepatocutaneous syndrome

pulliptears

hotcookie101 wrote: »

Unfortunately you need a biopsy to diagnose it-a skin scrape won't show it as it only looks at the surface. They may be able to do a punch biopsy with local/biopsy punch &skin staple if he's a VERY well behaved pooch, but they generally need sedation at least (local STINGS )

Is he having the bile acid stim test done on wednesday, or is that done monday, and potentially surgery wednesday?

Try to keep upbeat for him-I know its hard, but they really do pick up from us when we are worried. It helps to be prepared, but also try to keep positive.

I hope its not hepatocutaneous syndrome

He's having the test on Wednesday, no date has yet been booked for an exploratory Op. I'm assuming its a bile acide stim test he's having? She said she wanted to see how his liver was functioning and she was going to feed him then do some more tests so that does sound like the bile acid test.

We do know at present he is utterly fed up. I think we may take him to the beach tomorrow, not that I think for a moment he'll run and play but I think getting out may do him (and us!) good. I've bought him some scratch mitts from Tesco which he's happy to wear as socks so they will stop anything going into his paw pads.

hotcookie101

pulliptears wrote: »

He's having the test on Wednesday, no date has yet been booked for an exploratory Op. I'm assuming its a bile acide stim test he's having? She said she wanted to see how his liver was functioning and she was going to feed him then do some more tests so that does sound like the bile acid test.

We do know at present he is utterly fed up. I think we may take him to the beach tomorrow, not that I think for a moment he'll run and play but I think getting out may do him (and us!) good. I've bought him some scratch mitts from Tesco which he's happy to wear as socks so they will stop anything going into his paw pads.

Yep that sounds like the bile acid stim Sorry, I misunderstood when you said he was going in for his operation on wednesday.
Take him to the beach, it will certainly do YOU some good, try to relax and yourselves, he will pick up on an improved mood-I think dogs are very sensitive to our moods. (unlike cats, who just couldn't give a !!!!-well, certainly mine doesn't :rotfl:)

Padstow

pulliptears wrote: »

Hotcookie, after some research last night I discovered an article on heptocuteaneous syndrome and I was devastated to read that almost every symptom jack has is a match. My plan of action for today is to take a copy of the article to Kate our vet and ask for a skin scraping.

**edited to add**

He's having some tests on wednesday prior to the operation, however, my feelings at present are that a skin scraping will reveal heptocuteaneous syndrome. If this is the case then an operation is not something I would put him through and palliative care would be my choice. To be honest he's pretty low at the moment with scaly eyes and paws and not really moving around. We are facing up to the fact that we are probably going to lose him.

I've called our vet and she's reading up on the syndrome as I type. I'll keep this thread updated.

I'm following you pullpittears and cheering Jack on, though I have a heavy weight in my heart, as I too looked at what you saw.

Seeing a picture of Jack makes it all too real. I have been there. We have all been there on the pet forums.
Have a good day at the beach Jack. One thing's for sure Jack, your mum and dad love you to bits.:A

pulliptears

The vet called me this afternoon, she'd been reading the paperwork I dropped in on heptocuteaneous syndrome and she did tell me she'd considered it. She went on to explain that before working at the PDSA she spent several years in a referral clinic so saw all manner of weird and wonderful cases, including 2 cases of hepto, which is 2 more than your average vet.

She said she did agree that a great deal of Jacks symptoms fit, but she also went on to say that a good deal of his blood results dont and that she would still consider other things before this. The upshot was we decided to go ahead with the bile stim next week and get him into surgery.

He seems livelier this afternoon, he's still eating well and his paws seem a lot less swollen and sore today. He's fighting so we'll fight all we can and enjoy whatever time we have now.

MrsAtobe

(((Hugs))) for both you and Jack.