Other than his bloodwork abnormalities, is his only other problem not being able to go to the bathroom? Is he acting normal? Is he bright and alert? Is he eating and drinking? You said your vet put him on Amoxi 150 mgs and sent him home to die? Why did she think he was going to die? Also, has your dog been on Immuran and Dexamethasone consistently for the last 4 years?

Lizwiz,

Ok. So I reviewed the other question you posted. It appears that your dog has not been eating well for a few days. If this is the case, he may not have to go to the bathroom. So, he may not be constipated, it may just be that there is no food in his stomach/intestines, and therefore he doesn't have to go. Are you seeing him strain when he's trying to go to the bathroom?

Regarding his liver enzymes. Both Immuran and Prednisone can elevate the liver enzymes. The good news is that usually the liver enzymes can return to normal once the medications are stopped. The liver is one of the only organs in the body that can heal itself fairly well. Has your regular veterinarian done an ultrasound on your dogs liver to eliminate other causes? If not, I would request one.

Also, if your dog is drinking well, that is a good sign. I would offer him as much water as he wants. You can also try to boil white rice and mix with Gerber chicken baby food and a pet vitamin. I remember you cooked for him before, which was good. Just make sure you don't feed him anything too high in fat or you could cause other problems. Stick with rice and chicken or rice and chicken baby food.

Since he has been taken off of his medications, he could have a relapse of his skin condition, but this is the least of our worries right now. We need to get him back to eating again.

I think there is some hope for your dog. I would not give up on him yet. I would continue to feed him water and cook for him as I described above. I don't know how much money you have to spend on him, but if he doesn't seem to be improving over the next 5-7 days or if he seems to get worse at anytime, the best thing for him would be to be hospitalized and on IV fluids to ensure he does not get dehydrated.

While his problems could and probably are related to the Immuran and Prednisone, I think it is very important for an ultrasound to be done of his liver. Other things (such as liver cancer) can cause the liver enzymes to be high. Did they measure his ALT on his bloodwork? Do you know what his ALB (albumin) was on the bloodwork? Do you know what his PCV or HCT is on the bloodwork? If so, I would like to know. Does your dog have red spots anywhere on his abdomen, ears, or gums?

Will your dog get up and walk around, or is he just lying around the house depressed all day?

Dr. Wendy

Lizwiz,

It sounds like you have been through a lot. I am sorry to hear you've had a tough time lately.

$2380 is alot of money, especially if you are on a set income. I know you are trying hard to manage things on your own, but if your dog (I don't know his name) is not eating or drinking, and refuses the chicken and baby food tonight, then you may need to have him hospitalized for the best chance.

One thing that concerns me is that he was eating fine a few days ago after his bloodwork was done, but now he is refusing food (and water too now). He was receiving a steroid (dexamethasone) every 4 days, and that was withdrawn because of his elevated liver enzymes. I will try to make as much sense as possible here...

Sometimes when you withdraw steroid medications like dexamethasone without tapering off the dose first, you can end up with problems as well. The steroid will not kill your pet, although it will cause the liver enzymes to go up over time. The immuran is more likely to cause true liver damage than the steroid. With this said, I would recommend giving your dog half of his normal dose of Dexamethasone, and letting me know if he improves within 24 hours of giving him this. If it does help, then he may have stopped eating because of the sudden withdrawl of the dexamethasone. You may need to taper the dose of dexamethasone slowly over the next 3 weeks or so. I can tell you how to do this if your dog improves after giving 1/2 his normal dose of dexamethasone tonight. Sometimes pets can become Addisonian (search on the web for this) if steroids are withdrawn without tapering. When a dog is Addisonian, he can become weak, refuse food, and have vomiting.

From what I remember, your dog was on a low dose of dexamethasone and it was only every 4 days, which isn't too terrible. But certainly because he's been on Dex for 4 years, he might be experiencing a lack of appetite from sudden withdrawal of the medication. It seems like he lost interest in food about 4-5 days after you stopped the medication (which was just when the next dose of Dexamethasone would be due). Tell me if I am wrong on this.

My advice is this:
Give 1/2 of his normal dose of Dexamethasone. Try to get him to eat or drink. Remember he needs more water each day than you think. A small 20# dog normally needs 300-400 mls of water each day. It may be hard for you to get your dog to drink enough water with the turkey baster each day. However, if you can get him to eat the rice and baby food, then that will help.

Thank you for the complete update on the bloodwork. I have seen liver values higher than your dogs. An ALT in the 500's is high, but may still be manageable. The PCV is the same thing as HCT.

I have 2 questions for you:
1. Is your dogs skin yellow?
2. Did you notice any red spots on your dogs skin?
3. Is your dog really depressed? Or does he still seem bright and alert?

Talk to you soon,
Dr. Wendy