Open Surgical Liver Biopsy!

This is long, but if you have the time and you can help, Please Read and Answer! Does anyone here, have any experience with or know anything about, “OPEN SURGICAL LIVER BIOPSIES”? I have 2 Chihuahuas who have Liver Disease. They are 1 1/2 years old. They are brother and sister, from the same litter! The vets have ruled out Toxicity and Genetic Problems with both of them. Zoe is 3.3 pounds and she has been fighting this for 1 year! Her ALT Levels are off the scales at 3500! The vet said, that she should have been gone 6 months ago, but she’s still a little Energizer Bunny chasing everyone around! Gizmo, was diagnosed about 3 months ago! His ALT Levels are off the scales at 2700! He plays with Zoe and my other Chi’s, like there is nothing wrong with him. I don’t know where either one of them gets all that energy they have! The vet can’t figure out, where this lousy disease came from. It seems to be a Mystery to him! Neither Zoe or Gizmo is acting sick or getting sick, they are both very active, not in pain according to the vet, eating, drinking, using the potty just fine, maintaining their weight, happy and acting like perfectly normal dogs. My vet told me, that if he had not seen for himself on the bloodwork, that they were both so sick, he would never have suspected that they were sick at all, by the way they act and look. He said they both look really good! I uploaded a recent picture of Zoe and Gizmo, so you can get an idea, of what they look like! My current vet, wants to do an “Open Surgical Liver Biopsy” and do some exploring while he’s in there on Gizmo, because he says that Zoe is too tiny and would never survive the surgery. It’s sounds very scary, traumatic, risky and painful. He said he would be making a 2 inch incision on Gizmo! He said that Gizmo would still be a risk, but it would be safer to do the procedure on Gizmo because he’s bigger than Zoe and when he gets the results of the Liver Biopsy, he will treat Zoe and Gizmo, with the same medication, because he thinks that Zoe and Gizmo both have the same problem. Problem is, he can’t guarantee me, that doing the Biopsy would even be beneficial, in treating Zoe and Gizmo or extending their lives, but it’s a chance to find out what’s going on and try to treat it! He refuses, to put either one of them on medication of any kind, including Milk Thistle, until he does the Liver Biopsy and knows exactly what he’s treating, so I have to make a decision on what to do by Monday, when I bring them both to the vet for a check up! He said that if we don’t have the Liver Biopsy done, that Zoe and Gizmo would have 1-12 years left to live. I’m beyond scared and confused, I’m on brain overload, I don’t know what I should do, as far as the Biopsy and I don’t want to lose either one of my babies. I also don’t want to put Gizmo, through anymore trauma than I have to, because Gizmo and Zoe have both already both been through a lot, with all the testing and getting jabbed in the Jugular for bloodwork. At the same time I want to do anything, that I possibly can to save their lives. Does that make sense? Should I go ahead and risk having this surgery done, or should I just let Zoe and Gizmo, live whatever lives they have left content, happy, comfortable and right now loving life and generally feeling good, until the time comes when they do become uncomfortable, and I need to put them down? What would you do, if you were in this situation? Thank You So Much, for taking the time to read this and answer! I’m just trying to do the right thing and save my babies lives! They are so much a part of my family and I love them so much, that it would break my heart to lose them, by doing the wrong thing!

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Answer #1

Hello Phrannie! I’m sorry I dropped off for a while. Been kind of busy remodeling my house! You’re right, it doesn’t make sense, that Zoe and Gizmo can be so sick ,with such a deadly disease and doing so well, but they are. Both Gizmo and Zoe have each had several blood tests done since they were diagnosed, to test their Liver Enzymes and each time, their ALT Levels were off the scales. I don’t understand why or what is happening here. They have both had second opinions from another vet, but like I said my current vet is the only one who has said anything about doing an Open Surgical Liver Biopsy on Gizmo. This morning (Monday) I had to take one of my other Chihuahuas Daisy to the vet for a recurring ear infection, that she was treated for 2 months ago and it came back with a vengence, even when I was cleaning her ears once a week with Virbac Epi Optic Ear Cleanser, like the vet recommended , after Daisy finished her Antibiotics the first time I took her in 2 months ago. He took an Ear Culture on Daisy, cleaned her ears out and put some medication in her ears in the office. He said that it would take 4 days to get the Culture results back for Daisy and in the meantime he prescribed the Antibiotic called Baytril Otic Ear Drops and told me to start giving them to her, Tuesday morning and do it twice a day. He said he has to put her on something until he gets the results from the Culture back, and he would decide on the best treatment then, when he knows exactly what’s causing Daisy’s Ear Infections. He also gave me some Metacam to give to Daisy for pain if she needs it. He told me to give her 2 drops only in her food once a day. Do you know anything about either of these 2 drugs that he prescribed for Daisy? The picture I uploaded is a recent picture of little Daisy, so you can see what she looks like! I also brought Zoe and Gizmo with me to the vet this morning along with Daisy, so I could have the vet check their ears, because they looked a little red and they can’t afford to get an Infection. I just wanted to be safe and not take any chances.The vet said that Zoe and Gizmos ears are perfectly clean, with no sign of any Ear Infection, so at least I don’t have to worry about that. He also looked them both over, weighed them and clipped their nails .He asked me how they have been doing and I told him, that they had not been acting sick at all, still eating, drinking etc., and are still very active, but I also told him that Gizmo’s belly sometimes swells and he said that he thinks it’s because he’s cramping and like you said has a tummy ache. Today, he did not even bring up the subject of doing the Liver Biopsy on Gizmo which surprised me. He kept commenting on how cute they are. He said that they look good, neither one of them show any signs of Jaundice and have both even gained some weight.! He told me this a while back and said it again today, that if he had not seen for himself on the bloodwork, that Zoe and Gizmo were such sick little babies, that by seeing the way they are acting and looking at their appearance and the light in their eyes, he would never have suspected they were sick at all. Since they both had their blood last drawn 3 months ago, the vet wants to wait 1 more month and do another bloodtest on both of them again, to see if their Liver Enzyme Levels have dropped any. Everytime I get my hopes up on that happening, it seems like my hopes on their Liver Enzyme Levels dropping, just go right back down again. It does make me feel a lot better, knowing that taking blood from the Jugular Vein, isn’t painful for them. By the bruise it leaves behind on their throats, it just looks like it would have been painful and traumatic for both of them. I also want to Thank You for the link that you provided for me. I have read some of it, but I keep getting distracted and will keep going back until I can read all of it. From what I’ve read so far, it’s very informative and helps answer a lot of questions I have. Thank You so much for caring enough, to help me, help my babies. It means a lot to me to know, that I have someone I can talk to about this. Like I said before, all I want to do, is try and save my babies lives. They mean everything to me! I’m desperate, very confused, really scared of losing both of them and I’m trying to do the best I can for them. Take Care! Have a great day! Elaine

Answer #2

I typed out a long thing last night, and it went poof!!

Ok, because both of them seem to feel good, are eating pretty good, are happy and active…and because there is no jaundice (especially)…I keep thinking that maybe the blood tests were read wrong or something. If the blood has only been tested one time, I’d be tempted to ask that it be tested again before any surgery. It just doesn’t make sense that they feel so good, when they should be feeling really crappy. I’d also be tempted to get a second opinion…before I put my dog thru surgery. (My sister’s little dog is happy that she did that for him…one Vet had him on heart meds, and when she went to another Vet, it turned out his “cough” was from a collasping trachea…a BIG difference in treatment).

A needle biopsy is less invasive, but not as reliable…they miss things with it…

You don’t have to decide by Monday…if you tell him that you want to think it over some more, he can simply reschedule it…right?? :) You can take him thru the list of symptoms…afterall, they aren’t showing many. Looking at their belly, could be just a gut ache…ya know?

Also, to ease you mind. Taking blood from the jugular isn’t painful…it’s probably scary, because a stranger has to hold them to do it, but honest hon, taking blood from anywhere is pretty darn painless.

I’ve been reading some site about liver disease in dogs…this one is written for the layman…I’ll check some more when I get to work…

http://www.canine-epilepsy.com/liverdisease.htm

Answer #3

Ok…this IS a dilemma…I can only offer you what I would do…but I want to ask you some questions first…the first one is…What is your gut feeling with this Vet? I’ve met a few who’s big interest was my wallet…and I’ve met a couple who were just curious…and then I’ve met some who truly had my dog’s interests as their primary concern.

I’m also wondering if getting a second opinion has ever been brought up, by you or the Vet? (Your pups wouldn’t have to go thru all the tests again, but two heads are sometimes better than one)…there are Veterenarians who specialize in internal medicine. Did your Vet send any of these blood tests to a Vet School? (My Vet sends lots ot urine, blood, even stool samples to Washington State Vet School if there is something puzzling, or something she might be missing)…

Are their bellies swollen? Are their appetites bad? Has their water intake and urine output significantly increased? These are all symptoms of liver disease. Any weakness or confusion? And then there is the biggie…the most common thing seen with liver disease…Are your pups jaundiced? Yellow skin, yellowish “whites” around their eyes, yellowish gums, etc. Are your dogs showing any of the above symptoms??

I need to know answers in order to tell you how or what I would do…

Answer #4

Hello Phrannie! Thank You for taking the time to read this and answer. This vet came highly recommended to me by my niece, who used to work for him. My niece and I are very close, so I don’t think she would recommend this vet, if she did not think he could help my Chi’s. He’s been a neighbor of hers for years and his daughter, is my nieces BFF. She’s known this vet for years and is like a daughter to him. I have only been going to this vet for only a year. He has treated my other Chihuahuas for various things and I never had any problems. He treats my dogs very well and really seems to care about them. Zoe was seeing a different vet, but that vet was responsible for taking one of my other Chihuahuas lives, by misdiagnosing her and giving her the wrong medication. I did not want her treating Zoe anymore and I pulled Zoe out of her care and took her to this vet. This vet also has Chihuahuas of his own, so he is familiar with the breed. He’s been a vet for 35 years! I trust him and he acts like he has my Chi’s welfare at heart, but I’m not sure that he’s done enough of these surgeries or has enough experience with this particular surgery, to take the chance and let him go ahead and do this Liver Biopsy on Gizmo. He has never recommended a Specialist to me. Sometimes I feel like he’s just curious to see what’s going on. When I ask him, he gives me a very vague answers, when I ask him about certain things! Gizmo also has seen another vet other than this one, but I did not stay with him, because he had a lousy attitude, he seemed to be too rough with Gizmo and I did not feel comfortable putting Gizmo’s care in his hands. This vet that they are seeing now, is the only one who has suggested this invasive and risky surgery. As far as sending test results to any other vet, I don’t think he has. As far as their bellies being swollen, Zoe’s is not, Gizmo’s is at times a little swollen at times, not always. Their appetites seem to be ok, and they are still eating drinking water and maintaining their weight. There are certain times when I put the food down and they act like they are Nauseous, they also both lift up their back right leg sometimes and look down at their bellies, in the area where the Liver is located, so I’m sure they are cramping, but the vet still refuses to give them Anti-Nausea medication or medication to help with the cramping and sometimes I have to handfeed them, but I can still get them to eat. Other times when I put the food down, they go right for it no problem and eat very well. The vet wants them on a low protein food, so I’ve been feeding them Innova Adult Wet Food and they are keeping it down and seem to be handling the food ok. The vet does not want them eating any kind of dry food, because he says that it has too much protein. I’ve tried feeding them both Science Diet L/D, as much as I hate the brand and they won’t touch it. They don’t drink water any more than any of my other Chi’s do, so I don’t think their consumption of water has increased and they are urinating normally. There is no weakness of confusion at all and they are both so active, it makes me wonder how they can be so sick. Sometimes I wonder if the bloodtests could be wrong! Neither Zoe nor Gizmo are Jaundiced anywhere. There is no trace of Jaundice on their tiny bodies! Their skin, eyes and gums, are all healthy looking. I hope I answered any questions that you had and that you can help me, help my babies! Again, I love them so much, I would do anything for them, but I don’t want them to suffer in the process. I don’t care about the money, I just want to do anything I can, to give them a chance to enjoy their lives without pain and get the opportunity to love them and care for them for years to come. They are only 1 1/2 years old and I would love to have more time to enjoy them. Thank You for caring enough to help me, help my babies! I can’t tell you how much I appreciate anything you can do or suggest. There has to be a less invasive way to do this Liver Biopsy! Have a Great Night! Looking forward to hearing back from you! I really respect your opinion! Zoe http://www.flickr.com/photos/11921192@N02/3117444801/ Gizmo http://www.flickr.com/photos/11921192@N02/2841309085/ Zoe and Gizmo http://www.flickr.com/photos/11921192@N02/3107503565/

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