Cocker Spaniels & Chronic Hepatitis

The information contained in this document should only be used for further discussion with the vet treating your dog. It is not intended as instructions for the treatment of liver disease.

I have two darling black & tan cocker spaniels, a male and female. They are not related and are six years old. My female Dylan,became very sick in April of 1998, she was diagnosed with chronic hepatitis. I would like to share my experiences with people so they can get good care and perhaps not spend as much as I have. I spent about $2000 that I now know was not wisely invested with the first three vets, and would like to spare anyone else this expense.

There are many different reasons dogs get liver diseases. It can be genetic, viral, infections, toxins, or an auto immune reaction to an unknown factor. Cockers are not as prevalent to copper toxicosis liver disease as are Bedlington Terriers. This appears to be an inherited disease. My understanding is that Dobermans also are frequently affected. The diet of these dogs needs to be carefully managed and be low in copper as the liver is not able to process the copper and causes toxicity. A liver biopsy can determine if there is a high accumulation of copper in the liver cells as well as tell how badly the liver is already damaged. There is a good book that can help you, UCDAVIS Book of Dogs. I got one at the local Borders Book Store.

DYLAN’S STORY
The primary symptoms I noticed was that she slowly had stopped eating and became very bloated looking in her stomach area. She began to look much like a new born puppy looks after eating a big meal. She was not moving around like normal and her paws and ear leathers were cool to the touch. Her belly felt and sounded like a ripe melon. I called my vet and he suggested that we take Dylan to the local Animal ER. The vet there said she had ascites (accumulation of fluid within the abdominal cavity) and was probably caused by a heart, liver or kidney disorder. Dylan has never had any health problems and has been on a good Nutro diet all her life.

The next day I took Dylan to my regular vet. He examined her and ran a EKG. It did not seem normal and he suspected congestive heart failure and started Dylan on what he said was a low dose of digitalis. Dylan began to vomit and have diaherra. The vet gave her IV fluids and told me she was so sick she should go to the local Animal Hospital. The vets at the animal hospital ran another EKG and said it appeared normal. They suspected that she had a bad liver as her blood chemistry revealed a very low albumin level of 1.3. They recommended a liver biopsy to determine if the liver was damaged. This is a needle biopsy, which removes a core of the liver cells,it is not major surgery and not that expensive. The amount of liver damage was hard to determine from the final report, though we have since learned that about 80% of her liver is damaged. We were told she had chronic hepatitis. Dylan was sent home to live out her final days on low protein dog food and some medications. No one could tell us how much time she had left to live, but all said the prognosis was for a few days ,weeks to maybe a few months at the best. They all acted like the best thing to do was to put her to sleep. Needless to say, we were devastated.

She was sent home on the following medications.
Carafate -- a coating agent for the stomach and intestines
Actigall- 150 mg a day
Lasix - 25 mg once daily

At home Dylan was stumbling, not eating, vomiting and breathing very shallow. Seven days after we had taken her to the ER she was no better and actually much worse. She had stopped eating again and I was force feeding her a special dog food for convalescing dogs. She was also being force fed her medications. It seemed that Dylan had also given upon herself. She was very close to dying. I was an emotional wreck, calling my vet to find out what to do, he was talking to the specialist at the Animal Hospital who then was calling me and readjusting the medications my vet had just changed. I felt like I was directing Dylan's treatment in many ways and I had no clue as to what to do or who to listen to. I was terrified that something I might or might not do would result in her death due to my ignorance. My bills at this point were almost two thousand dollars.

Needless to say, I was not pleased with the confusing care Dylan was getting decided to get a second opinion. I went to another specialist who made no promises and gave me no false hopes. He was willing to spend the time with me. I found this very good vet by asking friends, I let him clearly know I was seeing him for a second opinion only, due to loyality to my first vet. He did not have a problem with this. He recognized my extreme need for information and let me read to my hearts content about liver disease and treatment thereof. He explained that there is not much known about how to successfully treat liver disease because either the vet treating the disease has little or no experience with it and does not manage it well, or the expense of treating it is more than most pet owners are willing to pay.

He kept her on some of the same medications but did make some changes and additions. He drew out (tapped) the fluid build up around her heart and abdomen. She had close to 4 pounds of asitices fluid in her abdomen (this was a clear transudate). My regular had vet tapped her belly but did not get all the fluid and he never was aware that she was collecting fluid around her heart. The fluid around the heart was caused by a ruptured thoracic duct that was leaking into the sac around her heart. This was what caused the abnormal EKG. This vet examined all her old records and assured me that the other vets did no evil, however, they could have done some more tests and been more proactive in her treatment. My current vet says there are some vets who just are most comfortable dealing with normal mundane pet issues and are not thrilled about dealing with really sick pets (not to mention the pet's owner and the emotional wrecks these loving persons are)

However due to his exceptional diagnostic skills and wonderful bedside manner (he calls me mom), Dylan seems thus far to have achieved a stupendous recovery, she has had two bile acid tests which determine the level of liver function more accurately than the biopsy. Her pre test was 35.8 and her post test was 147.2 ( Normal pre test is 5 and post test is 25) .Her bile acid tests results have improved a little so there is some hope we can maintain her for the longest time possible. I have learned so much about this disease, and I am convinced that if I let my first vet treat her she would have passed away by now.

She is, as of today, (Feb 99) the perkiest and healthiest she has ever been. She maintaining on a lot of medications with no apparent side effects. They are as follows:
She was on Re-Sorb a oral hydration electrolyte fluid for about three months.
Actigall 150 mg per day
Spirono/HCTZ 25/25 1 tab twice a day (Potassium sparing diuretic)
Soloxine 0.3 mg 1 tab twice a day
Colchicine 0.6 mg ½ tab once a day
Tumil-K (Potassium Glu) 1 tab twice a day
Zinc 50 mg per day
Stress Tab (B complex) 1 tab twice a day
Vitamin E 400 I.U per day
Milk Thistle Seed Extract 200 mg per day

The medications cost about $80 per month.

She is also on special food from the vet, KD. She does not like it very much so I mix one tablespoon of canned food and water in with it to improve the taste. She seems to gobble it up now.

We take things day by day and hope that on April 17, 1999 I can send the other vets a copy of their depressing reports (which gave Dylan 4-6 months to live) a one more year of life birthday card. I am hoping to send them an annual card for many years thereafter. It really terrifies me that I almost had Dylan put down because I almost believed the first three vets when they said she was not going to get any better. When I think of how readily my first vet would have agreed to put Dylan to sleep to spare me the pain and how I almost did it, I still shudder.

If you can afford it (it is expensive) and are willing to invest in your pooch knowing and accepting there is NO magic cure, work with a highly respected and recommended vet, when the end does come, you will know you did everything possible for your precious fur baby. There are fair, good and excellent vets. It was a tough and painful search and I hope my decisions and faith serve Dylan and I well. I am here for anyone who needs me, I know too well the price this disease takes on humans and canines.

Send me an email.

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