test results from the vet - any advice on what I should do next?

[squeaver]

Will try to be brief...
Tibetan Terrier, aged 12.5 years. Went to the vet the other week for a scale and polish/possible extractions under GA. At this point I should say that, apart from his dodgy teeth (mea culpa), he is a healthy boy - still runs around, walks for an hour-plus every day, no issues with food etc etc

They did a blood test pre- the GA and found a spike in results in enzymes in his liver. Didn't do the dental work and took some more samples to send off for analysis.

Those results say:
Degeneration of liver cells
Inflammation in the liver
No infectious organisms
No cancer detected (in the sample they took)

Plus a list of things it could be: some kind of liver disease/gall bladder infection/hepatitis and some other less likely things. If it's an infection, there is a possibility that it's been caused by his bad teeth.

So now, they've given me two options:

1 A biopsy and bile sampling to determine what it actually is, under GA (so blood tests first again). As I'm sure you can imagine, this will be ££££. Then, we'll discuss treatment options for whatever it is
or
2 Do his teeth and then test him again in a month to see if hat was the cause (still £££ but not as much). Will need a higher dose of general anaesthetic so associated risks with that.

Or (and I haven't discussed this with the vet!)...we do nothing. He's an old dog, he's fine, as I say - no outward symptoms at all. If we find out what's wrong, treatment options may well be limited by his age anyway.

Would be really interested to know if anyone else has had a similar experience with an old dog and what you did.

PS Don't have pet insurance - he also has a very minor heart murmur which we discovered the one year I forgot to renew it so now I don't think we'd even get cover.

Our dog (a cairn terrier -12) was off colour and after blood tests it was identified as liver. We had a scan first. But ultimately had a biopsy. She has chronic liver disease. Tablets from vet keep it under control and you wouldn’t think there is anything wrong with her. We had thought something was wrong about 6 months earlier but after tests vet eventually said arthritis. I wish I’d got more tests then as by time it was found it was quite bad - they thought she had cancer as there were so many pockets on her liver.

in summary, I’d go for biopsy so if it is liver you can deal with it quickly.

Thank you - that's really helpful

quick bump

thats old for a big dog I think? From my understanding all old dogs or at least most, would show liver degeneration if tested. I’m not sure if put an old dog through more anaesthetic or a biopsy tbh, I say this as someone who did with my old boxer dog and wish I hadn’t as he didn’t last for many year longer and I should have just kept him happy x

Ignore me! Read that as Tibetan mastiff 🙈
I don’t know then tbh as he could have a good few more years in him, probs best to check it out

Tibetan Terriers usually reach 15 or 16 and of course I'd like him to get to that. I think I'm inclined to go for it.

I'd be inclined to do his teeth first, it can be surprising the effect on bodily systems tooth bacteria can have.

Agree with this

Thank you both - argh, I'm usually good at making decisions!

It’s always tricky to make vet decisions I think as we are balancing our beloved pets wellbeing with if it’s worth the potential trauma of the investigation/ treatment and the reality of the cost. By the sounds of it he needs his teeth doing anyhow so get them done then see what happens before you make any next steps on liver function. Good luck x

I agree with this too.

I’d definitely just do teeth first then wait and see. There are so many tests that they can do now, doesn’t mean to say you should always do them or that it’s best for the dog. You said yourself, otherwise he’s a happy boy and bad teeth could well be the cause.

It would also depend on the vet as well, I am lucky enough to have an independent vet that I absolutely trust to recommend what’s best for my dog but in the recent past I’ve had experience of vets working for big companies and driven by profit so I’d be more inclined to go with my gut in a case such as this.

As the owner of a virtually toothless greyhound, I have to agree that teeth are definitely best seen to.

At the very least, she's going to be more comfortable when eating 🙂 hopefully for many years to come 💐

I'd do his teeth and see how it goes.

I would expect him to go on until he's 15 ish, I wouldn't want to put him through too much at 12. We have a cairn x Lakeland terrier who is 13.5, we want him to go on forever of course so familiar with the general dilemma. Just because you "can", doesn't mean you "should"... I am however forever racked with guilt from when my first dog died under anaesthetic at 15 1/2. I can't even remember exactly what for now but it was to see what was going on and if it could be treated. I still feel guilty, I should never have put her through that and I just wish the vet had gently and kindly advised me that perhaps PTS was the kindest option for her at her age and clearly unwell

My 6 year old bernese had blood tests pre op (on his prostrate) and his liver scores were sky high - they did a liver biopsy as part of the prostrate op and discovered he has copper storage disease.

This is an unusual condition.

Anyway, it is treatable through diet (special kibble for liver problems), giving filtered water, and tablets for about 6 months.

We had no idea.

His scores are still high ( but not as high) and vet thinks it is something he will just live with.

Just to update you, he had his teeth done (including a couple of extractions!) on Friday. They also took another sample from his liver and his bile, but not a full biopsy. We'll see how things are with the results of these and then again in a month.

He's doing absolutely fine. Thanks for everyone's advice.

Ask for a bile acid stimulation test. If normal, proceed with dental but ask for fluids throughout to flush drugs out quicker. Liver is often nicknamed the sympathy organ and can release its enzymes just for the sake of it. A bile acid stimulation test will tell you the function of the liver, enzymes can’t. If liver enzymes remain high, denamarin is great.

Do you mind saying how much you paid?