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Liver Disorders In Scottish Terriers
Vicki Campbell, GSM 'HealthWatch' Columnist
The idea for this column came from a new e-mail friend in England. She has a Bearded Collie named Willow with a liver shunt disorder.
Unfortunately, our Scotties have more than their share of liver disorders. My only experience with liver problems has been when some sort of cancer has spread to the liver before my Scotties died. Sydney Bohnlein was kind enough to issue a request on the Scottie-L and in our club newsletter soliciting information on Scottie liver disorders. Many people responded, some with some very sad stories. I want to thank Sydney, Kathleen, Earl and Ann, Barbara, Marge, Monica, Mary, Carole and others for telling me their stories. I also want to thank the Scotties and Scottie Angels, Duffy, Jackson, Rosie and Sarge, Noel, Bonnie, Sandy and Courtney (and those not named) for allowing their suffering to be revealed. Scotties are a proud breed and often hide their pain.
The liver is the largest organ in the body. It is well-supplied with blood vessels, receiving blood from the spleen and gastrointestinal organs. It also receives arterial blood as its source of energy. The liver is located above the stomach and is divided into lobes, or sections. There are 10 basic functions of the liver. They are carbohydrate metabolism, lipid (fat) metabolism, protein metabolism, vitamin metabolism, immunologic function, hormone metabolism, storage (of water soluble vitamins, triglycerides, copper-zinc-iron, fat soluble vitamins, glycogen and blood), hematologic functions, digestive functions, detoxification and excretory functions. Liver disease or dysfunction can affect or be affected by any of these metabolic events.
There are various ways to test for liver disease. Blood tests are the most common, but can be very difficult to interpret. The SALT (a.k.a. SGPT) and the SAST (a.k.a. SGOT) tests indicate leakage of material from liver cells. This is not indicative of liver function. The Alkaline Phosphatase counts indicate certain types of liver damage - especially disorders of bile metabolism and cortisone related disease. Bile acids and serum ammonia counts can indicate the presence of reduced liver function. Thanks to modern technology, many vets have access to ultrasound. This makes a picture of the liver's structure using sound waves. It is an excellent, non-invasive technique of detecting tumors, abscesses, and bile obstructions. It is superior in many ways to x-rays. Sometimes it is necessary to do a biopsy of the liver to uncover specific types of diseases.
The blood tests can't always tell you what is wrong, only that something is.
There are a number of congenital problems that Scotties can have. These are disorders that are there when they are born. They include portasystemic shunt, storage diseases and hemophilia. The shunt problem involves an abnormal communication between the vein that carries blood from the gastrointestinal tract and the vein that carries blood back to the heart. The communications are normal during the fetal period, but close down after birth. This is a very complex disorder, as my friend in England could tell you. The storage disorders are either glycogen storage disease or copper storage disease. The glycogen disorder is where puppies are unable to maintain normal blood sugar due to the inability to metabolize glycogen. The copper storage disease is where a metabolic error causes the accumulation of dietary copper during life. Noel Hyatt was diagnosed with storage disease. She was not quite four years old when she died. Her first symptoms were stumbling and loss of balance. Scottie Cramp was ruled out. Her blood tests showed that something was amiss. The vet was sure it was a genetic storage disorder.
A biopsy was not done, but the ultrasound showed nodules and scars on her liver. As the end approached, a fluid buildup started and she seemed to be in pain. The vet said her liver had failed and her kidneys were probably shutting down too. Rosie Eickwort appeared to have signs of a copper storage disorder. She had many tests to rule out other disorders and the blood work and the needle biopsy indicated liver problems. Her diet was eventually changed to Nature's Recipe Vegetarian Canine Maintenance Diet (dry) and her blood work has improved. We are keeping our paws crossed for Rosie and her offspring.
The liver can be damaged by a variety of drugs or toxins your dog may have taken (e.g., steroid anti-inflammatories can be a problem). Some are safe to use, but others can be toxic, depending on the dosage and the condition of the dog's liver. Note that the new drug, Rimadyl, has been found in rare instances to produce a severe, but reversible form of liver disease. Check with your vet if your Scottie is on this medication for arthritis or other pain. Oxibendazole, an ingredient in Filaribits Plus is thought to have caused liver damage in several kennels of Scotties, when the product first came on the market years ago. The drug caused severe, but usually reversible liver disease in some dogs, although I heard that some Scotties did die. I was trying (unsuccessfully) to trace down a former Washington, D.C. Scottie club member whose dog had this problem. I remember hearing that the company came through and supplied regular Filaribits for the rest of the dog's life. Anticonvulsants can cause changes in blood work and can occasionally cause true liver disease. Prednisone and Cortisone, whether given to treat specific diseases or erroneously produced in excess can cause Cushing's Syndrome. I am always cautious when using steroids because of adverse side effects they can produce. Carole Owen, Scottish Terrier breeder and widely-read authority on our breed, related a story about a Scottie having bad liver counts after ingesting a chocolate bar. She had taken a visiting Scottie in for a teeth cleaning. During preliminary blood work, her vet discovered irregularities in the dog's blood count. A bit of investigation indicated that the Scottie had stolen and eaten a chocolate bar. This is one of the reasons vets are always warning you about dogs and chocolate. Carole advises having blood work done before any operation, even for something as simply as a dental cleaning. Ask your vet what his policy is on that.
Dogs occasionally develop primary tumors of the liver. The more common scenario is the involvement of the liver when cancer from elsewhere in the body has spread. Treatment is usually not attempted, except in cases of signs of liver disease. Signs of congenital disorders include stunted body size, abnormal behavior (including balance problems), weight loss and cryptorchidism. Signs of acquired disorders, such as drug-induced, include anorexia, bleeding tendencies, jaundice as disease advances, lethargy, and greenish colored feces. Increased thirst and increased urination are signs of both types of liver disorders. This is what you might notice first. You must know your Scottie and what is normal for him. You must also take him for regular checkups, so your vet can check what is normal for your individual dog and what might be a problem.
The liver is able to heal (sometimes) if the dog is provided a diet that supports a normal liver function. It is important that the patient eat. The diet must be based on protein from milk or soybeans. Meat impairs healing. The diet should provide adequate amounts of vitamin C and zinc, but should be low in copper. Vitamin A can be toxic to the liver, so be careful. Vitamin E is protective to the diseased liver and can be added in greater than usual amounts. Carole Owen told me of a holistic remedy to detoxify the liver. It is a concoction of beet, celery and carrot juices. I can just see my dogs' faces now (yuck). Maybe if you put it in a fancy glass with a stalk of celery and tell them it is a cocktail, they'd enjoy it more (I know I would).
Take good care of your babies and Happy 1998 from the Victorian Scotties.
©1998 Tartan Scottie. Reprinted from Vicki Campbell's "HealthWatch" page Great Scots Magazine Vol 3 No 1 1998.
©2001 Tartan Scottie. All Rights Reserved