Gallbladder Sludge

[dinib]

Hi Cairn Family!  It is has been a long while since I've posted. Have any of you had gallbladder issues with your Cairns?

 I'm having a health issue with Gracie, who is 8 years old, that has me worried.   At the end of March, I boarded my dogs at the vet and planned to have their annual vaccines and dentals.  I received a call from the vet stating Gracie's labs came back abnormal and did not preform her dental.  Her liver tests came back elevated.  He put her on two weeks of antibiotics and another blood check afterwards.  We completed the round of antibiotics and checked her labs.  Even though the levels have improved, but they were still high.  He then ordered an ultrasound of her liver to make sure it wasn't enlarged or had any masses and referred me to another vet for the scan (he doesn't have an ultrasound in his office).  

Everything looked normal except for her gallbladder.  No gallstones, but the image showed she barely had any bile.  The gallbladder was 95% full of "sludge".  She said treatment would be medication for 6-8 weeks and it should clear up.  Gracie is very stoic and very rarely shows discomfort.  The vet said she didn't appear to be in pain with palpating Gracie's abdomen.   While we were waiting on the scans, they returned her to the exam room, but left the door open.  She stood in the doorway and charmed everyone walking by into petting and chatting with her.  

I'm waiting on my regular vet to call me about the rx. Meanwhile, I worry.  

The attached picture was taken yesterday after the vet visit.  Rules of Gracie: car rides are to be tolerated, not enjoyed.

[sanford]

Wow,! She's gorgeous! Hoping for the best for Gracie.

[Sam I Am]

What a lovely girl! 

If she isn't on it already ask your vet about Ursodiol. It really helped Jock.

[oscar's mom]

Hi, I remember Gracie.  You were living in SF a few years ago.  Sorry to hear she is not feeling well, sounds like you have her in good hands, love her lots.

[dinib]

Sandford and Terrier Lover - thanks!  We think she is darling even though she can be a grump.  We got her from a Cairn rescue as a puppy.

TL - I am still waiting on a call from my vet.  He was out of the office yesterday, so I hope he calls today.  I'm ready to get her started on her treatment!

Oscar's Mom - Yes! We were living in SF, then moved to NJ.  Now we are back "home" in Arkansas.

[beccadiane374]

What a beauty she is!  Wishing for the best for you all!

[Dempsy's Mom]

Aww - so sorry Gracie.  Hope you get well soon.  And yes, you are a beautiful girl ... giving all the rest of the girls a run for their money.

[Idaho Cairns]

Having never heard of "gall badder sludge" in dogs (or anything else), I looked it up and found this interesting comment:
"

The gallbladder contents become inspissated (sludgelike) when more fluid is reabsorbed or more mucin is added. Biliary sludge is a mobile mixture of precipitated cholesterol crystals, bile pigments, bile salts, and mucin. ... At present, the significance of biliary sludge in dogs is unknown.Apr 1, 2009"

Note that comment about "significance" and perhaps that will ease your mind a bit about you beautiful Gracie.  I hate to bring it up but my suspicious nature about how car repair facilities, furnace folks, etc., and, unfortunately, vet clinics have sort of started "selling up" their customers for services that are sometime not needed--it is an unfortunately quite common these days.  Of course, when it comes to our pets we want the best we can buy and that attitude makes "more tests, more visits, and more medicine" necessary and that old "we want to be sure" can move us to perhaps pay too much. 
Might want to research this "sludge" thing a bit and see if there is some significance to the dog's health and, more importantly, if there is a recognized treatment and/or solution to the condition.
Otherwise poor Gracie is going to have to endure all those rides to the vet!

[pkcrossley]

She is adorable. I look like that when I go to the doctor, too. It doesn't sound like you should be worried. It is a problem you found by testing, which means that she does not have symptoms. if intervention is indicated, it sounds like it will be simple and effective. She looks very healthy and when not going to the vet may be very happy. This is what vets are for, and sounds like you are doing everything right. 

[sanford]

I agree with the comments of  PK and Idaho, especially his reference to the practice of  "selling up". One possibility is to try try for a second opinion, but of course, this means spending more time and $$$ on tests, appointments, etc., still with no guarantees.

It depends on your level of trust, your pocketbook, etc.

Wishing the best for you and your "grumpy darling".

Edited April 21, 2017 by sanford

[Sam I Am]

Not that I want to alarm anyone but bile sludge can cause a whole pile of issues and it can also resolve by itself. Given the fact that her liver enzymes were abnormal,  I am glad that the vet is taking further tests because pancreatitis is one of the complications.  

Edited April 21, 2017 by Terrier lover

[dinib]

Thanks for everyone's well wishes and input.

I have Gracie's Ursodiol rx of 100 tablets on order.  It should be delivered early next week. She is also getting Denamarin as a liver supplement.  

When liver function is compromised, the exact cause can often be difficult to determine. Supporting the liver, regardless of the cause, is essential to keep it working properly.  

Administering SAMe (S-Adenosylmethionine), which is found in Denamarin, has been shown to markedly increase liver levels of glutathione, 1, 2 an important compound for liver health formed when SAMe is metabolized. The SAMein Denamarin has also been shown to help protect liver cells from cell death 3, 4 and may help cell repair and regeneration.

Denamarin also helps support your pet's liver through the administration of Silybin.Silybin is an active part of an extract from milk thistle, known as silymarin, and has been shown to support liver function by helping maintain a healthy oxidative balance.

I feel comfortable with both of the vets recommendation.  I'm actually the one who opted for the ultrasound, since Gracie has had pancreatitis in the past and she hasn't been quite herself in the last year.  Her skin is so dry and flaky.  She has gotten chunky.   She should be around 12 lbs, but is now at 15 lbs (despite walking her 1+ miles nearly every day -- the boys are are now lean and muscular, she is still squishy).  And...she is gassy.  Like, loud human sounding toots! 

A couple of years ago, her blood panel showed an abnormal kidney levels.  The vet wanted her on a lower protein diet like senior dog food, but looking at labels, the fat content was higher and we had to watch fat levels because of her bout of pancreatitis.  I opted to put her on Wellness weight maintenance and she ballooned up!  After a year of the diet food and normal kidney levels, I opted to put her back on her Wellness Core.  She looks like she has more energy.  

[Sam I Am]

Glad they are putting her on those meds. It did wonders for Jock. He never had any symptoms either but when a routine pre dental blood panel was done (at 6 yrs of age), very high liver enzymes were noted. He went on the meds as Gracie is going to go on for the remainder of his life. He lived a great life till almost 13 yrs old.

Edited April 21, 2017 by Terrier lover

[Hillscreek]

I have no experience to offer but can send lots of good wishes for Gracie's future. She is fortunate to have great care all around.

[kjwarnold]

As someone who suffers from bile sludge periodically and takes Ursodiol, I feel for the poor girl.  For me, it does cause pain but it sounds likes she's better off.  The Ursodiol should help keep the bile from becoming "sludgy."  Bile can actually sludge up in bile ducts (do dogs have bile ducts like us?) and back up into the liver, causing scarring and eventual liver failure.

Well, shoot, now that I've come this far, I might as well continue on with a commercial for organ donation.  Primary Sclerosing Cholangitis (PSC) is a disease of the bile ducts that can eventually cause liver failure.  There is no cure (and no known cause) other than a liver transplant when the liver gets too scarred.  I have PSC, hence my interest in getting the word out about organ donation.  

So back to Gracie, she's gorgeous and I'm sure she'll be fine.  Our first Cairn, Willie, lived almost his whole life with elevated liver enzymes.  Keep in touch and let us know how she's doing!

 

[pkcrossley]

wow, PSC, never heard of it before this. would it be connected to her weight, i wonder? reading dinib's later notes i wondered about hypothyroidism. has she been tested for that?

[Hillscreek]

Absolutely support organ donation. When you don't need your body and it is healthy I say give it to someone else to enable them to live. Sorry to hear of your situation kjwarnold. PSC is new to me. I have no knowledge of sludge for humans or for dogs. Hoping the best for you in the future. Good thing you have two cairns to keep an eye on you

[dinib]

I just wanted to give a quick update.  Gracie had blood work done this morning.  Her ALP values have significantly dropped.  She went from 308 on 3/30, to 277 on 4/17, to 128 today (reference value 23 - 212 U/L).  The vet said since she is responding to our treatment (Denemarin and Ursodiol), she will more than likely be on it for the rest of her life.  I'm okay with that treatment plan.

[Sam I Am]

Best news!

[sanford]

Thanks for this encouraging update!?

[hheldorfer]

Very good news!

[Dempsy's Mom]

Good job Gracie!!

[kieiras mom]

Yea!!!!

[kjwarnold]

Yay!