“Dear Dr. Shawn:
“My veterinarian says my dog has liver disease and he’s recommending a biopsy, yet my pet looks and feels fine. Is the biopsy really necessary?”
”Before you your pet has a liver biopsy, it’s important to make sure that the diagnosis is correct. In my practice, I often see pets whose prior veterinarians had diagnosed “liver disease” and recommended a biopsy, yet a review of the laboratory tests tells a different story. The confusion for veterinarians seems to arise from a misinterpretation of the test: the ALT test (which usually increases in liver disease,) and the ALP test (which can increase in liver disease but usually increases as a result of adrenal gland disease.) Often the veterinarian misdiagnoses liver disease when the ALP is increased. Most of these pets do not have liver disease but have an overproduction of steroid hormones from their adrenal glands. Doing a liver biopsy is not only unnecessary in these pets but can cause problems such as an increased rate of postsurgical infections in failure of the surgical wounds to heal properly.
I am reminded of a case I saw during my employment as a new veterinarian when I had just graduated from veterinary school. My boss, an older veterinarian at the time, misdiagnosed a case of severe adrenal gland disease (called Cushing’s disease) as a case of liver disease. The young dog, a female dachshund, had surgery for a liver biopsy and her wound never healed properly. Unfortunately, once the pet was correctly diagnosed, it was too late and she failed to respond to chemotherapy for Cushing’s disease and ultimately was euthanized by her owner!
Therefore, prior to doing a liver biopsy on any pet it is imperative that a diagnosis of liver disease is properly made. Carefully assessing the results of a complete blood profile will help in this regard. If there is still any question, an ultrasound examination of the liver, gallbladder, and adrenal glands is easily performed on the pet and can reveal a lot of information. Additionally, specialized blood tests to check for adrenal gland disease (an ACTH stimulation test and a low dose dexamethasone suppression test) can also be done.
Finally, if liver disease is truly the cause of your pet’s increased liver enzymes, natural therapies using herbs such Dr. Shawn’s Liver Support and homeopathics can often bring a resolution to the problem without the need for a liver biopsy or conventional medical therapy.”
Dear Dr. Shawn:
“My cocker spaniel Noodles always has anal sac problems. At least once each month he goes to the veterinarian to have his sacs expressed. I’d like to have surgery on them to have them removed, but his veterinarian is against this. What are your thoughts?”
“Anal sac disease is very common in smaller breeds of dogs like Noodles. Briefly, all dogs and cats have 2 small sacs (anal sacs) located around the anus. The sacs have their own glands that produce a foul smelling liquid; the liquid is normally expressed when the pet has a bowel movement. These sacs are not the same as anal glands, even though many owners and veterinarians call them anal glands. In some pets for unknown reasons, the sacs don’t fully empty during a bowel movement and instead retain the glandular fluid. This causes irritation to the pet; as a result, the pet scoots its rear end or may excessively lick in this area. Usually a trip to the veterinarian will allow the doctor to express the secretions, bringing relief to the pet.
Some pets need this done on a regular basis to prevent further problems. Rarely surgery might be needed. I only recommend this for pets with frequent, chronic problems, usually those pets who actually rupture their sacs or suffer from chronic infections. Surgery is a drastic procedure for such a minor problem, but for pets with chronic infection it may be needed. Rarely, damage to the nerves that run right by the anal sacs may result in fecal incontinence, so I consider surgery a last-ditch option.
At this point I would agree with your doctor that surgery is not needed yet. You might try scheduling Noodles for regular visits to express the sacs; alternatively, natural therapies are very helpful for most of my patients. Two supplements I recommend for all pets with anal sac issues (as well as diarrhea and/or constipation) are Dr. Shawn’s Herbal Scoot No More and Dr. Shawn’s Enzymes and Probiotics. Using these products reduces the number of times your pet will need to go to the doctor’s office to have the sacs expressed.”
A recent article highlighted the tumors most commonly seen in dogs and cats. These include lipomas (benign fatty tumors,) intradermal cysts, papillomas (warts,) lymphoma (cancer of the lymph system,) and mast cell tumors (another common cancer.) Because the last 2 tumors look and feel the same as lipomas, it’s important that all lumps and bumps be aspirated for a proper diagnosis. In many cases early surgical removal can cure the cancer, and ongoing immune support following surgery can make the pet healthier and keep the cancer away.