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  Discussion on Liver problems?
Author Message

Posted on Tuesday, Dec 4, 2001 - 4:25 pm:

Hi Dr. O.
I have a Quarter Horse gelding 7 yrs old. Eats well but it is hard to keep weight on him. Developed a fever and was eating poorly, just wasn't himself. Vet came, drew blood and gave him a shot of antibiotic and bute. He was back to his old self for 36 hours though slightly dehydrated. This horse usually drinks a lot under normal conditions. Fever came back and they put him on antibiotics for 30 days. We're on day 8. He seems like his old self. But the labs were "odd" the vets words. He said there was liver involvement but couldn't pin it down. I'd like to post them and have you offer any insight. I've read every post on the liver there is but don't see my horses case. Here are the labs.
Bilirubin,Total 7.5(H) MG/DL 0.8-3.2
AST(SGOT) 735(H) U/L 180-380
GGTP 40(H) U/L 1-35
WBC 3.1(L) THDS/CMM 5.5-12.5
Absolute Polys 2356(L)76% 2600-7500
Absolute LYMPHS 456(L)15% 1500-7700

Everything else in the blood work was in the normal range. Blood will be drawn again at day 10.
I figured two heads are better than one! Thank You
Jennifer

Posted on Wednesday, Dec 5, 2001 - 7:36 am:

Hello Jennifer,
I see you beat me to the new posting, Thanks. Let's see I still need to see the normal values. I would also like to know how high the fever was and how long it lasted on each episode.
DrO

Posted on Wednesday, Dec 5, 2001 - 9:46 am:

Hello Dr. O,

His fever was 102.5 when it first started, it lasted two days. stopped with the antibiotic/bute. The second time it was 102lasted until antibiotics were given. Here are the rest of the blood test values.
Result Range
Glucose 91 MG/DL 60-125
UREA nitrogen 13 MG/DL 8-26
Creatinine 1.5 MG/DL 1.0-2.2
Total Protein 6.0 G/DL 5.4-7.8
Albumin 3.6 G/DL 2.3-3.8
Alkaline Phosphatase 111 U/L 50-250
Cholesterol 93 MG//DL 50-140
Calcium 10.9 MG/DL 10.8-13.5
Phosphorous 2.2 MG/DL 2.0-5.0
Sodium 135 MEQ/L 132-146
Potassium 3.4 MEQ/L 2.4-4.7
Chloride 97 MEQ/L 97-108
A/G 1.2 Ratio 0.6-1.6
Globulin 3.0 G/DL 2.2-4.4
CPK 183 U/L 100-300
Hemoglobin 12.8 G/DL 11.0-17.0
Hematocrit 35.8 % 32.0-50.0
RBC 7.3 MILL/CMM 7.00-12.00
MCV 49 34-58
MCH 17.5 12-19
MCHC 35.8 31-39
Platelet Est Adequate
Absolute Bands 0 0-300
Absolute Monos 279 9% 0-1000
Absolute Eos 0 0-1000
Absolute Basos 0 0-290

O.K. That's all of it. Both fevers cleared up within 12-24 hrs of the antibiotic. Thanks so much for your quick response!
Jennifer

Posted on Thursday, Dec 6, 2001 - 6:01 am:

The symptoms, low WBC count, and diphasic fever are consistant with many of the viral diseases common in horses. This means the antibiotic improvement may have been coincidental. On the other hand if we did have a bacterial disease that was sensitive to your antibiotic it would appear this way also.

The tests shows some mild changes in some parameters that are associated with the liver, GGT, and total bilirubin. Bilirubin will rise with simple inappetance to the point there may be mild jaundice so this may be all this is. The rise in GGT is almost negligible and though the SGOT may look high this type rise is not remarkable by itself and it is not specific for the liver like the GGT is. Lastly some of the enymes that are release from the liver when it is insulted, though not specific for the liver, are normal. This is not to say there is not something going on here but at this point it is not clear there is is a problem.

Two important points:
1) I would be interested in making sure the rises did not continue and the bilirubin returns to normal once the appetite becomes well established.
2) More information could be derived by having the bilirubin broken down into its two components: direct and indirect. I am surprised the lab did not do that when they saw it elevated and it will let us know the source of the rise in bilirubin.
DrO

Posted on Thursday, Dec 6, 2001 - 11:00 am:

Dear Dr. O.

Thanks so much! I will ask for the more specific test on the bilirubin the next time the blood is taken. He has been eating normally for the last 9 days. Thanks again. I let you know how it all turns out.
Sincerely
Jennifer

Posted on Tuesday, Jan 1, 2002 - 11:57 am:

Hi Dr. O.

Happy New Year. Just wanted to thank for your help. My horses second set of blood work came back completely normal. He's fine. Have a great year!

Sincerely
Jennifer

Posted on Wednesday, Jan 2, 2002 - 6:35 am:

Thank you Jennifer and Happy New Year to you too!
DrO
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