Liver Enzme test

We have a 5 year old Chocolate Lab who has been on Phenobarbital for 4 years now. He has suffered from Seizures since the age of 1. He started out on 160 milligrams and went up to 240 milligrams for 2 years and was still suffering from seizures once a week. His ALT was good in 2007 when he first started treatment for seizures. Just recently the vet increased his PB up to 300 Milligrams a day. We noticed a little change in him and thought about pulling the extra 60 mil. But decided we would give it the 3 weeks and take him into the vet for his therapeutic levels. One week before we were to bring him in, he got diarrhea, vomiting, and would not eat. All he did was drank a lot of water which came right back up. Didn’t want to play at all. Brought him to the vet and they ran ALT on him and this number is not a lie. His level was 5,536 he was started on iv’s and they did an x-ray and the liver was real large. He had several other blood work and all the numbers were high. He had iv for 3 days and he started to get jaundice and getting worse. The vet started treating him with more in his iv and by the 4th day had his levels down too 2,389 better but not good. He had a liver biopsy done on day 5. At that time they were able to see the liver and felt safe to treat him with steroids.
We need to take him back next week and run his ALT again he has been home for 2 weeks taken pills for the liver. His liver biopsy came back showing positive of copper staining/storage. They are doing one more test on this as well.
Vet keeps saying could be a mushroom but I am leaning more on long term use and possible overdose of PB for seizures. I have been trying to read up on this and get answers but no such luck. I do know the vet stated they won’t put him back on PB. Because he has a weak liver now.
He is now back home seems to be doing well but he also has been barking at a lot more noises and seems to be more protective.
If anyone can give us answers it would be great we really don’t want our little boy to go through this again.

Thanks
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Wow, that's a lot to deal with...I'm so sorry and I hope your boy will be OK.

As much as I know we'd all love to help, this is probably beyond this board. Nonetheless, and keep in mind I'm not a vet, a couple of things come to mind:

Long term PB use would be my first suspect as the cause of the liver issues as well. Have they talked about other drugs to control his seizures? Some dogs do well on potassium bromide, some times alone, some times in conjunction with a lower level of PB if he can tolerate it.

The copper they found upon biopsying his liver - did they give you a reason? There is a copper storage disease best known in Bedlingtons, but I know an OES who was diagnosed with this as well. It looks like it may also occur in labs ( http://vet.sagepub.com/content/46/3/484.full )

If so, some tweaking of his diet may be in order as well. Doesn't mean it's relevant for your boy -obviously something you need to discuss with your vet(s).

Wishing you and your boy all the best.

Kristine
I'm sorry... I seldom ever read this section so I missed your post. I don't have any experience though we came close to having a biopsy done on our Schipperke-mix to determine the cause of high ALT (around 1,200 at it's highest, copper storage was briefly discussed however all other liver numbers were normal). The following articles on Copper Storage Disease may be helpful-
http://www.peteducation.com/article.cfm ... 03&aid=406
http://www.vin.com/proceedings/Proceedi ... &O=Generic

More scientific articles specifically mention that Labrador Retrievers can be afflicted-
http://vet.sagepub.com/content/46/3/484.full
http://wvc.omnibooksonline.com/data/pap ... 0_V137.pdf
http://veterinarymedicine.dvm360.com/ve ... =&pageID=3

There is a brief statement in the book, "Handbook on the toxicology of metals" By Gunnar Nordberg about Phenobarbital and copper metabolism. See page 542. http://books.google.com/books?id=nKulgz ... &q&f=false I have no idea how or even if this applies so it's important to discuss it with your vet.

Make no changes without your vet's guidance. Hoping you and your vet can figure this out and that your boy will be ok.
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