Case 2
After discussion with the owner you decide to try the NSAID and SAMe, and Spot will return in four weeks for a repeat liver panel.
Five weeks later, Spot comes in for a recheck. The owner has seen some improvement in mobility, and Spot still seems to be acting fine.
These are the notable findings from your liver panel.
Patient values
Reference range
ALT (IU/L)
220
12-118
ALP (IU/L)
520
5-131
Bilirubin (mg/dl)
0.1
0.1-0.3
QUESTION 3
What is your next step?
a) Continue the NSAID therapy, and recheck Spot in six months.
c) Continue the NSAIDs and SAMe, and add silymarin to the regimen to aid in liver support.
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