Liver/Kidney Issues.

This page will show cases of dogs with hepatic issues and how feeding whole food nutrition helped.


Ava, a Pit Bull mix, with multiple liver shunts and reoccurring UTI and E-coli infection.

Ava is a Pit Bull mix, approximately 4 years old, and was surrendered to the Cumberland County SPCA in February 2015.  On 4/21/15, she was vaccinated for rabies and tested heartworm positive.  In late April 2015, Polished Pitbull Rescue pulled her from the shelter into their rescue program.  She was a spunky, affectionate dog despite her previous life of neglect. 


She was taken to the vet on 4/27/15 and weighed 46 lbs at that time.  She was spayed at this time.  She also had pyoderma (chin/inguinal area/abdomen).  She was given Clavamox 250mg and Doxycycline 100mg and placed on a regimen with Doxycycline, Prednisone and Heartgard.


On 5/28/15, Ava returned to the vet because she had blood spotting from her vaginal area which was believed to be a UTI. It was also noted that the pyoderma continued.  She was given a treatment plan with Cephalexin 500mg 2x/day and Zyrtec 10mg 2x/day for skin allergies. Her weight was 57 lbs.


On 7/7/15, she was brought to the vet for her first of three heartworm treatments including Immiticide injection, Prednisone and Robaxin.  During this visit, there was still blood while urinating.  She was again given Clavamox 250mg. 

It was during this time that Ava had her first head tremor (see video).  Though this one seemed an isolated incident at first, in October 2015, Ava began to have tremors regularly and consistently about an hour after she ate.  She also began stargazing at this time.


On 8/19/15, Ava returned to the vet for heartworm treatments #2 and #3.  Her weight was back down to 46 lbs.  She was again given Prednisone, Robaxin and Immiticide injection.  Staff noted she was uncomfortable and would not stand to eat; she was given Tramadol 50mg.  On 8/20/15, her demeanor was happy and she urinated large amount with no visible blood and had normal bowel movement.  She was given Prednisone and Robaxin, followed by Tramadol, and then Immiticide injection.  She was discharged and sent home with Prednisone and Robaxin.  The UTIs continued; Clavamox was not helping.  UA showed rods and elevated pH; a culture and sensitivity test were done and Ava was put on Enrofloxacin 68 Mg.

On 9/12/15, Ava was brought to her vet for excessive urination and had a distended and tender abdomen.  Ultrasound was ordered and performed on 9/14/15.  The diagnosis was polycystic kidneys and incontinence.  Also noted that she had a large left kidney.


9/30/15, foster parent noted her urine was dark and Ava’s activity level was decreased. Still eating, but drinking less.  On 10/1/15, a urine sample was provided and rods were noted.  She was given Zenequin 100mg. 


Despite her “minor” medical UTI problem, Ava was adopted in August.  But as her health issues continued to be challenging, the family decided they could not bear the heartbreak of watching Ava’s slow decline which appeared to be inevitable and decided to return her to the rescue. 


10/26/15, urinary issues continue.  NDSAID panel with urine.  Ava was put on prescription kidney diet. Referred to Dr. Schelling for Ultrasound (reference VRC document, page 2).  Diagnosis: multiple mesenteric, extrahepatic, portocaval shunts; E-coli infection involving left kidney.  No treatment for UTI/E-coli, waiting for further testing/results.


11/25/15, Dr. Schelling performed a liver biopsy.  Diagnosis: congenital as well as inflammatory components.  Still no treatment for UTI/E-coli, waiting for further testing/results. 


11/28/15, Ava was rushed to the vet, presenting with a temperature of 106, lethargy, lack of appetite.  (Reference document: VRC Emergency Visit)  Weight still holding steady at 46 lbs.  Another U/A and culture were run.  Results indicated E-coli at approximately 100,000 colonies/ml.  Ava was placed on IV fluids and finally began treatment for the UTI/E-coli infection with Amikacin.  Her prognosis at this time was bleak with a projected imminent death of 6-12 months, though less than that was more likely.  She was sent home with a treatment protocol using Trimethoprim/sulfamethoxazole for the E-coli infection as well as Metronidazole and Lachilose.  She also began a twice daily cleaning with a Chlorhexidine solution around her vulva.


Ava’s condition continued to deteriorate during this time.  Her coat was dry, coarse and thin.  Her skin in general was dry, scabby, and raw/bleeding in some places. Her chin erupted with blisters and a bacterial infection.  On 12/16/15, Ava was brought to a Doylestown Veterinary Hospital. Additional labs were run and she was placed on an Omega 4 supplement as well as Chinese herbs to support her kidneys.

On 1/5/16, Ava completed her course of antibiotics.  On 1/12/16, she had blood in her urine again and Doylstown Vet was contacted.  The blood resolved within 12 hours.  On 1/18/16, the blood in her urine returned.  On 1/20/16, per Ludwigs Corner, she began another six week round of TMS, and she continued the Chinese herbs for kidney support. 


2/8/16, Ava returned to Ludwig’s Veterinary.  She had lost 10 lbs (more than 20% of her body weight) and was now at 37.5 lbs despite eating vigorously.  Veterinarian believed her weight loss was due to her underlying disease process but would not rule out endocrine/parasitic/malabsorption diseases.  U/A and culture were ordered; both negative, but Ava was currently on TMS.  Thyroid tested at Michigan State – results were not supportive of hypothyroid but could not rule it out either.

Ava continued to lose weight and on 02/27/16, she took a dramatic turn for the worse and had an ataxic fall event while attempting to go upstairs.  Her gums and eyes were pale; anemia suspected.  She was given Floradix liquid iron and began a home-made diet; Ava rallied in energy but body was still deteriorating.  TMS was immediately discontinued.

On 3/2/16, Ava had a recheck appointment with Doylsetown Vet. They prescribed Lactulose, Metronidazole, and Denamarin.  Her foster, Kelly, began searching for dietary options to support Ava’s end of life.  On 3/5/16, she attended a seminar given by Jacqueline Hill of Answers Pet Food.  Everything “clicked” in Kelly’s mind and she immediately contacted Jacqueline about Ava. 

On 3/11/16, Ava began her “raw milk diet” with Answers Pet Food.  Her diet consisted of 20 oz Goat milk in am, 8 oz fish stock in afternoon, 13 oz kefir in evening based on 50 lbs, and she was on NO medications or supplements. This was eventually bumped up quantities to 24 oz goat, 8 fish, 16 kefir to better match her ideal weight of 55-60 lbs. Ava's body began to respond immediately although she was purging toxins through skin eruptions which continued for a while but ultimately resolved.

3/28/16 - Ultrasound guided cysto to obtained sterile urine sample.  Results showed E-coli positive, resistant to all but Amikacin and TMS. Ava’s foster declined any medications and chose to continue with the raw milk diet. 

By the end of May, 2016, Ava’s diet was changed to begin introducing Answers Straight Beef but was stopped within a couple of weeks due to PH issues.  By July 2016, her foster began introducing small amounts of Straight Pork into her diet.

Ava has continued to grow healthier and stronger every day. She has not had a single reoccurrence of UTI since starting Answers.


October, 2016, from Ava’s foster, Kelly:  Ava is thriving today and the change is remarkable. She has been completely medication free since the end of February and shows no signs of slowing down. The shine has returned to her coat and the twinkle is back in her eye. She tap dances again and finally remembers what it should feel like to be a young and exuberant dog. We don’t know where road will take Ava but I believe in my heart that the next chapter of her life will be the best yet. It is hard to imagine that a dog who spent the first few years of life nearly invisible has, through her indomitable spirit and endless capacity for love, won over so many hearts and brought together so many wonderful people who I am proud to call friends. It takes a village and oh my, what a miraculous, wonderful village have been there to carry Ava through her darkest days.

Update 8/11/17:  Ava was adopted into her forever home in February 2017.  From Ava’s forever mom, Jenn:  "When she came to us she was a bit stressed, down in weight, chin issues and skin eruptions. Now that she is adjusted and happy, we only have some summer allergy issues and occasional chin break-outs (mostly if she chews her bones too long).  Her urine is normal and clear and she has normal, healthy dog poop!  She will “leak” occasionally but from what I have been able to conclude it is when she gets overheated outside and drinks too much water.  Her weight is good.  Her current diet consists of ALL ANSWERS products!!  She gets one patty of the raw meat, with kefir poured on top and then about 48 oz of raw fermented goat milk per day."


A dark brindle Plott hound with possible liver shunt.

When Holly found out about Allie being returned to a “kill shelter” by her month-long foster on April 26, 2016,  she went to the shelter the next morning and adopted Allie. But Allie did not look or feel well at all. Recently spayed, with her incision still healing, Allie was emaciated, severely depressed and clearly in pain. Her malnutrition may have been lifelong as she also had musculoskeletal and dental abnormalities. Holly described Allie’s severely depressed condition this way: “Allie was ‘dead.’ She just laid down in the corner all day with no desire even to stand. She refused all food. I had to lift her. She walked into walls like a weak drunk. She refused to allow the other dogs near her.” Allie weighed just slightly over 34 pounds.

Holly had Allie examined by her veterinarian. At the shelter, she had been spayed and had been given Bravecto and Drontal. Her spay incision was now swollen and infected. She had had her tail broken in two places at some point and she was Lyme positive (293 ul/ml on Idexx C6 test). She was put on antibiotics and anti-inflammatory medication. She was given DAPP vaccine and a Lyme Vaccine. See buttons below for copies of Allie's fecal and Lyme tests.

Subsequently, since Allie would not eat, the veterinarian switched from Doxy to an injectable antibiotic, two doses, two weeks apart. Due to her emaciation, the veterinarian was challenged to find a suitable site for her injections.

Allie had a seizure. It was videotaped and her veterinarian thought it was a petit mal seizure. Allie vomited after eating what meals she would eat. She coughed after playing. She did not want to eat. She would not take the doxycycline, which was prescribed for the Lyme, so none was given. Her urine was an orange color and oily in appearance due to bilirubin content, and her feces were small and soft with mucous.

Allie returned to the vet due to Holly’s concern about her vomiting, inappetence, coughing and weight loss. The veterinarian found tachycardia, and weakness. A fecal test was negative. Since Allie was afraid of Holly’s other dogs, the veterinarian speculated that Allie’s food refusal might be behavioral in origin. However, in order to be thorough, the veterinarian sent Allie’s blood to the lab to run a chemistry panel and CBC in order to rule out physical causes (following good practice principles which include always rule out the physical before focusing on behavioral).  

When the lab results were received, it was discovered that Allie has evidence of liver disease. See button below history for copy of labs.
High ALP (190)
High AST (303)
High ALT (826)
Low BUN (7)
Low cholesterol (120)
High RBC count with low MCV and MCH
The veterinarian then recommend a bile acid test. In the meantime, Allie was getting worse. She had decreased menace response, decreased visual acuity, and was stumbling with decreased proprioception in the rear. As Allie’s physical issues worsened, Allie was becoming aggressive toward Holly’s other dogs.

Allie’s bile acids came back:
See button below history for copy of bile acid test.

Further diagnostics were recommended  to determine if Allie had a liver shunt or had been exposed to liver toxins, but regardless of further diagnostics, a poor prognosis was given. Allie was prescribed famotidine and given a second injection of an antibiotic (Convenia®).

Concerned about Allie’s severely depressed and emaciated state, guarded prognosis and the aggression Allie demonstrated toward her other dogs, the local veterinarian recommended euthanasia. Finally, Holly reluctantly agreed euthanasia would be the kindest course for Allie. The Saturday morning Holly made her decision about euthanasia, her roommate, Lawrence, asked Holly if he couldn’t take Allie to a holistic veterinarian for one last try at helping Allie. Holly was skeptical, but decided to give it try.

The holistic veterinarian weighed Allie at 34.2 lbs. Other than emaciation, no abnormalities on PE were noted. At this time, her owner had her on many supplements (including but not limited to vitamins, minerals, and milk thistle). The holistic vet prescribed a Standard Process product called Livaplex and suggested Allie start a liquid raw diet with Answers Pet Food products. Allie’s diet now would be a liquid diet consisting of Answers Raw Goat's Milk, Raw Cow Kefir and and Fermented Fish Stock.

The additional supplements were stopped.

Allie responded remarkably to the new diet. Holly shared that “instead of refusing to eat, she runs and sings hound songs to eat.” She no longer vomited her food. She started playing with Holly’s other dogs (who did not trust her at first since previously she acted aggressively). The neurologic issues ceased. Feces and urine had a normal appearance (previously the urine had bilirubin and the feces were soft with mucous).
Did this diet help Allie?  

Holly’s reply: “Yes! I wish we’d taken pictures of the dying, fleshless skeleton that Allie was before this Answers diet. The difference is unbelievable and rapid. Even her eye color changed from vacant black to a warm brown iris. We need to shout about this from the top of every mountain!”

Allie eats 32oz goat milk, 32oz kefir and 8oz fish stock per day. She is playful with the other dogs. Holly put it this way: “Allie LOVES to play – she outruns everyone in tag outside, tosses elk bones into the air, rolls and plays with my roommate’s dog for hours, squeaks the tennis ball in glee, and sings hound songs with joy. She’s making up for her lost ‘childhood.”

Allie was retested for Lyme C6 and results went from almost 300 down to 93! Click on button below for C6 test result.

Allie continues to do well!  She weighed in at 37.8 lbs.

Note: the original veterinarian recommended further diagnostics to confirm the diagnosis of a liver shunt including CT nuclear scans. They also recommend exploratory surgery +/- correcting the liver shunt, which would be a very invasive procedure, not without risk. Medical management is always preferred. Allie is doing fantastic on a diet change alone without these expensive and/or risky procedures.

Allie had a checkup including blood work. She weighed in at 41.4 lbs. and Dr. Pema reports she is clinically doing great despite the liver values on the attached lab work (see labs dated 9/10/16 below).

January 2017:  Allie has been on the Answers liquid diet for 7 months now. Dr. Pema reports that Allie's labs still show elevated liver enzymes and evidence of a liver shunt on the bile acid tests.  However, Allie's "mom and dad" report she is doing very well and loves to play. See Allie's January labs below.  Allie now weighs 41.8 lbs.

05/27/17:  One year!  Allie has been on the Answers liquid diet for one year and has reached her goal weight.  Her diet consisted of 36oz Kefir, 36oz Goat Milk and 8oz Fish stock per day but she was not eating all of it so was cut back to 28 oz Kefir, 28 oz of Goat Milk and 4 oz of fish stock.  Dr. Pema reports that she found a heart murmur that was not there in January, and that her liver disease is stable and bile acid slightly improved.  See labs below.  Allie was titer tested for rabies; results were >/= 0.5 which is protective.

Allie’s owner, Holly, says , “Allie is physically very strong, bright, happy and full of life.  She’s tall, muscled and bright-eyed, and full of play and dance, and loves teasing me to pull the squeaky tennis ball from her mouth.”  “You know I continue to totally believe the only reason she’s alive, let alone so full of life and healthy, is solely because of the Answers “milkie” diet. My continued heartfelt thanks to all of you.”

Allie's weight history:

6/4/16 34.20lb

6/14/16 33.80lb

7/20/16 37.00lb

8/3/16 37.80lb

9/10/16 41.40lb

1/7/17 41.80lb

2/7/17lb 42.20lb

5/27/17 45.20lb


11/2/17 (update from Allie's owner): She has not had any seizures and her energy is fantastic! Her joy and happiness overflow.  She loves to play, and even roughhouses a bit.  Tug of war, or keep-away with the tennis ball are favorites.  Being a hound dog, she’s very vocal – not just barking – she sings and talks.  She is currently eating 16 oz of Answers raw goats milk and kefir, and 4 oz of turkey stock, twice daily. She is supplemented with Colostrum-LD Powder:  ¼ tsp. at each feeding (2x/day); I capsule RX Vitamins 90 Formula CV for dogs (hawthorn berry) at each feeding to address the heart murmur detected by Dr. Pema.  She will occasionally get into the cats food and when that happens, she gets one capsule of livaplex.

Just wish everyone with a beloved dog who suffers from disease could see what the Answers fermented diet has done for her life.  Given her life back to her.  It’s just so compelling."

12/18/17 (update from Dr. Pema):  She now weighs 45.6 lbs and Allie has grade 1.5/6 systolic murmur normal rhythm.  She is still taking CV Formula and Colostrum supplements in addition to her all milk diet.

Allie was treated at Holistic Veterinary Healing in Germantown, MD by Dr. Pema.


Maggie, a 15 year old Beagle/Daschund mix, with high liver values.

Maggie was adopted when she was about two years old and led a very active lifestyle - hiking, running, and long walks were favorite pastimes for her.  Her diet consisted of dry kibble purchased at big box pet stores and treats like Snausages, Begging Strips and Milk Bones. 

In 2008, Maggie (as well as her owner, Krista, and another adopted dog) was diagnosed with Lyme Disease.  She was asymptomatic and the diagnosis was given based on results of her annual blood work. She was treated with Doxycycline 100mg/every 24hours for 30 days, and given a Lyme vaccination.

In 2013, Maggie tore an ACL.  She did not undergo surgery for this, and was rehabbed by her owner, Krista.  It was at this time, that Krista recognized the need to change her diet and made a switch to a commercial raw diet.  In November 2015, Maggie began displaying symptoms and odd behaviors (swollen ear flap, excessive scratching).  In December, her owner noticed a small bump on her rear leg.  This was diagnosed as a mast cell tumor. She had a successful surgery in January 2014 and was placed on Chinese herbs for supportive care.

In May 2016, Maggie and her family moved to a new home.  Shortly after, she began having urinary incontinence.  Her new vet suggested that it may have been due to the stress of the move.  No medications were given. In July 2016, her Chinese herbs were adjusted to better support her immune system. 

In February 2017, Maggie presented with loss of appetite, vomiting, loose stools. Maggie's owner was able to clear this up with at-home care within a few days. 

On April 10 2017, while on a walk with her owner, Maggie's rear legs gave out and she collapsed. After a few moments, she seemed okay and walked home.  On 4/12/17, Maggie was treated with acupuncture  to help with blood flow and it was suggested that she get blood work done.  On 4/14/17, Maggie went in for her annual exam and blood work.  As a result of that, she was placed on Denamarin for high liver values (ALP: 202 high; ALT: 245 high; AST: 82 high). She finished the Denamarin on 5/18/17.  New blood work was completed showing continued high liver values (ALP: 175; ALT: 385; AST: 74) and Maggie was referred for an ultrasound as well as bile acid test.  The ultrasound showed no masses but her liver values continued to be elevated (ALT: 356; AST: 78) . A biopsy was recommended and Krista was informed that Maggie had liver disease and would be on medications for the rest of her life. Not wanting to subject Maggie to additional testing or put her on life-long medications, Krista began researching alternatives and discovered Answers Pet Food.

Answers Raw Fermented Goat's Milk was added to Maggie's existing diet in June 2017.  On 8/11/17, she started a 30 day fast.  All medications and supplements were stopped (including fish oil, dasaquin, OraVet, frontline & heartgard).  Week One - only raw fermented goat's milk.  Week Two - Answer's Cow Kefir and Fermented Fish Stock were added.  Week Three - Answers Fermented Cheese Treats were added.  From Kristen, Maggie's owner:  "Almost immediately, within 2 weeks, Maggie began was showing more interest in eating. Before Answers, she had lost her appetite; now she looks forward to her meals and always finishes. Before Answers, she would leave food in the bowl - that was especially bad for me because my other dog would then eat her leftovers & he gained too much weight!" 

1/10/18 Update from Maggie's owner, Kristen: "Today, Maggie is wonderful!!  She’s healthy, happy, & has a great appetite for food & life!  Maggie still eats Answers.  After the 30 day cleanse, I slowly added Answers raw meat, turkey, to her fermented goats milk & cow kefir.  And, after her amazing lab results showed perfect liver levels, I started adding in beef.  Maggie gets 1/2 of her calories from goats milk or cow kefir and half of her calories from Answers turkey or beef."

Cha Cha.

A young Chihuahua mix with demodex and elevated liver enzymes.

Cha Cha, an intact female Chihuahua mix, weighing 10 lb. 3 oz, first came to see Dr. Lisa Brienen, a holistic veterinarian at Mercy Veterinary Clinic on 12-27-13, when she was 16 months old. 

Cha Cha had been suffering from generalized demodex (diagnosed via skin scraping) since she was 8 weeks old (2012). Before she came to see Dr. Lisa, she had been treated with two series of ivermectin treatments. However, post-treatment, Cha Cha developed elevated liver enzymes.

In May of 2013, her ALT ranged from 196 on May 4 to 377 on May 15 when her ALP 84 and her bile acids were 14 (pre) and 98 (post). The conventional practitioner she was being treated by at that time prescribed antibiotics. Below please see liver scan results completed prior to Cha Cha’s first visit to Dr. Lisa. Additional lab results are also posted as well as a summary chart of liver values over time. Whereas liver toxicity is not a side effect commonly thought of from ivermectin, any drug can cause an idiosyncratic reaction.

Dr. Lisa noted Cha Cha appeared severely depressed. She described Cha Cha as “moribund, lying limp on her owner’s lap.” At that time her skin was normal, but there was concern about her reaction to the ivermectin treatments and the resulting liver damage. Dr. Lisa treated her mainly with homeopathy (first remedy was Nux vomica) and a liver tonic (low doses of dandelion, milk thistle and a few other herbs) but  the herbs were discontinued when Cha Cha developed diarrhea. She was switched to Denamarin® (Nutramaxx) and she tolerated that.

But then the demodex came back...

Cha Cha had areas of alopecia and hyper-pigmentation of her skin. Her immune system must have been severely compromised.

Dr. Lisa has had success in the past treating demodex with homeopathic remedies, but homeopathic treatment is not a quick fix, it takes time to heal the body. For over a year, homeopathic remedies were given while Cha Cha’s owner continued to try additional treatments such as herbs, acupuncture, and supplements from Standard Process plus ultimately an herbal shampoo.  Additionally, homeopathy was successfully used for Cha Cha when she demonstrated clinical signs of lethargy, significant appetite loss or hemorrhagic diarrhea. Cha Cha’s ALT liver enzyme remained high.

On December 10, 2015, Cha Cha’s mom started her on the Answers Raw Goat's Milk cleansing diet. She decided to try this because, after taking Cha Cha to two conventional vets and three different holistic vets, Cha Cha still was suffering from demodex. Her mom told me "I was more than desperate as I refused to give her a 3rd dose of ivermectin, a neurotoxin."  She heard about the benefits of a raw goat's milk cleansing diet from Lana Mack, an employee at Natural Pet Pantry in Kirkland, Washington and decided to try this with Cha Cha. Dr. Lisa provided veterinary oversight.  

Answers Fermented Fish stock was added to the goat's milk in April 2016.

Dr. Lisa noted hair growth in March 2016. Cha Cha had one incident of depression and inappetence June 2, 2016 which Dr. Lisa treated successfully with one dose HP – Arsenicum album 30C. On June 7, 2016, Cha Cha had dark diarrhea but a negative fecal. She was treated with a few additional doses of Ars. Alb 30C – which treated her diarrhea and her energy return to normal.

At her veterinary visit on September 2, 2016, Cha Cha’s liver enzymes were normal for the first time (8 months after starting on the cleansing diet). Please see lab work dated 9-2016 .

Cha Cha’s diet at that time consisted of 24 oz goat milk and 4 oz fish stock and no other supplements. She still had topical shampoos. At her exam, Dr. Lisa noted her hair was almost completely grown back in (she only had one 3-4 mm hairless spot left lateral thigh). Dr. Lisa noted Cha Cha’s hair was dry, but her skin had only slight hyperpigmentation on her abdomen and very few comedones. Her mom reported her stools overall were normal though on occasion she did have watery stools. Cha Cha showed great energy and has normal body condition. Her heart rate was 80 bpm with normal auscultation. Cha Cha had regular and normal heat cycles. She weighed 9 pounds 13 oz.

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