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Mutts and Cats

Hi Aimee. Unfortunately, my dog is continuing to have the partial seizures nearly every morning. But, as disturbing as it is, at least he hasn’t had a full blown seizure in 9 days. I do worry that he could be having more partial seizures than I realize – like at night. I’m confident that I’m not missing any full seizures, but I could easily miss a partial.

I’m continuing to give him a smaller dose of CBD Oil in early in the morning, and also continuing Keppra 2x. I guess I will take it one day at a time as far as deciding when to completely stop the CBD.

Back when I was giving him only CBD Oil I had worked up slowly to 2.5 mg/kg/day CBDs (in 2 doses). From what I had read, the studies were typically using around 5 mg/kg/day, and the McGrath study on adverse effects used much higher doses of 10 and 20 mg/kg/day. I would have kept increasing the dose I was using if his liver enzymes hadn’t shot up. From what I could glean from studies it seems that most dogs had only a minimal rise in enzymes, if any, at the lower doses, yet a few dogs did have a significant rise.

You make a good point that although I think that I am using a quality brand (organic and aggressive third party testing, etc), it is possible that there is something unique about the oil I am using that caused the dramatic rise in enzymes. I just hope that his levels are coming down when the next bloodwork is done in early March.

I was just rereading the 2018 McGrath Report (A Report of Adverse Effects Associated With the Administration of Cannabidiol in Healthy Dogs) again and noticed a statement that made me want to have a better understanding of liver testing, and I thought you might be able to help me with that.
This was part of the discussion about a rise in ALP levels. “There was no evidence of short-term hepatotoxicity since fasting and postprandial bile acids remained normal for all the dogs throughout the study. However, the potential for long- term liver toxicity was not evaluated in this study.”
And then from an article by McGrath discussing her studies “Bile acids were monitored every two weeks and no changes were noted, suggesting the liver continued to function normally.”

My vet has never even brought up a bile acids test, and I now don’t understand that. I’ve actually been frustrated that she really didn’t seem all that concerned about what I considered to be dramatic increases in my dog’s ALT and ALP. Especially ALP, which is now at 6x the upper reference range value. So evidently the lab results as a whole she doesn’t find terribly troubling. The other liver-related results on the lab report (AST, GGT, and Bilirubin) were within range. Although, confusing to me, is that the Bilirubin Total was about mid-range, while the Unconjugated was at the very low end and the Conjugated at the very high end.

When we were discussing the last lab report my vet did say that I could have an ultrasound done, but it felt more like a response to my concern than a recommendation. It was at that point that I decided to discontinue the CBD and see if that causes the enzymes to come down. It seems to me that it would be prudent for the next blood test to include a bile acids test, instead of skipping that and jumping right to an ultrasound. I hate to even think this, but the ultrasound would be more of a money maker for her clinic . . .

If you care to comment on the usefulness of a bile acids test that would be great. You are so good at boiling information down so it is understandable. Thanks. M&C