My doctor ran a blood test on my 8-year-old male Pomeranian, Ricky. He said something about his liver enzymes being high. He put him on antibiotics for two weeks and then retested the blood. The liver enzymes are still high.

Now he says that Ricky should have surgery and a biopsy. Ricky is not sick, and I don’t want to spend $1,000 for a surgery I’m not convinced he needs. Do you think we should get the surgery for Ricky, or is there an alternative approach?

In my practice, most pets I see for a second opinion do not have liver disease as their primary problem.

Instead, they have adrenal gland disease (Cushing’s disease) that is often misdiagnosed as liver disease. So I would hold off on any surgery at this point.

If Ricky does have adrenal gland problems, he would not heal well from his surgery. If it turns out that the liver is not the real problem, treating him with antibiotics won’t help.

If Ricky has adrenal disease, complementary therapies may be helpful (see the next letter).

My lab, Smitty, was diagnosed with Cushing’s disease. His doctor recommended a medicine called Lysodren. I’ve read up on this, and it seems as if it can be toxic. I’d like to try something other than drugs for him. Do you have any suggestions?

Lysodren can be toxic in dogs and requires careful monitoring. I have used it with minimal side effects, but I pick my cases carefully and monitor my patients closely.

In severe, advanced cases, Lysodren may be needed. I have been fortunate to diagnose Cushing’s (adrenal) disease early in many pets. Early diagnosis is critical.

These pets often respond well to nutritional and herbal supplements (we have the herbs specially made for us).

I’ve noticed many animals that have blood tests indicating the possibility of Cushing’s disease, but these dogs showed negative results on further testing. I believe these dogs are “pre-Cushingoid.”

Early intervention with supplements has helped most of these pets stabilize and not develop full-blown Cushing’s disease.