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Ask Dr. Michael Salkin Your Own Question
Dr. Michael Salkin
Dr. Michael Salkin, Veterinarian
Category: Vet
Satisfied Customers: 33258
Experience:  University of California at Davis graduate veterinarian with 45 years of experience.
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Our Cavalier King Charles Spaniel is in her 11th year

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Hi Our Cavalier King Charles Spaniel is in her 11th year and was diagnosed with CHF 14 months ago by our Vet he put her on Vetmeden 2.5mg twice daily / Furosemide half of a 5mg tab twice daily / Spironolactione 10mg once daily / Benefortin 10mg once daily over the last few days she has had bad diarrhoea and been lethargic and not eating so I made an appointment to see my vet on Saturday after examining her he said that her liver was heard and she had fluid in her abdomen he then did a blood test and the results for the liver where all in the high range he the put her on Protexin Denamarin but did not say to stop the Spironolactione, my question is should my vet have stopped the Spironolactione as I have read that this is not recommended for dogs with liver problems
While spironolactone should be used cautiously in patients with hepatic disease, it often is used to treat ascites - that fluid in her abdomen. We're primarily concerned with a liver functioning so poorly that it can't excrete the spironolactone efficiently. Although your CKCS's liver enzymes are elevated, her liver may still be functioning satisfactorily. To tell if that is, indeed, the case, a blood test called serum bile acids can be performed. Please respond with further questions or concerns if you wish. (The mechanism of spironolactone hepatic injury is unknown, but is most likely due to a metabolic idiosyncrasy. It's a rare occurrence in people in any event.)
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