This story is about Tate, a female Norwegian elkhound. Believe it or not, this gal is 14 years young.
December 3, 2011
When Tate's dad took her for routine bloodwork on December 3rd of last year, her ALT (Alanine transaminase) liver enzyme was 1237.
The normal range for this enzyme is 12 – 118, so obviously Tate's was extremely elevated.
ALT is found primarily in the liver, but it's also found in smaller amounts in the pancreas, kidneys, heart and muscles. ALT levels are a very important measure of liver health.
Low levels of ALT are seen in the blood when the liver is healthy.
But when the liver is diseased or damaged, it releases ALT into the bloodstream, which increases the levels.
Most high ALT levels are caused by liver damage.
Tate's veterinarian recommended an ultrasound of the liver which revealed a very large tumor and several other changes within the liver that suggested hepatocellular carcinoma.
More than 80 percent of dogs diagnosed with this type of liver cancer are 10 years or older.
Most studies have not found a breed predisposition for the disease.
Hepatocellular carcinoma is, unfortunately, a malignant liver tumor that isn't responsive to surgery or chemotherapy.
After meeting with Tate's dad, we decided our goal would be to
- Support remaining healthy liver tissue through detoxification
- Provide anti-tumor support.
Phase 1 and Phase 2 Liver Detoxification
The liver is the most important organ of detoxification in the body.
It spends all day, every day processing substances from the GI tract and other locations. It must sort through all the various compounds and decide which are toxic, which are beneficial, and what to do with them.
The liver has many jobs to do, including producing certain compounds, detoxifying others, and sending substances all through the body to be used, stored, or excreted.
There are two main pathways the liver uses for its detox processes. These are called the phase 1 and phase 2 pathways.
Phase 1, in simple terms, breaks substances down and then sends parts of them on to phase 2, which builds new substances by adding molecules to them in a process known as conjugation.
In phase 1, enzymes are used to break down substances in a process similar to how food is digested in the stomach. Phase 1 can't take place without these all-important enzymes, and their performance is dependent on a number of variables, including nutrients in the diet that can either enhance or inhibit the process.
After the phase 1 enzymes have metabolized some of the substances, metabolites (toxic byproducts) remain and must be quickly picked up by the phase 2 pathway where they will be made safer for the body to use.
Tate's Healing Protocol
When Tate came to see me on December 26th, we began a protocol that included the following components.
Inositol. Inositol hexaphosphate (IP6) is a naturally occurring carbohydrate found in the cells of almost all plants and mammals. IP6 possesses significant anticancer properties, including reducing the proliferation of cancer cells and increasing NK (natural killer) cell activity.
The enhanced immunity and antioxidant properties of Inositol are also thought to contribute to tumor cell destruction.
IP6 is easily absorbed from the GI tract, and is safe. In clinical trials, it enhanced the anticancer effect of conventional chemotherapy, controlled cancer metastases, and improved quality of lifeii.
Broccoli sprouts. Broccoli sprouts, which look and taste similar to alfalfa sprouts, contain the substance sulforaphane in high concentrations. Sulforaphane is a compound identified 20 years ago as having the ability to marshal the body's own cancer-fighting resources and reduce the risk of developing cancer.
Scientists at Johns Hopkins University discovered three day old broccoli sprouts have 20 to 50 times the chemoprotective property of mature broccoli headsiii.
Sulforaphane is a powerful mobilizer of phase 2 liver detoxification enzymes – the enzymes that counteract cancer-causing substances before they can damage DNA and promote the growth of cancer cells.
- Journal of Agricultural and Food Chemistry, 2006, 54 (6), pp 2069–2076:
Epithiospecifier Protein from Broccoli (Brassica oleracea L. ssp. Italica) Inhibits Formation of the Anticancer Agent Sulforaphane
- Integrative Cancer Therapies, March 2004 vol. 3 no. 1 5-12
Cruciferous Vegetables: Cancer Protective Mechanisms of Glucosinolate Hydrolysis Products and Selenium
Proteolytic enzymes. Proteolytic enzymes, also called proteases, are enzymes that break down proteins. These include pancreatic enzymes, bromelain (pineapple enzyme), papain (papaya enzyme), fungal proteases, and Serratia peptidase.
Proteolytic enzymes, once absorbed by the body, promote the production of anti-proteases which work against invading tumor cells. They also inhibit metastases (spread of cancer) and enhance immune system response.
Clinical trials using proteolytic enzymes showed they are well tolerated in conjunction with traditional cancer treatments, and helped improve patients' quality of life and life expectancyiv.
- Clinical and Experimental Metastasis, Volume 10, Number 3, 145-155
The role of proteolytic enzymes in cancer invasion and metastasis
Milk thistle. Milk thistle (Silybum marianum) has been used for centuries as an herbal remedy for liver, kidney, and gall bladder problems. Studies show certain substances in milk thistle – especially the active substance silymarin, a flavonoid – have a significant protective effect on the liver.
Laboratory studies have shown silymarin functions as an antioxidant. It also stabilizes cellular membranes, stimulates liver detoxification pathways, and promotes regeneration of liver tissuev.
Studies also suggest silymarin and other active substances in milk thistle have anticancer effects. These substances stopped cancer cells from dividing and reproducing, shortened their lifespan, and reduced blood supply to tumorsvi.
MedCaps DPO. This is a pharmaceutical grade liver support formula made by Xmogen®. This dietary supplement aids both phase 1 and phase 2 liver detoxification processes. It also contains antioxidants to minimize the damage done by free radicals generated between the two phases.
SAMe. S-Adenosylmethionine or SAMe, is a naturally occurring substance found in almost every bodily tissue and fluid. It plays a role in immune system function, maintains cell membranes, and supports several other processes within the bodyviii.
Researchers in Southern California have concluded SAMe is effective in preventing the formation of hepatocellular carcinoma in ratsix. It is able to selectively kill liver cancer cells without damaging healthy liver cells.
Tate on January 27, 2012
In addition to the supplements, we also changed Tate's diet to a commercial low carb, dehydrated raw food. We rechecked her liver enzymes on January 27th, and her ALT was 261.
We can't cure Tate's incurable tumor. But by supporting her primary organ of detoxification (the liver), and assisting her body's ability to recognize and address abnormal cell growth, we can extend the quantity and quality of Tate's life.
Sadly, most of my professional peers do not advocate liver detoxification as a regular part of a healthy lifestyle. Our pets are exposed to substantial levels of environmental toxins the liver must address -- in the air, water, and food supply, not to mention yard and household chemicals, as well as chemicals we may intentionally put ON our pets. As the body ages, its ability to effectively remove toxins diminishes and liver stress increases.
Reducing environmental toxins will minimize the workload carried by your pet's liver. Providing periodic liver detoxification is a smart idea, and one I recommend every pet owner discuss with their integrative vet. In my practice, I recommend milk thistle supplements for a week following any liver stressor such as administering heartworm pills, flea/tick treatments, or any other sort of medication.
Tate's dad had her regular veterinarian check her organ function a year ago, and the results were normal.
Tate's case highlights the heartbreak of cancer—the body doesn't recognize it.
Very often, it isn't until there is enough disease present to cause organ dysfunction that we learn there is malignancy.
Fortunately, after learning Tate's diagnosis, her dad researched options for treatment. He discovered that chemotherapy and surgery, while still recommended by many vets, have not proved statistically beneficial for hepatocellular carcinoma, and can ultimately reduce the quality of life that remains for the patient. Tate's dad wisely chose instead to help her live the rest of her life in joyful comfort. I'm honored to be a part of that.
Partnering with a proactive veterinarian who is focused on your pet's vitality is extremely important, nor matter how old your companion is.
Even for pets with a terminal diagnosis like Tate, there are many things we can do to improve the quality and quantity of life.
Primary hepatic and biliary tract tumors in dogs and cats: An overview, dvm360 June 1, 2006
The Journal of Nutrition, November 1, 2003, vol. 133, no. 11, 3778S-3784S
Johns Hopkins University, March 15, 1997,
Proteolytic Enzymes in Cancer Therapy, 2001,
National Cancer Institute at the National Institutes of Health
University of Maryland Medical Center,
MedCaps DPO Dual Optimizers,
University of Maryland Medical Center,
SAMe Prevents Primary Liver Cancer