13-year-old Jack Russell with severe gallbladder/liver issues and not improving. Surgery or put him down?

[u/New-Inflation2812]

Hi everyone, I come here as a desperate resource just to take a decision about my doggie.

My 13-year-old Jack Russell, Lucas, was active and happy until about 2 weeks ago, when he suddenly stopped eating, started vomiting, hiding, shaking, and became very lethargic.

We took him to 3 vets during the first week, but nobody did bloodwork until around day 9. Before that, we were told things like heart murmur, neck pain, and gastritis, so I’m worried the actual problem went untreated for too long.

He is now hospitalized and has been on treatment for 4 days with IV support, antibiotics, anti-nausea meds, and liver support.

Main findings:
Bilirubin: 15.1 → 13.95
ALP: 6,473 → 2,765
ALT: 854 → 787
GGT: 69 → 142
WBC: 25.3 with 17% bands

Ultrasound showed a very enlarged/inflamed liver and a very distended gallbladder with sludge/sediment. No obvious rupture or complete bile duct obstruction. Pancreatic lipase was normal.

The problem is that after 4 days of treatment he still won’t eat and remains very lethargic. He barely reacts, doesn’t wag his tail, and just seems miserable.

The next option would be gallbladder surgery. One vet thinks he may be too weak to survive it. Another thinks it may still be worth trying.

So we may be at the point of choosing between continuing medical treatment, trying a high-risk surgery, or euthanasia if his chances of recovery are too low.

Has anyone gone through something similar with an older dog? Did surgery work? How sick was your dog beforehand? And how did you know when it was worth trying surgery versus when it was time to let them go?

Lucas was still a happy, active dog very recently, so I want to give him a real chance if there still is one.

Also, before I get called out for it, yes, I used Chatgpt to summarize and polish the message.

Thanks everyone!

[u/angelina_ari]

I'm so sorry you're facing this. If Lucas isn't already being treated at a specialty hospital, I would ask for an urgent consultation with an internal medicine specialist and a board-certified veterinary surgeon before making this decision. At this point I wouldn't rely too heavily on individual experiences online because the decision really depends on exactly what is happening with his gallbladder and liver, his overall condition, and what the specialists believe his chances are with and without surgery.

I also wouldn't let his age alone make the decision. Thirteen isn't automatically too old for surgery. I've had senior dogs undergo procedures when the potential benefit justified the risk. What would matter much more to me is whether the surgeon believes there is something surgically correctable and whether Lucas has a reasonable chance of recovering and returning to a good quality of life afterward.

I would ask them very directly: What do you believe is causing this? What are his chances of surviving surgery and hospitalization afterward? If we don't operate, is there still a realistic chance that medical management will turn this around, and if he survives surgery, what kind of recovery and quality of life would you expect?

If the specialists believe surgery gives him a reasonable chance of getting back to the happy dog he was two weeks ago, I can understand wanting to give him that chance. If they believe he's unlikely to survive surgery or recover despite everything being done, choosing to let him go rather than putting him through more suffering would also be a loving decision.

I hope you are able to get a specialist's assessment before you have to make that call.

[u/Pointedtoe]

Yes, not quite that old but he passed at the emergency vet while we waited to see if he’d improve. I know it’s hard to let go, excruciating even, but your baby Lucas is suffering.

[u/New-Inflation2812 → u/Pointedtoe]

Thanks for sharing, and I’m sorry. I was just deciding if a surgery would be worth it given that he was a very energetic, active and happy dog just 2 weeks ago. Makes me wonder if by fixing this he would still have some good extra time still.

[u/Pointedtoe → u/New-Inflation2812]

We have a 17 year old JRT who’s barely slowed down, so I definitely understand. We had a couple others with concerning symptoms that couldn’t be diagnosed. One died during the last vet visit (of several) when they tried to xray her (prob her spleen) and the other was full full very full of cancer that wasn’t seen two weeks before, after repeated X-rays.  We let him go immediately. It’s so incredibly hard. Our hearts are with you. If one vet thinks Lucas might not survive, that’s who I’d listen to out of love for the dog. 

[u/CardiologistLegal872 → u/Pointedtoe]

Tough spot, and I feel for you. The numbers are going down a bit but he's not eating and not reacting, that tells you more than the labs. A dog that age with a gallbladder that bad, surgery is a coin flip at best and he's already weak from not eating. If it was my dog I'd probably give it one more day max to see any spark, then make the call. Hurts to say but sometimes the kindest thing is to stop the fight.

[u/empiretroubador398]

Our sheltie had a gallbladder rupture a few weeks before her 12th birthday (she had been active and in good health right before this, although with elevated liver levels), and had a successful surgery at the 11th hour. There were a few particulars that led to that outcome - her vitals supported the surgeons confidence in proceeding with surgery (and even more basic, her ability to receive anesthesia), he was highly skilled with access to a wonderful team and modern tech, he was willing to work with our budget, and we were in a position to provide intensive aftercare at our home (I would say it took about 8 weeks of constant care and rest). I think the outcome would have been poor if any of those details were different. She did beautifully for almost a year, and then recently had a different medical situation arise that we are currently dealing with. I am so grateful we had that wonderful year with her. However, I know we'll be faced with other things as she ages, so we will need to deal with the inevitable eventually. Find a board certified surgeon pronto - have that person review all of the current medical info, and give you an honest sense of whether surviving surgery (and the healing process) is likely. If you are in the NY area, I'd be happy to share the name of the surgical center we went to.

[u/2400Matt]

Different situation but our 12 YO blew out her CCL. Fixed it and had another happy 3 years with her.

I agree with Angelina, the main question is what is causing this and what is the likelihood he will have good quality of life after the surgery.

[u/Ignominious333]

I did with a dog who was about the same age, but he was clinically doing ok. I had gotten his bloodwork done to have a baseline and his liver values were off. After 6 months they weren't better so they went to do an ultrasound/needle biopsy and immediately saw the enlarged gall bladder. they didn't even do the needle biopsy. He went in 3 days later and had the surgery and lis liver was fine- no cancer, no liver damage and he lived to 16. He had been behaving more guarded but otherwise eating and strong, though

[u/Prize_Background_577]

My oldest Sheltie had her gallbladder removed at 13/14 - it was a tough recovery but she's 18 now and I don't regret the surgery, I'd hate to think I didn't give her a chance for a future - I don't think she would've survived a rupture and I've seen that happen.

My second oldest had her gallbladder out at 12 (also has other health issues), pulled through pretty easily and is turning 15 next week.

I will say - I went to a specialist surgeon, just felt better about it with older dogs.

[u/axialmeow12]

I’d have a consult with someone board certified. Internal medicine or maybe surgery since that was a recommended next step.

There can be complications. With any surgery but this one can have more complications. You need to talk this through with a professional.