Although increases in bilirubin (likely a mixture of conjugated and unconjugated) are seen in dogs with hepatic failure (Toulza et al 2006) (likely due to a combination of reasons, such as inflammatory cytokine-mediated alteration in transporters, toxicity from accumulated bile acids, alterations in intrahepatic blood flow from fibrosis, hepatocyte swelling resulting in cholestasis), the high bilirubin is not specific for failure and can be seen in various diseases that are not associated with liver failure, e.g
Kif1C, a kinesin-like motor protein, mediates mouse macrophage resistance to anthrax lethal factor
Diagnosis can be made with a combination of studies (send out labs for most folks): plasma free & total carnitine, plasma amino acids, urine orotic acid, plasma acylcarnitines, urine organic acids, comprehensive metabolic panel, creatinine kinase, and a lactate level
Though rare, more serious problems can occur, like nerve damage, especially if injections are given near important nerves in your face or neck
Nevertheless, fewer than half of patients treated with GLP-1RAs achieve guideline-recommended glycemic targets (typically HbA1c 10%), catabolic weight loss, and progressive -cell dysfunction 19
