High liver ALT + GGT blood levels in a puppy

Hi! Teddy is my 8 month old purebred chihuahua🐶. He had a pre-anaesthetic blood test before his desexing procedure which showed his ALT liver enzyme was high (normal range is 0-88➡️Teddy’s result was 97). We were told he likely ate something in the garden and to do a more comprehensive blood test in 3 weeks time to allow the level to lower. After 3 weeks Teddy’s ALT level remained around the same level (normal range for this blood test is 16-90➡️ Teddy’s was 103). We were then given “Hepatoadvanced” tablets to help the liver repair itself and to lower the ALT enzymes. After 2 weeks on these tablets the vets were shocked that Teddy’s ALT levels had increased from 103 to 115 and now his GGT liver levels increased from 4 to 11 (normal range for GGT is 0-9). Teddy shows zero signs of illness or lethargy and is a good weight for his age. The vets said it could be a liver shunt, a liver mass or Teddy's individual values could just be outside the normal range- but now with 2 liver values trending upward this is now unlikely. I am wondering if anyone could offer advice on what could be happening or what test to do next? We have now spent hundreds of dollars on testing and aren't sure what the next best thing to do is. Thank you🙏🏼

Hello - and as you are finding out, tests to get numbers are only part of the process.  Another part of the process is using those data to make decisions relevant to the patient in front of them - and thats where your vet comes in.  You say very little of your vet - what is their opinion of the matter?  - They know both the dog and the situation at hand.  A single injection of certain medications for example, or perhaps exposure to certain moulds from sniffing leaf-litter in the woods, or even growth in a young dog, or exposure to certain supplements, might account for the mild elevations in liver enzymes seen here.  Sometimes I would expect ALT to increase two-fold before I considered an elevation to be significant, for example.  Teddy is also potentially still growing which may have an impact on the 'normal' levels for his age.   For this reason, I do feel that his own qualified veterinary surgeon, with or without the input of a clinical pathologist, should interpret these results which may turn out to be less concerning than they appear.   If your vet is concerned, they may suggest that you simply monitor for now, or they might wish to take biopsies or ultrasound the liver.

Sorry - I see that you have indeed told me what your vet thinks.  Because they know and are dealing with the patient, they have much more information available to them than I do.  If they need more information in order to satisfy themselves on this matter (liver levels do indeed go up and down in normal life) then I am not the best choice of second opinion - usually a clinical pathologist would be in a good place to advise.