AST/ATL Bloodwork

Vets only: Maybe emergency? My 12 lb mini aussiedoodle was put on trazodone daily for anxiety/reactivity on 4/12 (25mg/ml .5 ml once or twice a day but only give him once). Previously around December he was prescribed trazodone for big scary events-ex going to the vet, long car rides. This wasn’t more than 1x every 2 weeks. I THINK it was about 20mg. His blood was checked on 2/17 because he was sick and his ALT was a little high but we assumed because he was fighting something. ATL 137U/L Then tested on 4/12 because vet wanted to make sure it was okay and for a baseline with the new medicine. ALT 105, AST 52 On 5/9 tested again and his ALT is incredibly high and AST is elevated. ATL 232, AST 85 I don’t know what safe levels are/if it’s actually incredibly high, but from the form it seems to me to be. My vet has not called me (I just got the results to my app) and is closed for the weekend so I can’t ask if it’s emergent. I also moved out of state this week and have not re-established somewhere. I’m more than willing to go to a hospital if needed- but I haven’t found anything so specific online. My other wonder if it could POSSIBLY be from a UTI. He occasionally pees when he’s excited to see someone but he has a few times this week (but we have been around more people). I’m also struggling to see any other symptoms because this is a huge move/schedule change so I’m unable to tell. Thank you for your time. I’m just very worried. Really, we all thank you.

Hello!  I can hear that this sounds confusing.   To nit-pick, there are no 'safe' or 'unsafe' levels of ALT or AST; they are not actually dangerous in themselves.   These are simply chemicals that reflect breakdown / inflammation happening in the liver - and of course, breakdown happens in the liver all the time, every day as old liver cells die and new ones are replaced, which is why ALT is almost never going to be zero.  You can probably read more about these markers by searching for 'liver enzymes' or searching by their names, in our blog. So what we know when there is a spike of ALT, is that liver cells have broken down or been damaged in higher than usual numbers.  Sometimes this is simply because a pet has eaten something that their liver has to had to work very hard to cope with, or because the liver cells  are working extra-hard because body metabolism is going very fast, eg in hyperthyroidism (rare in dogs).   It is not uncommon to see a high ALT level and go to test it a month later and the levels are normal again. Other times, you will go back later to to see that ALT has increased instead, because liver cell damage is still going on.   If your vet has already spotted this trend, it puts them in a position to find out more information. I cannot comment on a dog that I know nothing about, but good questions for your vet are as follows:  How can we find out what is causing this in my dogs' case?  What is our next step?  And, what are the chances that this is being caused by something innocuous at the moment Vs the chances of it being caused by something worrying and significant?  What tests would you like to do now? Is your vet working this morning?  If so, definitely give them - or their  emergency vets -  a call.  They alone can advise you on how soon they would like your pet to be seen.  All that I know is a lot of numbers;  relatively little about the patient and because of this, we are not allowed to triage for you on this site.  However, they or their emergency cover will be able to review the case for you - likely by taking a thorough history about how your dog is -  and tell you how soon you need to be seen. In the even of it being imminent and a vets visit essential, they should be able to transfer you to another vet.  In any case, you will need a vet locally to take the history over and continue treatment! Best of luck from here and please let us know how you get on.

To answer your question, ALT is not usually something I'd look for as a sign of a UTI but it doesn't rule one out, either.  However, some diseases that cause a high ALT may cause excessive urination so it's good that you have been alert to your dogs' toilet habits.