elevated ALT/SPGT

I have a 2 yr old Shih Tzu Bischon Frise mix pup. Several visits she has had elevated ALT levels, as high as 525 and in Jan 2022 it was 375. The vet started her on Denamarin once daily. She completed that round of meds and had been off of it for about 3 weeks when she went back in for a check up. Her ALT level was back up and they recommended putting her on the med. The next steps they want to take is an Ultrasound or MRI of her liver if we want to delve in further to the cause. My vet does not offer either of these services so I would have to find a vet that does. How common is this in dogs? What does it usually mean? Are there any long term effects of her being on this med? Do I need to look into a special diet for her and what kind?

Hello!  You are best to ask your vet if and what diet they reccommend.  There are diets designed to go easy on the liver and they may or may not think that this is appropriate.

Hello!  It is not uncommon for dogs enzymes to be raised sometimes when the liver has been working extra hard for various reasons, sometimes simply including growth, and often they go down again on their own.  You can read about one of these levels, ALT, in our blog (search 'liver enzymes').   However, a persistent elevation (repeated high reading) is worth looking into; why is the liver having to consistently work so hard?  An ultrasound often identifies areas of abnormality in a liver, but doesn't always identify the abnormality; a biopsy may be needed for that.  Some dogs are simply eating something that the liver has to work hard to metabolise (perhaps hence the trial special diet);  other times there can be an abnormality, for example a liver shunt.    The bloods and ultrasound are peices of a complicated jigsaw used to assess liver health.   Good questions to ask your vet include: what could this still be?  Which of these possibilities are likely?   What are the implications if that is going on?  ....   This will hopefully help you to understand what your vet is thinking in this case.