Elevated liver enzymes

Hello vets! I am looking for a second opinion or more information!! I took my six year old Australian Shepard to our lovely family vet for dental work. In routine blood work they found her liver enzymes to be elevated. X-ray of her liver was negative. She has been started on Denamarin for 30 days. The doctor has me holding her multivitamin for the next month as she thinks it may be contributing. I have below the ingredients of vitamins I give her daily.  She eats Merrick grain free beef and sweet potato. My question is do you think her diet and supplements could be contributing to her liver issues or do you think it is something else? Thank you in advance for any advice and information you can give me!

Hello!  You don't tell me which liver enzymes were raised and why the vets thought that was.  X-rays can give an impression of the silhouette of the liver, but they do have many limitations.  Liver tissue is of a similar radio-density right across.  X-rays can't tell you what's going on metabolically (as in, at a chemical level in the cells) within it and don't always pick up or differentiate tumours or inflammation.  For this reason, your vet may ask to perform an ultrasound in order to view the organ in greater detail. Furthermore, you don't tell me what the x-ray was negative for - what specifically were your vets trying to rule out by radiography?   Having ruled it out, do they have a list of possibilities at the present time? Sometimes, raised liver enzymes are just 'one of those things'; perhaps something has been eaten that needed a lot of work by the liver in order to break it down, leading to a surge in one or other of the liver enzymes.  At the other end of the scale, raised liver enzymes might represent hyperthyroidism or a response to infection or inflammation or cancer.  Your vet will have seen the liver enzyme results and examined the patient, and used their professional judgement to reach the conclusion that they have reached, hopefully talking it over with yourselves. Having not been party to any of that, I just know that  you and your vet opted to fully supplement the liver in order to ensure that the organ was fully supported, with a view to checking the enzymes again further down the line. For this, I would strongly recommend using liver supplements that have been clinically shown to work, and that have clinical trials supporting them.   Your vet will know which these are and may even be able to supply clinical data to support their assertions.  Unfortunately liver supplements have not been well regulated in the UK and it is hard to appreciate from the packaging whether a product has decent clinical trials, the appropriate proportions of ingredients and science behind them or not.  Cheap drugs companies rely on this to sell their products. Your vet and the clinical support line associated with the higher quality  neutraceuticals are hopefully available to help to answer any questions that you might have about the finer details.  Some of the companies have a useful helpline. I'm afraid that this isn't my speciality so I cannot speak for these products  but would would encourage you to investigate with your vet before changing neutraceuticals.

It is indeed possible to overdose or double up on supplements (at best this wastes money, at worst it can cause harm)  or more commonly, to give a chemical in one supplement  that cancels out the effects of another, similar chemical in another.  This is why it is common for vets to ask owners to stop giving any existing supplements before they introduce something else.  Always declare any such products to your vet and ensure that they are happy with their use at any given time, for maximum safety.

Finally, if you search for liver enzymes in the blog, there are a few good articles and you may discover a multitude of useful information.