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Elevated liver enzymes

Published on: August 10, 2022 • By: 331stang · In Forum: Dogs
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331stang
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August 10, 2022 at 05:06am
I stumbled across this form trying to find some answers to my elderly dogs deteriating health. A few weeks ago my dog started throwing up and not eating along with small amounts of diarrhea.  After 3 visits  to the animals er they admitted him for a 4 day stay.  After numerous test  bloodwork and a stomach ultrasound  we were sent home with no clear diagnosis. The only possible senerio giving was that he  has cushings and possibly the tumor has grown affecting the part of brain that controls hunger.Since his return home he has still not eaten much .... though he he no longer throwing up and the diarrhea has subsided. Today we went to our primary care for follow up in which my vet  ran liver enzymes test that showed extremely high  alt, alkp,ggt, and tbil levels.  Any recommendations  would be appreciated,   im trying to keep my little buddy going if at all possible.
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Liz Buchanan BVSc MRCVS
Moderator
August 10, 2022 at 08:43pm
Hello - you missed a couple of things out in your question, which would make a huge difference to my answers.   First is, when you stated the words 'primary care vet' towards the end of the question, has a specialist had been involved at some point?  I wouldn't necessarily expect it at this stage, but wanted to be clear.   The second thing I'm unclear about, is what the vet said or proposed when they saw the elevated enzymes, because this sounds like a significant development and I would expect them to have made some proposal to find out more information - perhaps an ultrasound scan, biopsy or some other blood test or investigation?  The finding is significant because it may suggest that whatever is causing high enzymes in the liver is continuing to worsen.  Liver enzymes do go high periodically and usually come back down again, but when they continue to worsen than, unless the levels can be explained, further tests are often merited at this point.   What is on your vets differentials list (the list of possibilities that haven't been ruled out?)  What does your vet want to do from here?  If you are not clear about this, it is important to revisit the subject with them.
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amia87
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August 13, 2022 at 02:04pm
Hi, I am also facing the same for my elder Pomchi . You may not know about this breed, it's a mix of Charles King Spaniel and Bichon Frise. I have many foods at home to get rid of the issue. But still my pomchi is not fully recovered. In fact, it's getting worse with time. Let me know if anyone here on the forum can help me to get out of this issue. Thansk!
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Liz Buchanan BVSc MRCVS
Moderator
August 14, 2022 at 12:45pm
Hi Amia87, it sounds as though you need to speak to your vet and try to understand why the enzymes are high.  Saying that a dog's liver enzymes are high - how do we solve it? Is a bit like saying 'My friend is unhappy - how do I solve it?' The answer is always to go back to the friend and find out why they are unhappy, or back to the pet and work out why the liver is unhappy, or rather why the liver levels are consistently high.  I find that asking the vet questions such as 'Why are my dogs' liver enzymes high?' 'Is that a problem at this level' (sometimes it isn't) and 'How can we find out what is causing it?' can be helpful.  Sometimes, this may involve ultrasound, biopsy, MRI or other methods.  Sometimes levels go briefly high and return to normal - after eating something very mildly toxic to the liver, for example.  However ongoing high levels can be a sign of repeated liver insults or an ongoing pathology and your vet may be working hard to understand the larger picture.  Owner-vet communication is very important and sometimes, owners want more information than the vet would naturally offer.  In this event, keep asking questions.
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Liz Buchanan BVSc MRCVS
Moderator
August 14, 2022 at 12:48pm
'The food doesn't seem to be working - what else can we do?' might be a good question.   For example, a lot of the special liver foods are designed to be less challenging to the liver - not to solve the problem, but to make sure that the waste products going to the liver for breakdown are as easy to deal with as they can be.  Often this is used alongside more diagnostic tests and so on to pinpoint the cause of the high enzymes in the first place ('diagnosis').
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