Liz Buchanan BVSc MRCVS
I obviously don't know the patient and even normal ALT levels won't tell me that her liver is ok. However, the blood in the urine is definitely abnormal and may reflect any of a bladder infection, cystitis, cancer of the kidney / ureter / bladder / urethra, polyp, clotting problems, random kidney bleeds (rare) in different situations. It may be that your vet decides to test the urine for crystals and / or scan the bladder as a next step, for example. Best of luck and do let us know how things progress!