Possible liver issue

Hello all... hoping to get some help from you all. My senior girl's past 3 senior blood panels have been showing a steady increase in ALT (All above normal 181 to 194 to 263) the ALP (normal ranges) has been up & down (95 to 59 to 113).. I am sooo anxious A few other numbers are off. She is getting a bit picky on her food right now. I feed homemade food. She is also on Vetmedin for her heart, Denemarin & milk thistle. Posting pictures of her bloodpanel ..would love some insight on how much I should be concerned Fyl her sdma is high but this is not the first time that has happened. This happened a few years ago and it went as far as 53 but her creatinine and BUN numbers were always within normal range. Finally the vets sent her blood work to Idexx and they said something like she has a protein in her blood that causes the SDMA to go up. Right now she now not finishing her food like she normally does..

Hello!  I hate the red and white nature of these test results; it takes me right back to getting my spellings sheet back at school; back then, some words were spelt right and some were wrong and there was either a tick or a red cross and no disputing it.   With blood tests, its a bit different.  The ranges are worked out for a normal cat.  But if, for example, that cat has eaten something inappropriate and its liver is working extra hard to sort it out, one might get a raised ALT which will sink back again on its own.  The same applies if they are on certain drugs, which their liver has to work harder to digest.  This might be printed out bright red and the owner be 'Whats wrong with my cat?!' and as a vet, we then have to say, 'Well actually, for your cat, thats completely appropriate.  It might just be that that their liver's working hard,' or  'That might be something or nothing let's test again' or 'Oh my goodness!  Thats horrendous!'

The contextual things that your vet might look at when interpreting blood results, including the drugs that your cat is on, their particular conditions and their clinical signs.  Good questions include, might there be another reason for the lack of interest in food eg Might the pre-existing conditions explain the signs you are seeing?  Might there be something else causing the new symptoms eg panceatitis / primary liver disease / arthritis?   Your vet will have a much better idea of what might be appropriate to your particular cats, so its worth keeping talking to them, especially if the clinical signs are deteriorating.