So, your vet has told you that your dog has raised liver enzymes. Understandably, you’ll probably have a few questions.; is it serious? What might have caused it? And, what exactly does it mean? As is often the case, there isn’t a single answer to any of these questions. So in this article, we look at some of the most common causes, the underlying conditions and the role of the liver in your dog.
Table of contents
What does a dog’s liver actually do?
First of all, let’s talk about what livers do. A lot of confusion surrounds this: we all know that livers are important, but many people find it hard to explain why. This is probably because they have a variety of different complicated jobs, mostly connected to metabolising food.
I like to think of them as the body’s boiler. Not because they literally generate heat, although they certainly do. But they are also a hotbed of metabolic reactions, releasing energy and other products from food, so that the body can use them. They also clear dead blood cells, toxins, poisons and waste products from the blood and make bile and some essential vitamins and minerals.
In short, our livers are vitally important and luckily, they are regenerative. That is, animals can grow new liver tissue when their livers are damaged. As the liver starts to struggle, lumps of extra tissue grow on the side. Sadly, the capacity of the new liver tissue is often limited. In severe, ongoing cases, the liver can become large with increasingly few useful cells and additional lumps on the side.
As an aside, this explains why it can be difficult to tell the difference between a cancerous liver and one that isn’t working but has tried to regenerate. A vet might tell you that a liver looks irregular or lumpy, but it may be regeneration or may be cancer, so biopsies are often needed.
Liver Enzymes In Dogs
Anyway, back to liver enzymes, which are made by the liver and found in the blood. They have slightly confusing names which are usually shorted to initials. The concentration (amount per ml) of these chemicals reflects what’s going on in the liver. I’ll focus on two basic ones:
ALT (alanine aminotransferase)
This is found in liver cells. If liver cells break down for any reason, it is released into the blood. When ALT levels in the blood are high, it tells us that liver cells are breaking down more quickly than usual. What it doesn’t tell us, is why. The liver might be perfectly healthy, but the metabolism too fast: this is common in Hyperthyroid cats. The animal may have recently had a dose of a drug that the liver finds difficult to cope with, such as a steroid. But it may also be a sign of a serious breakdown of liver cells.
ALKP (Alkaline Phosphatase)
Is found on the cell membranes (the outer borders) of liver cells and the bile duct. The ALKP in the blood will increase when bile is not flowing properly out of the liver. This may be because the liver is inflamed and thus preventing it. It will also increase with certain drugs, hormonal diseases and bone growth in young dogs.
Liver enzymes ind dogs are only a piece of the puzzle
The problem with liver enzymes is that they don’t tell us which of these things are causing the elevation. They are useful for ‘screening,’ i.e. for looking out for pets that might have a problem with the liver. If the vet knows of a possible reason for the increase in liver enzymes e.g. hyperthyroidism or poisoning, they may treat the underlying cause rather than investigating further and run the liver test again later on. Very often, however, further tests are needed in order to work out more.
These tests may include an ultrasound to look directly at the liver tissue, or a bile acid stimulation test (BAST). This evaluates how well the liver is working and whether it needs extra support. Another way to get a better idea of what’s going on in the liver is a biopsy; in which a small amount of liver is removed and examined under a microscope.
So in short, having raised liver enzymes isn’t a diagnosis, but a small piece of the jigsaw to find out what is going on with your pet.
You may also be interested in;
- What does it mean if my cat has a high PCV blood result?
- Liver disease in Old Dogs – What Does a Diagnosis of Chronic Hepatitis Really Mean?
Discussion
Sorry need to add to previous comment, all other results have been normal, but she has low potassium 3.6 and glucose in her urine? Pancreas was ok on the scan too, we did think it could be pancreatis. One vet suggested Fanconi disease?
10 days ago our 4 year old French Bulldog became ill while we were holidaying on Exmoor. Excessive thirst, sickness and refused to eat. She is now in hospital. First test results on day 3 of illness showed Liver enzymes were raised ALT 700 and ALKP 538, on day 6 ALT 614 and ALKP 1273 now day 10 ALT 300 and ALKP 1000. White blood cell indicated infection. Lepto test is negative. She’s had abdominal scans that have all come back normal. Hepatitis has been mentioned which is really worrying. She’s got a feeding tube and line for fluids, finally on day 7 she started accepting chicken by hand, but she’s not eating a huge amount. Vet says she’s up and down. She’s obviously fighting some infection or toxin, or could it be a chronic illness she won’t recover from? We are in bits!
These are really hard to deal with, and I really do sympathise! The problem is that we don’t always know exactly what’s going on. These bloods would be consistent with a liver problem, although optimistically they do seem to be starting to improve. The changes you mentioned in your other post might suggest a renal issue, like secondary Fanconi syndrome, but could also be related to the liver issues. For a full diagnosis, a liver biopsy might be the best option, however, if she seems to be improving it would be reasonable to hold off on that for the moment. It sounds like she;’s in the best place at the moment – please do keep us updated as to how she’s getting on though.
Hi there! My dog Benji went under blood work for his teeth cleaning (prior to getting out under). His ALT came back at 320 and has since rose to 390. We did an ultrasound, organs all look good, including his liver. However, they found a tumor on his spleen, and we need that removed due to risk of cancer and it bursting. With that being said, my vet said he was more than comfortable doing to the surgery, and would highly recommend it…. BUT I am SO scared to put him under with an ALT of almost 400, all other blood work is perfect…. What should I do?!
I think in this situation, be guided by your vet. If the liver is functioning normally, a high ALT doesn’t on its own increase the risk of anaesthesia, whereas splenic tumours tend to be malignant and spread rapidly. So good luck!
Our 12 year old Welsh Terrier was taken seriously ill whilst were on holiday. When we came back the vet informed that she was dehydrated, wouldn’t eat, diarrhoea and almost comatose. Luckily after a lot of treatment she is now almost back to normal albeit lost about a kilo in weight but she has been diagnosed with pancreatitis but also has high liver enzyme values (ALT was 212 at vets, 174 when coming home and now 669). She is on a low fat diet now but presumably need to get the liver values reduced but how ?
You often get liver inflammation along with pancreatitis, so I would expect to start to see those decline once she’s better and on the low fat diet; might be worth talking to your vets about SAMe and silybin supplementation; and definitely a recheck after a few weeks on the new diet. It is possible that there’s also a liver problem, but that seems less likely at this point. Good luck!
Please can you try to help me understand. I rused my dog to the out of hours vets on sunday and agreed to pain antisick xray and ultrasound as he was being sick and in terrible pain. They did the bloods and only the ultrasound as his liver count came back as 5695. I was told 79 is normal. He was still crying in pain after they had given pain relief. I was showed his ultrasound and told the perfectly round all the same sixe circles I was shown were tumors. I asked if this was causing the pain, which was no. The vet was obcessed about the blood rests and not what was causing the pain. I was then asked if I had 15k for a biopsy, which I did not. I was told I had no other choice to PTS. I don’t undrstand why they didn’t look for the reason for the pain, and is the blood count possible.? I’d only had him 10 wks he was 11.
Liver disease can be a very painful condition, so that might have been the cause, and there may have been a misunderstanding? Otherwise, I’m not sure, so I would suggest asking the practice for an explanation, to help you understand what happened – good luck!
We have a 12 year old Yorkie with very elevated liver enzyme. She has various other health problems; arthritis, collapsed trachea, hypertension, and oral issues (which can’t be solved with a dental until her labs are better) and is on a variety of medications. She is overall, not in good health and hasnt been for several years. Our vet had us put her on denamarin for a month but her labs haven’t improved and he has now recommended a costly ultrasound as he suspects tumors. My question is; if we are not planning to put her through surgery to remove any tumors, is it worth the cost of an ultrasound? Are there any other avenues you would pursue that are less costly? It’s hard to strike a balance here since she doesnt have any new symptoms.
I have to say that I agree with your vet – the ultrasound is the next step: because if you find tumours, you know that the medical treatment options aren’t really worth trying, and you know what you’re dealing with; if it’s not a tumour, then hopefully the scan and potentially a biopsy might tell you exactly whats going on so more specific treatment is an option. The other options would be to trial SAMe and Silybin (which you’ve done), and a bile acid stimulation test (which will tell you how much function the liver has lost, but not why).
So that’s how I’d approach this. If you don’t want to know, though, that’s absolutely fine – keep her comfy and happy, and keep on with the supplements, and if it’s not a tumour the liver may be able to regenerate; but there aren’t that many more options without having a better idea of what you’re trying to achieve.
My healthy but 17 year old doodle mix was recently at the vet for a check up after increased appetite, thirst, and urination. She has never been a food motivated dog and now begs for treats and additional meals. I suspected possible cushings or Diabetes (I have human health care experience). She’s 68lbs, up 3 lbs heavier than last visit 8 months ago.
Labs most notable for elevated liver enzymes
ALT 416 (12-118)
Alk 198 (5-131)
GGT 36 (1-12)
Cholesterol 477 (92-324)
Triglycerides 671 (29-291)
Urine
Specific gravity 1.009 (1.015-1.050)
pH 8.5 (5.5-7.0)
Occult blood in urine -trace
She voided on her own.
All other labs were within normal limits including thyroid, CBC, BMP, Mag, bilirubin, glucose.
Her medications include DES for urinary incont (that she’s had for most of her life). She was given one dose of Carprofen the day before the visit.
My dog is active, eats, drinks, moving bowels normally. Other than her vision and hearing she seems like a younger dog with exception of these new issues.
Suggestions on what to do next?
Vet wants to do an ultra sound but I don’t want to spend another $750 if it’s not going to give us defining information.
To be honest, an ultrasound would be my next port of call too, to see if, given her age, there is evidence of a focal lesion or mass.
However, you could consider talking to your vet about other option, such as a BAST to check liver function (as opposed for moderate signs of hepatocyte damage), or even supportive therapy and repeat bloods in 2-4 weeks.
My 9yo German Sheppard/mastiff mix has the following results :
ALT 267 (10—109)
ALP 502 (1—114)
AST 17.0 (13.0–15.0)
TBILL 0.36 (0.00-0.30)
UREA 39 (8–35)
CREA 0.9 (0.5–1.7)
UA 0.77 (0.20–0.40)
GLU 62
AST/ALT 0.23
I don’t know what it means and vet gave medication: Hefa Merz 5ml; Tab Liv52 and Tab Silver 200g Daily for 3 weeks.
Can you please give some recommendation?
I’m afraid these aren’t meds I’ve come across before, although they seem to be supportive products for liver damage.
These bloods do suggest cholestasis (failure of bile to flow) and some liver cell damage, but I think you need to have a chat with your vet about what’s going on here. Good luck!
My 4 year old husky mix, had elevated liver enzymes at 800 alt in 2022. We figured it might have been something he ate recently because he did not seem to have any symptoms and was acting perfectly normal. We recently had labs done which showed 300 alt levels and bilirubin found in his urine. We took him in because he had a decreased appetite and was acting more lethargic then normal. The vet wants us to have his liver biopsied which we have an appointment set up. I’m worried he won’t have a long life. Is there still a chance for my dog to recover or for us to slow down the progression of liver disease if it’s gone untreated for 2 years?
Yes, definitely, it just depends what it is – there are lots of different causes, and some are treatable, You’re right that anything that’s gone on this long is likely to have a worse prognosis, but that doesn’t mean untreatable!
Hi. My 16 yo Teckel was having anorexia and dehydration. I took her to the vet and her labs are as follows:
ALT = 5134
AST = 1320
ALP = 2458
GGT = 92
Total Bili = 14.4 (Unconjugated = 5.4 / Conjugated: 9.0)
Cancer vs. Intoxication? We can’t think of how she could have had ANY access to medications.
What are we looking at?
Thoughts?
Thanks!
Hi Evelyn – my dog has similar blood work results. All other blood work is within normal range. Abdominal ultrasound was also negative. Could you share the outcome of your dog? What treatment was provided? Thanks
Hi Sara – my dog is having a similar elevated liver enzymes. US was negative. Could you share the outcome of your dog? Did it recover? What treatment was provided? All other blood work is normal range.
Without reference ranges, it’s hard to interpret, but those do look pretty high – which sometimes (but not always) suggests a more acute (sudden onset) cause.
I think to determine if you’re dealing with a toxicity, a tumour, or an infection, you’d need more information – blood tests for white blood cells (possibly repeated after 2-3 days to look for a trend), a bile acid stimulation test for liver function, a liver ultrasound, and maybe a liver biopsy would all be on my radar.
Have a chat with the vets about how far you want to go, and good luck!
My Boston also diagnosed with IVDD (intervertebral disk disease). She is 12 1/2 years old with elevated liver enzymes. Any help regarding both problems. I appreciate your comments re the liver.
There are different grades of IVDD, and some can be managed conservatively without surgery. However, almost all spinal disease is painful, and requires pain relief – which can put additional strain on the liver. So I think you’ll need to have a chat with your vets about how to approach this; it might be worth talking about a bile acid stimulation test (BAST) to see if the liver is working – enzyme tests tell us it’s unhappy in some way, but not how well it’s functioning. If liver function is OK, then careful use of anaesthetics and pain relief is unlikely to be a problem at least in the short term.
My 12 year old Boston terrier has been diagnosed with ivdd and elevates enzymes. We are 80 and 84. We cannot get her meds in her. What do we do ?
OK, time to go back to the vet and have a chat, Explain that you can’t get medications into her, and talk about the options. There might be alternative treatments – or alternative formulations of the meds – that can be tried. Good luck!
Hi. My 4 year old lab has been diagnosed with lepto and we are incredibly incredibly worried. Could you please help us out with whether you think a comeback is possible from these parameter readings? He is hospitalised.
Here are all of his non-normal range values:
RBC = 4.82 M/μL
HCT = 34.7%
HGB = 10.1 g/dL
MCH = 21.0 pg
MCHC = 29.1 g/dl
RDW = 23.8%
RETIC = 120.0 K/μL
MONO = 2.51 K/μL
EOS = 0.01 K/μL
PLT = 42 K/μL
MPV = 13.8 fL
PCT = 0.06%
CREA = 2.7 mg/dL
ALB = 1.4 g/dL
TBIL = 13.1 mg/dL
Na = 164 mmol/L
K = 5.9 mmol/L
Cl = 129 mmol/L
Please, any advice would be much much appreciated. Thank you.
I’m afraid that without the reference ranges, it’s really hard to interpret this data. The other thing to remember is that in many cases, it’s the overall clinical picture, rather than specific blood results, that give us the best indications for prognosis.
Our boxer (age 9) went for her wellness exam. We were told her liver numbers were double what they should be. She also has a grade 3 heart murmur and pancreatitis. She is still active, hungrey and all bodily functions are normal. They said her liver bile (?) is still normal and working properly after doing the fast for 18 hours. They want to start her on Zentonil 1 1/2 tabs daily. We are pensioners and find it hard moneywise to add this to her already costly monthly payments. She is on special RX food and medication for her pancreatitis and also RX eye drops (both RX twice a day). The Zentonil is almost $200 for a 20 day supply which would bring our total monthly bill to almost $1000 per month. The vet bills & RX have doubled in the last year.
We love our little girl, but we are hurting financially. Would giving one tablet instwad of 1 1/2 tablets still give her enough supplements to keep her liver working ok?
Possibly – but you would have to talk to your own vet about this, as I can’t give advice that’s so specific!
My dog is 2 years old, he had difficulty urinating so they placed a catheter and upon the blood chem test, it revealed that his ALT is 300 plus. The vet called me and told me that there was a problem in her kidney and he had babesia. I am worried, can my furbaby survive his liver disease? is it dangerous for dogs to have this? can he be treated?
There are lots of different liver issues, and most of them can indeed be treated effectively, especially in a dog of that age. So good luck!
Last Monday my seven-month old puppy managed to eat around 25 multivitamin gummies (luckily no xylitol). I realised very quickly and got him to the vets who injected to make him sick. As such, within 90 mins of ingestion (and probably around 70 minutes) his stomach was clear. The vet said that it was likely that he would be fine but suggested that he come back in a week to take bloods to check liver function. Since this he has been fine – no increase / decrease in drinking or appetite, no change in energy levels etc. How useful is the blood test? Can anything be done if his liver was affected? Obviously I’m happy to pay for tests if they can help him should his liver function be impaired but if it’s just for peace of mind when there is little that can be done if he has been affected, then I’m not sure if they’re worth it.
If his liver was affected, there are treatments that can be given to help it to regenerate, and certain drugs and risks that should be avoided until it does. Personally, i think it’s really valuable to know, especially as high doses of some vitamins can indeed cause serious liver issues.
two weeks ago, my dog (at least 10yr) started drinking a lot of water and having many many accidents in the house. at the vet, they did bloodwork that showed alt was at 190. vet said to come back in a week to recheck bloodwork, I did return the next monday and her alt was at 400. She had also started spitting back up the water she was drinking, lost 3lbs and becoming lethargic. They gave me some denamarin to give her at home but she wouldn’t eat the chewable table, even wrapped in something she likes, as she also started eating less, I did tell them this. For the remainder of the week (T-F), they had me bring her in during the day to get IV fluids, do a lepo test , x-rays, ultrasound and liver function test while continuing to check her alt. On wed her ALT was 430, friday it was at 390, and friday was when told me they wanted me to take her directly to an ER hospital to receive IV fluids over the weekend (after picking her up from their facility) and transfer care to them to find the cause of her liver problem. I did ask if it could just be “old age”, I was told no, since it came on so suddenly. I asked why she was not on ursodol, they said they didn’t have it there, but would be willing to call in a prescription, which she started that day. I reviewed all the invoices for the week and it seems during her time at the vet, she got anti nausea med, antibiotic and IV fluids, she was not given any meds for her liver, even after I told them she was not eating the denamarin. I guess my question is why, is that normal not to give a dog meds for liver issues when your giving them IV fluids for it? Shouldn’t she have been put on something the very first visit when her ALT was already too high?
I’m so sorry to hear about your struggles – and I hope she’s doing a bit better now.
The reason they didn’t give her any meds for her liver is because, fundamentally, there aren’t any drugs with a solid evidence base for improving liver function. Even urdox and SAMe are at best supportive treatments. The aim in managing liver disease in dogs is to try and identify the underlying cause, and treat that; if a cause cannot be identified, then supportive care (fluids and symptomatic control, treat for infection in case of ascending cholangitis, increase bile flow with urdox, and provide glutathione precursors) is the mainstay of treatment, while hoping that the liver regenerates on its own.
In this situation, I’m not entirely sure what the diagnosis was, but in my experience, you often never find out what’s going on without a biopsy – which with a dog in liver failure is relatively high risk.
That said, I hope she’s doing OK now – good luck!
Hi! I just recently found this article as my 5 yr old Chihuahua/jack Russel mix has had an increase in her ALT the past 2 years. We have been trying to give her a dental since 2022 but things kept getting pushed or she had some weird stuff going on with other blood work we wanted to investigate.
So since July of 2023 her ALT has been 225, then 125 and now back to 225 after a month of Denamarin and Liver Happy ( Chinese herbs). We are going to do a BAST on Monday but I keep putting off the dental because of her elevated ALT. Her front teeth ( she has an under bite) are hanging on by a thread and the gums are very inflamed…as well as one of her lower canines is now extremely sensitive.
Could an infection of her mouth cause the ALT to raise?
Will an antibiotic help if so?
And last, is it safe to put her under anesthesia with a liver enzyme of around 225 or slightly higher?
Thanks so much
T
Liver disease can be caused by all sorts of things, but chronic infections are reported to be a risk factor for liver and kidney issues – so maybe that is a factor?
In general, anaesthetising animals with active liver disease is complex, but as long as her liver is actually functioning (which the BAST will tell you), a modified anaesthetic plan would keep the risk relatively low. It’s never zero with any anaesthetic, but it comes down to the risk/benefit analysis – and if her mouth is that bad, then the benefits might well be a lot bigger than the risks!
I’d have a chat to the vet, but personally, I’d be quite keen on getting her mouth sorted while she’s pretty stable and seeing how she goes.
Thank you to Dr. Harris and all the participants. This discussion is priceless for dog owners struggling to make sense of the situations arising from these elevated enzymes. My 11 year old lab mix is currently hospitalized an an emergency hospital due to vomiting and inability to keep down anything, not even water. He was diagnosed with Kidney Disease six years ago and has been on a special diet for that, but the veterinarian working on his case said his kidneys seem okay but she is worried about his liver or possibly pancreas. Tomorrow he will undergo more testing. The blood test results that most alarmed her were:
ALT 1532 (!)
ALP 218
TBIL 0.9
I’m scared but feel that he is in good hands, and after reading the different stories so generously shared by the people here I have some hope maybe the outcome will not necessarily be terrible. I’m still almost speechless that his sudden deteriorated condition was apparently unrelated to the kidney disease that has been the primary focus of concern by his veterinarians for so many years.
Thanks again. This is incredibly helpful. On another website I saw that with an ALT that elevated I should be making his final preparations because he probably has about two or three months to live. So glad that’s not the final word on this complex issue!
My dog, an 11.8 lb miniature poodle, is almost 4 yrs old. She is full of energy, has a good appetite and shows no signs of illness. She had a full comprehensive workup with Blood work on 10-19-23 and everything was normal. Today, 1/19/24, we took her for teeth cleaning. The vet tech said they did bloodwork and her liver enzymes were 775. The tech said they wanted to do additional bloodwork and possibly a sonogram. It was not safe to put her under to clean her teeth.
I refused the additional tests. They then wanted to charge me for what was done even though it was part of the teeth cleaning included in my plan. I gave up the teeth cleaning versus paying $170 for the bloodwork they say they did. I took her home and I called and asked them to be sure to upload her labs. I am suspect that the findings are accurate or whether lab work even occurred. I checked the website and it says labwork not recorded. I have asked to speak to the Practice Manager.
In the interim, what if anything can I add to her diet? She had not eaten or drank any water for 10 hours prior to the visit. We came home and she ate her usual Hills Sciene diet hard and soft mixed ( chicken/barley) with a topper of boiled chicken and mashed a mashed piece of broccoli
I have extensive experience with this breed and my last miniature poodle lived to 15.
This is very strange; I think you need to get to the bottom of what’s happened. It’s certainly quite possible that the labs were done but not uploaded – in a busy shift, this happens sometimes. If she does have raised liver enzymes, though, it really would be important to know why it’s happened and what’s going on. The ultrasound scan is the normal next step after an elevated reading, but if there is a question mark over the results, then I’d get that sorted first. There are some supplements that can help with liver issues, but it’s important to know why the liver issue is happening, and to rule out some of the causes that need a different or more specific treatment.
So I’d advise have a chat with the practice and try to get to the bottom of what’s going on – good luck, hopefully it’s a lab mix up (which does occasionally happen, sadly), or that she bounces back!
hello
our dog is 7 years old and they found during her blood work routine her liver enzymes went up to 334 so the vet put her on urisdol and demarin she is acting good playful eating normal barking etc… all the normal things she does but the past week she has vomited not every day but when she does its usually in the morning and its liquid foamy yellowish greenish too but otherwise she is ok eating drinking water pooping being good health wise what could it be could it be her enzymes are going up or her medication side effects she never vomits her food or after she eats only in morning but not everyday thank you she is due for bloodwork again tomorrow please pray it went down 🙁 her liver enzymes
I think that does sound like she needs some more workup – regular vomiting like that isn’t what I’d expect. So I agree, back to the vet, and see what shows up – good luck!
Our nearly 13 year old German Shepard/hound mix started urinating excessively, refusing to eat, drinking a lot of water, sleeping more. Here gums are pale and dry. Her back legs are weak. She only vomited greenish vomit one time.
We had a traveling vet do a blood test. Her ALT and ALP were extremely high. Below are the other readings that were off. The vet says her pancreas and liver are involved. The kidneys have no issues. They were all normal (BUN, etc.)
I am scared. I realize she is 13 and don’t want to do the chemo route if it is cancer and I can’t afford X-rays and days of IV fluids in the hospital or surgery. She is nearly 13. (If she were much younger, my questions would not be the same).
I had one thought, I gave her Nexguard. Could that cause these terrible readings? Please be honest with me. Does this look as bad as I think it does? What should I do?
Here are the readings.. some way off the chart.
Albumin 2.67 L (range: 2.8-4.3 g/dL)
Globulin 4.50 H (range: 2.4-4.4 g/dL)
A:G 0.60 L (range: 0.8-2.0)
AST 87.00 H (range: 16.0-60.0 U/L)
ALT 860.00 H (range: 5.0-112.0 U/L)
ALP 3604.00 H (range: 10.0-126.0 U/L)
GGT 4.00 (range: 0.0-10.0)
Glucose 42.00 L (range: 65.0-130.0)
Cholesterol 380.00 H (range: 150.0-275.0 mg/dL)
Triglycerides 107.00 ( range: 50.0-150.0 mg/dL)
Amylase 2839.00 H (range: 300.0-1500.0 U/L)
CPK 345.00 H ( range: 50.0-300.0 U/L)
Lipase 891.00 H (range: 109.0-707.0 U/L)
WBC 34.32 H (range: 4.0-15.5)
Thank you for your help!!!
I’m so sorry to hear this – it’s really distressing when something happens like this.
So as the vet said, these results are consistent with liver and pancreas problems, but might be suggestive of an infection. It’s not a side effect I would expect from Nexguard, so I definitely think she needs more veterinary workup. It could be consistent with pancreatitis or hepatitis, but with just these bloods to go on, there are lots of other possible causes, so I really think she needs a full veterinary examination and then a plan! If she doesn’t respond to immediate treatment, then it’s time to consider other options, given her age.
Good luck, I hope she pulls through.
My dog is 3. He wasn’t feeling too well so we took him to the vet and after various blood tests it revealed his ALT liver level to be 1800 , extremely high but we don’t know what this means, more tests will be done but i’m worrying and just want to know what the likely causes are and if they are treatable.
There are LOADS of possible causes – but fortunately, most of them are treatable, and in most cases in a young dog, we can support them and they bounce back well.
Good morning, my 4 year old aussie corgi mix randomly started drinking a ton of water and had a major increase in urination. She started to have accidents in the house and then had an episode of vomiting. The vomiting is what concerned me so I brought her in and her blood work showed an ALT in the 2000s. It was so high, they had to trouble shoot the machine to read it. They immediately sent us to the emergency vet where they started broad spectrum antibiotics and tried to flush out her liver… I believe. They kept her overnight but when they redrew her blood, her ALT was still in the 2000s. All other levels are normal. Xrays didn’t show any blockage. They said they think it might be liver infection or gall bladder and they suggested we admit her to an animal hospital for an ultrasound and further testing. She seems to still be in good spirits…. How worried should I be!! What is the prognosis on something like this. I should say we brought her in within 24 hours of her increased urination starting and about an hour after her vomiting episode.
Sounds similar to what happened to my 16 year old Aussie/blue healer mix. I let them give her iv fluids for 24 hours and brought her home and have her Denamarin. A month later her liver values were normal. Never figured out what caused it. However I suspect it was because the day before, I took her in to the vet to have X-rays done just to make sure she wasn’t having any congestive heart failure. That stressed her out so much that I honestly think it threw her liver into a mess. I have read that can happen. She is fine now. Her kidneys went haywire after her liver was fine. Not sure why. But now we have it all back to normal. A couple months before all of that happened, all of her blood work was totally normal. It happened to her just like it happened to your dog. Just out of nowhere.
Oh wow you’re the first person I’ve read that said stress could cause elevated liver enzymes. My 5 year old Bichon Yorkie mix went for her pre dental blood work and they said they couldn’t do the dental procedure due to elevated liver enzymes. I was blown away because she has shown no signs or symptoms. They did a 4 week recheck and it came down but still elevated. They started her on Denamarin and Ursadiol and she’s since had another test and numbers cut in half but still in the 200’s. The vet suggested continuing the meds for 2 more months and we go for a recheck on 1/27. My dog really struggles with car rides. She gets super stressed and worked up but our vet is about 30 minutes away. Is it possible for a 30 minute stressful car ride to elevate liver enzymes? They did an ultrasound and it showed nothing abnormal. We’ve changed her diet but I’m worried her numbers will rise as soon as they take her off the liver meds.
I’m so sorry to hear that! Generally, acute liver disease like this is due to a sudden-onset cause – such as an infection. If you can treat the cause effectively, then the liver can bounce back really well. So good luck!
Hi!
My almost 12 year old boston terrier has had elevated ALT for about two year now. Shes been taking denamarin for about a year daily. Recently her liver felt swollen by doctor and they did an ultrasound and found spleen mass which we just had spleen removed and a liver biopsy (10/20/2023). Results came back Negative for cancer! Just before surgery she had bile test done and it was normal.
In 9/18/2023 alt was 245
11/16/2023 ALT 302 & TBIL is 1.3
On 11/16/2023 she went in for a nail trim and had a seizure. This was her first and only seizure.
Her liver biopsy diagnosis only says:
Liver: diffuse glycogen accumulation and ballooning degeneration.
I still feel like we dont have answers on what to do for her. The doctor now wants to test for cushings disease and redo the bile test. But I am scared taking her back and having to leave her at office all day for those tests will trigger another seizure. Any recommendations? I wish there was an easy blood test to figure out whats wrong or how to help her.
Unfortunately, liver disease can be really tricky to get to the bottom of – and while biopsies are the best option, sometimes (like now) they show you symptoms not causes. I have to say that a second follow up scan and test series would be a good idea; and if she does have a seizure, she’s in the best possible place!
It’s really hard, but I think that you really need more information before you can decide where to go with this – best of luck.
My 13 year old Miniature Schnauzer attended the vets to be neutered (lump on rear of him which vet correlated to testosterone imbalance). Other than this he is a healthy looking dog, with no symptoms. He is deaf which was gradual during the past 1-2 years and has decreased muscle in his back leg due to an injury he obtained years ago. Due to his age, he required a pre surgical screen. The vet phoned to notify us that the surgery wouldn’t go ahead as he had a raised liver enzyme reading. They performed an in-depth health screen including an ultrasound.
Everything about him was healthy, except for a localised mass on his liver. She initially said it was 1.5cm large however looked back at her photos and it measured 4cm in some of them and 1.5cm on others. The only other thing was that he had heightened cholesterol which the vet said was usual with senior terriers. They have sent his blood for liver function tests which we are waiting on.
They have suggested performing blood clotting tests, followed by a liver biopsy via needle (if blood is clotting ok) to check if it is cancerous. However they said that they would recommend not performing surgery on a senior dog. Therefore we are unsure as to whether we should go forth with the testing and biopsy for curiousity reasons. We wouldn’t want to cause complications or annoy him more than he needs.
However, we have read about dogs that live for years after surgery even at an old age. We don’t want to make the wrong decision.
It’s a really hard call, I agree. I think you definitely need to know if his clotting is impaired, that’s critical because it will change how you manage and care for him going forward.
In terms of knowing what the lump is, is it just curiosity? Certainly that’s a factor – but if you knew (say) it was a very aggressive malignant tumour, you’d probably go for different options (best quality of life, don’t worry about the surgery, etc), than if you knew it was a benign, relatively harmless one.
At the end of the day, you need to make that decision – and I’m sure from what you’ve said that you’ll make it for the best reasons! Good luck.
My girl was diagnosed with hyperthyroidism and also I was told she had elevated liver enzymes and to put her on a hepatic diet and liver supplements she however never had any repeat bloods for either her thyroid or liver and it’s been 25months
Surely the vet should have been watching both the thyroid and liver more closely? I have had some Devastating news now and can’t believe I trusted my vets and my girls health
I would usually expect both those conditions to be closely monitored, at least until stable, yes.
Just took our 10 year old Golden Retriever in for pre-operation blood work to remove a large benign cyst. . She is on Heartguard and Nexgard and a chondroiton daily chew. No other meds. Acting spunky and normal.
The vet called and she has elevated liver enzymes. GGT – 21, ALK Phosphatase – 1633 and ALT/SGBT – 250.
She’s going in for another round of testing and an ultrasound on Wednesday. What’s the likelihood this is cancer vs something that can be treated?
At 10 in a Golden retriever, a cancer is not unlikely. However, there are many other causes, and in my experience, maybe 2/3-3/4 turn out to be something else – so good luck! Please let us know how it goes…
My vet did blood work on my 8yr golden retiver. Her ALB was3.9 and her ALKP was 316 and her ALT was 553. The vet prescribed Metronidazole 500mg. But every thing I read say dont give to dogs with liver issues ?
Normally, it is a concern; however, if there is an anaerobic infection involved – as your vet clearly suspects – it might be the lesser of two evils; I’d definitely be inclined to double check with the vet why it was prescribed though.
My 9 year old jack Russell has Alt at 185 and Amyl is 425 and her mpv is 13.9
Vet is saying the pain she is in is from arthritis should I be worried by these results
Also she has orange poo so vet gave her prescription food
Without knowing the whole story and the reference ranges, I can’t tell! Follow the vet’s advice and get follow-up if he’s not improving…!
Hello, we have a 19lbs merle-colored Spitz who is almost 4 years old. She started vomiting her food a few hours after eating it. After a few days, we went to the veterinarian, and he thinks it’s a case of gastroenteritis. They gave her antacids and put her on a gastroenteritis diet.
Despite this, she continues to vomit, so we returned to the vet for more tests: blood work, X-rays, bile salts, and leptospirosis. The results: her liver is very sick! Her ALT is 11 times above average (over 2000), and ALP is 12 times at 1920. (ALT should be higher since the test doesn’t go any higher.) It’s not leptospirosis, and the bile salt test confirms that the issue is indeed the liver.
For now, she’s taking Zentonil, antacids, and antibiotics because she still vomits occasionally. She’s a bit more tired than usual, but otherwise, she doesn’t look like a sick dog at all! Our vet advised us to recheck her blood in a month, but that worries us a lot. If the results aren’t better, an ultrasound and biopsy have been suggested.
Reading the comments, I realize that an ALT of 2000 is a rare condition… we are worried.
That is a definite worry, and I agree it is very concerning. The good news is that the liver is very regenerative, so there is a good chance that she will bounce back and the liver will repair itself. But definitely if she isn’t improving after a month af supportive treatment, scan and potentially biopsy are the way to go.
Good luck…
Hi David
First thanks for answering so many people questions, that’s so kind.
My 15+ year-old rescue dog started having seizures earlier this year we rushed to the vet, and basically after a lot of problems we started to get him strong again and he has regular monthly blood tests. We got his ALT and ALP almost back down to normal. He’s on medication 2 times a day for the seizures and it definitely helps, he’s had about 3 episodes so far this year though. A lump has come up on his head that is very tender, so the vet has done a biopsy and it could be cancerous, it’s not conclusive. He seems very happy but cautious of people going near his right eye and definitely not pushing on his head. We had long conversations with the vet should he be put under anesthetic and remove the lump if possible, not fully knowing what they would find? And it could cause more problems for his ALT and ALP because the liver has to process everything and he’s old, we all agreed to monitor it. So today when doing his monthly check of the blood his ALT is over 1000 again and ALP 319. They said they would do an ultrasound in a couple of weeks when his regular vet gets back from holiday (he likes her, but he’s a very nervous dog) Should we do the ultrasound now do you think, I honestly don’t know what to do for the best as I don’t want to give him more stress and with his ALT so high could that be caused by the bump and many be his body couldn’t take it if he was to have any procedures. I just don’t know. My dog is a rescue dog in Portugal and it is a vet hospital in the area but after always watching the Supervet on UK tv I always feel they could still be at a vet practice that might not have enough skills and I want to give him the best chance possible to finish his years of happily. My gut tells me to get an ultrasound do quickly but maybe there’s something else to test the liver, I don’t know.
Thanks for your kind responce
This is a really hard situation. I definitely agree that an ultrasound is the next logical step, to see if there is a mass in the liver (which is the immediate concern in a dog of that age, especially when there’s another lump somewhere else). To be honest, it’s not likely that knowing will change the treatment very much; however, it would give you peace of mind as to what’s going on! There is another test you can do for liver function (a bile acid stimulation test), but while that will tell you if your dog’s liver is functioning well or not, it won’t tell you why there’s a problem (or even, if there is one).
So there isn’t a simple answer here I’m afraid! If you’d rather know sooner than later, then I’d suggest ask your vets to make an appointment with the hospital, and talk to them about tranquilisers to keep him calm and settled when he goes to a new place. Alternatively, the vet he trusts will be back in a couple of weeks, and those weeks aren’t that likely to make a massive difference – but of course, there’s always the possibility there’s something unexpected going on.
Hi
We took our 18mo old chowchow to the vet last week cause he started limping and not using his right paw one evening and he was crying in pain. No diarrhoea no vomitting. He had a fever of 105F!
The injected him with antibiotics, painkillers for 3 days. Doxy was prescribed.
He got better for 3 days, then he started limping again and his right front paw was swelling. Took him back to the vet, temperature was 103F. Made his X-ray, showed no fractures. Blood work show increased sgot 68 sgpt 114 alp 131. Negative for babesia and ehrlichia.
He shows no improvements with doxy and gabapentin. Can anybody kindly suggest/comment on this. We’re very worried.
There are a huge range of different conditions that can cause this, and your vet will be working to determine which one it is. It could be infection, or an immune mediated condition; the liver involvement may or may not be significant. Unfortunately, you probably need more diagnostics including bloods and scans to get to the bottom of this!
If you’re concerned that your vets aren’t getting on top of the condition, remember you can always ask for a second opinion, or a referral to an internal medicine specialist – so good luck!
Hello! My dog recently got sick suddenly with diarrhea, lethargy, and he isn’t interested in food/water on his own. His sickness timeline was:
Saturday 8/26 (4:30pm): just mucus with a couple of blood drops (thought it was throw up originally because the consistency was so soupy and clear)
Saturday 8/26 (6pm): he pooped again and it was a dark hue with clumps of poop and idk what else)
Saturday/Sunday (8pm-4am): was whimpering to poop throughout the night and it was only blood coming out when he did go; he stands in the pooping stance but almost nothing comes out every time
Sunday 8/27 (8am-5pm): Was at the ER clinic and they just said to give him a plain diet + the Pro-Pectalin every 8hrs (should last 5 days). I did syringe feed him boiled chicken, white rice, pumpkin, and bone broth that was blended up on Monday night because he’s not interested in food or water on his own. He hadn’t eaten since Saturday so I wanted him to have some nutrients.
Today, 8/29/23, was the first morning his poop has looked normal in color but it was coming out as diarrhea still + he just stands trying to poop but only little bits come out. And his butt has looked really irritated/inflamed.
I went to his normal vet today, they did bloodwork and it came back:
ALT 414.00 U/L when the range is supposed to be 10-125.00U/L & ALKP was 261.00U/L when the range is 23.00-212.00U/L. Vet was questioning if he could’ve eaten anything (he does get into stuff) and they mentioned stagnant pond water/bacteria and mushrooms could potentially cause it – we have both in our backyard but he’s never close to the edge of the pond.
Vet prescribed him:
-Animax Ointment every 12hrs for inflamed butt every 12hrs until it’s gone
-Metronidazole every 12hrs for 7 days
-Sucralfate every 12hrs for 5 days
-Denamarin Advanced every 24hrs on empty stomach
-Entyce every 24hrs for 7 days
– He was also put onto the Hill’s Science Diet: Digestive Care i/d
I’m just worried about him not eating/drinking on his own; I was told that dogs can go awhile not eating before it’s dangerous by the ER clinic but my main veterinarian said to slowly integrate him to the bland diet, but how do i do that without him eating willingly? Is it okay to syringe feed him until he works up the nerve for himself or should I just let him starve and see if he’s interested? I’m afraid feeding him by “force” will make it worse, which I don’t want at all, but also he might just need some encouragement before he can do it on his own since he’s been in the vet’s office and might just be tired from all the meds too. I was thinking just a little bit at a time throughout the day so it’s not too much at once. This all just happened in the last 3 days too which is why I don’t want panic but I want to be proactive and get him on track to be better.
Hmmm, sounds like a really nasty gastroenteritis! It sounds like he needs to be tempted to eat – try gently warming the food so he can smell it, and then putting a little bit on the end of his nose: he’ll probably lick it off, and then taste it. You’re absolutely right to split it into lots of little meals – suddenly filling his stomach might cause a bit of a relapse if his stomach is still a bit inflamed.
I think it’s all about tempting, rather than trying to force-feed him (which I’d never do unless your vet specifically ordered it, as it can be dangerous for both of you). If he still won’t eat despite tempting like this, then have another chat with the vet – but it does sound like he’s over the worst of it and just needs to get eating again.
Hope he gets his appetite back soon!
My 1 year 10 months old maltipoo recently vomitted 4 times during the day. We brought him to the vet and ran a blood test which turns out that the ALT reading was so high that the machine could not read it, all other readings were normal. We proceeded to do an ultrasound 1 week later, and results showed that the liver is smaller than the average liver, and one of the arteries near the gallbladder was inflamed. We then did a bile acid test 2 days later, and results were high too.
My boy is still active and still eat his meal happily and normally.
So the day before the vomiting, we fed him nexguard, wondering could that pill be the reason for this.
We are waiting for the appointment to see an internal medicine specialist but feeling very stressed about our boy. What could potentially be the problem? Could it just be a case of overworked liver or food allergy? PSS is possible too?
A PSS is a possibility, and would explain the findings – although it’s a little unusual for there to have been no earlier signs.
Vomiting is a recognised side effect of Nexgard – although it’s fairly rare, and I think it’s very unlikely that a one-off dose could have caused a shrunken liver overnight. It is possible that this is a problem that’s been there for a while but not caused him any issues – when he started vomiting (which may or may not have been due to the tablet!), the investigations found the more serious underlying issue.
However, there are lots of unknowns here, so I definitely think time to talk to an internal medicine specialist – so good luck with him!
My 14+ year old dog had cataract surgery July 19m 2023. Since the surgery, she has had a few road blocks. She recently had blood drawn and her ALP and ALT levels did not show, indicating further blood testing for liver bile levels. Prior to surgery, her ALT was 164 but the vet didn’t seem concerned and hydrated her intravenously prior to cataract surgery. On Aug 24, 2023, her liver bile acid was >200. He has her on Clvamox, Famotidine and Omeprozol. What could have occured that raised her bile acid so high when just a little over a month ago, her initial, pre-op blood test showed no elevation other than the one mentioned above where the ALT was 164.
Thank you
In a dog of that age there are lots of possibilities. A liver infection (Ascending cholangitis) is not unlikely; hopefully, that’s all it is and the medication she’s on now will clear it. However, at 14, a liver tumour is also a possibility. The next logical step if she doesn’t bounce back on the meds would be to talk to your vet about an ultrasound can to see if there is any focal pathology – good luck!
Hi, I have a black lab coonhound that had a blood test last year and we found her a LP level literally 10 times normal. All her other enzyme and liver functions. Bloodwork is perfect. Even did a biopsy liver biopsy. Found nothing wrong, tested for Cushing’s everything imaginable otherwise, a healthy, six year old dog. Any thoughts on this? Thank you so much.
ALP (also known as ALKP) is an enzyme that can be made in LOADS of different organs. The key ones are the bile duct and the bone; however, it can also be caused by certain long-term drugs (thyroxine and anti-seizure medications, as well as steroids). Rarer causes include toxins like moulds (although I would expect a raised ALT as well). So assuming there’s no liver, disorder, have gall bladder and/or pancreas and bile duct issues, or a tumour somewhere else, been ruled out? This would normally need an ultrasound scan.
Assuming that they have, what are the options? Although 10x normal is quite elevated, I’ve seen them go a lot higher than that. It may be that there’s a bone disorder somewhere (fractures, bone stress, even a bone tumour), or a nutritional one (high phosphate, low calcium or low vitamin D in the diet will result in the body compensating, which can lead to an ALKP spike). Often, we never know exactly what the cause is, and often, it just goes away on its own. However, it may also be an artefact – or even “just normal” for your dog!
I’d stay in touch with the vets and make sure you’ve ruled out the major causes, and then take it from there.
Greetings,
My dog just had a blood panel done and his liver enzymes came back 642 with normal being 135. Also, Glucose was 35 with normal being 70. My vet states that he believes my dog has insulinoma of the pancreas. My questions is with liver enzymes being that high is it safe to say that it has spread from the pancreas to the liver based on the markers? Thank you in advance as I am a very sad dad with this new and having to explain to a 8 year old little girl and 4 year old boy.
I’m so sorry to hear that – it’s a rare tumour but can be devastating.
While it’s impossible to be certain, the tumour having spread would be the first thing I’d think of given those findings, although an ultrasound might be needed to confirm it. It is possible that elevated liver enzymes could be secondary to something else, though, so to be certain, more investigations would be needed.
My Old English Bulldog will be 11 in November. She has IBD which is controlled by Pred, Metronidazole, Plavix, B-12 tabs and Chlorambucil, and Royal Canin Select Protein diet. She has been on this cocktail for over a year and has done amazingly well, no set backs. A recent CBC Chem shows her liver values are off the charts 975/4041. He liver values were normal 6 months ago. An ultrasound showed no masses or enlargement but architectural changes and some darkening of the area. The internist mentioned lymphoma. Note, same doctor mentioned Lymphoma a year and a half ago before the IBD diagnosis. I will not intubate my Bulldog so therefore needle aspiration and biopsy are out. Not to mention putting her through chemo for an additional 6-9 months for a questionable quality of life. She isn’t eating well and drinking could be better which is the reason for the initial vet appointment. Today she started vomiting bile then feel over a little dazed. I’m beyond upset…any thoughts.
Many of those drugs have the capacity to damage the liver, so it is possible that that’s what’s going on. It’s also possible that the IBD has resulted in an inflammatory hepatopathy – or that the original diagnosis of UBD was incorrect (biopsy is the only 100% certain way to differentiate lymphoma from IBD, although the other tests are pretty good), and it has now spread; or that this is a new lymphoma. Unfortunately, that isn’t necessarily going to help now.
It would be more helpful right now to consider her quality of life – because at the end of the day, it’s quality of life, not quantity, that’s the most important for our animals, and we have a responsibility to them. I am really sorry, and clearly you are too, but she needs you now. I’m not saying you need to have her euthanased straight away, of course, but it might be worth thinking about, and talking to your vets about, palliative care to keep her as comfortable as possible for as long as possible.
My 10 years old spayed Maltese had her liver ALT reading increased from 135 to 300+ within 2 months.
Did abdominal ultrasound, came back with a 1.8cm mass in spleen. Was told to remove the entire spleen for a accurate biopsy. But ultrasound shows nothing on liver.
Now i am very worried, cos only metastasis growth affects the liver reading? Otherwise how does a spleen mass translated to high ALT liver reading.
Yes, I would definitely be worries about secondary tumours from the spleen in the liver, but too small to be seen on the ultrasound yet. A biopsy of the removed spleen should tell you whether it’s an aggressive tumour, likely to spread, or not – in which case there’s something else going on. If your vet is doing surgery to remove the spleen, it might be worth talking with your vet about getting a liver biopsy at the same time to confirm the diagnosis?
Just to mention about my multipoo with presumed tumor on his ear and elevated ALT. He now has nothing on his ear.
My 6yr old Maltipoo went infor routine bloodwork to have a presumed tumor on his ear removed. Then found his ALT to be 150 in May, he had the acid bile test done which his levels were high. We put our dog on hepatitis support for 6wks, had him retested, ALT came back 234. The vet is suggesting an ultrasound now. Our dog is not sick, he’s playing, eating and pooping ok. We do feed him cooked liver and cooked beef, he gets beef liver treats. Should we be giving him anything else to bring down his numbers.?
I’d definitely get a scan to see if there’s any specific liver pathology or masses that need checking out. I’d also consider putting him onto a specifically formulated hepatic diet – eating straight meat and liver isn’t necessarily the best diet for a dog with liver disease, and might be causing more issues. Alternatively, if you want to avoid using a formulated diet, you should consult with a board-certified nutritionist to put together a diet plan.
Hello. My dog went to ER for a fever of 104 and a lot of vomiting and unable to keep food and water down four days ago. He is age 8 and a chihuahua poodle. They ran blood and saw his ALt and ALP was on the 1500-2000 ranges. Ultrasound was normal except a swollen gallbladder. They gave him IV fluids and IV clavamox and within a few hours he was eating but still quiet. They kept him for thirty hours and re ran his blood and his ALT was in the 600 zone and ALP was 778. All other markers normal. They sent him home and he seems much better. He is taking denamarin and seven days of clavamox.
I followed up with my regular vet today ( he was discharged from ER Sunday afternoon and they recommended a follow up this week to run in house labs to make sure the numbers were still coming down).
So today his labs were Alt was 321 and ALP was 550. But now his GGT went from 7 to 13 which is a little high! I asked my vet about this and she said GGT is not really that important and she does not look at it alot. I saw online if GGT and ALP
Are elevated it can mean cholestastic disease of gallbladder. Should I worry about this given his ALP and ALt seems to be falling well despite his GGT is now up a few points over the top normal level of 11? Does he need a bile acids test maybe? My vet told me to follow up with her in a month to retest the bile. I have a follow up ultrasound on August 25 to see if the gallbladder is still swollen. No one seems to be able to offer an explanation for This and whether it is liver or gallbladder. I kind of think gallbladder. Is GGT really not that important as my vet states? He is on a mix of Hills digestive IF canned food and he has a board certified doctor nutritionist who formulated his food for him to mix with the IF food so he also gets some Fresh food but it is balanced. He also takes the Vetriscience immune plus pill,
Forti Floria SA probiotics and Nutramaxx Avmaquin daily as recommended by his vet and nutrition person. Thanks for any insight. I worry about the GGT elevating after he is feeling better! Why is it doing that!
Personally, I’m not convinced GGT is all that useful in dogs, most of the time – it’s a marker that bile isn’t flowing, like ALKP. Unlike ALKP, it’s less affected by bones and medications, so both going up is a good marker of a bile flow issue. The ALT is the key marker for liver cell damage though, and so we’d sort of expect the ALKP and GGT to follow that.
The thing to remember, though, is a doubling of GGT is much less of a worry than a quadrupling (or more) of ALKP and ALT. Regarding gall bladder disease – it’s not all that common in dogs, so I’d be inclined to see how he goes, and run a scan if concerned.
So in this case, i’d be inclined to follow your vet’s advice as it looks like he’s getting better and better.
Good luck!
Last Thursday night, our 1-year old puppy started vomiting and it lasted all throughout the night. We decided to bring him to the vet the next morning, and they had him confined there for monitoring since he hasn’t stopped throwing up. They’ve been giving him anti-emetic meds but the vomiting still continues. He went through abdominal xray to rule out any foreign body ingestion, and the result came out clear. Last 8/4, we decided to have him tested for Chem10, and the result are as follows:
CREA: — (as per the vet, the result is so high that their machine cannot read it anymore)
BUN: >130 mg/dl
ALT: 137 U/L
ALKP: 289 U/L
Upon getting these results, the vet determined that there might be acute kidney injury because of the elevated kidney enzymes. They started giving him kidney supplements but I’m not quite sure how effective it is because he still vomits once/twice a day and it is an oral supplement. Our dog is also on continuous IV hydration.
Two days ago, we noticed that his eyes and the inside of his ears are turning yellow (jaundice), so we had him go through an abdominal ultrasound and also Chem17. Abdominal ultrasound results as per the vet: smaller than usual spleen, evidence of gall sludge, and cortical thinning. Chem17 results are as follows:
CREA: — (still can’t read by the machine)
BUN: >130 mg/dl
PHOS: >16.1 mg/dl
TP: >9.8 g/dl
GLOB: >6.0 g/dl
ALT: — (from the previous 137 U/L 4 days ago, now the result has gotten so high that the machine can’t read it anymore)
ALKP: 210 U/L
TBIL: 26.1 mg/dl
AMYL: >2500 U/L
LIPA: 4880 U/L
The vet told us that the results are definitely not good, and that it seems like the pancreas is also affected now. Through reading up on the internet, I believe the blood results do point to acute pancreatitis. We are not quite sure what is causing this, as xray and ultrasound didn’t show anything unusual in regards with our dog’s pancreas. What do you suggest we do next? I feel like we’re running out of options on what to do to help our dog.
This really isn’t good, it does look like there’s something multisystemic going on here. If your own vet isn’t getting on top of it, I think it might be time for a referral to a veterinary internal medicine specialist (even a virtual referral, if there’s no one close enough to transport him safely to). The trouble is once all these apparently unrelated systems start failing, you can get a cascade failure. This is often due to systemic disease (I don’t know what’s common where you are, but here I’d be wondering about Leptospirosis or even infectious canine hepatitis if he’s not vaccinated), or some sort of overwhelming systemic inflammatory syndrome.
All the best with him, I really hope he pulls through.
7 year old westie, went to vet was perfectly fine, four days later threw up breakfast and tried to throw up couple other times. We put on bland diet, he had loose stool with some blood twice, took back to vet and only elevated thing was ALT went from 57 to 828 in 7 days, every other part of blood was almost exactly what it was 7 days prior. Vet was very unsure of himself and said get ultrasound. Our dog has been fine energy wise and no more throwing up or loose stool. Getting a second opinion in a day. No other liver enzymes were high only ALT.
Hmmm, that does sound quite dramatic. I’d be inclined to repeat the bloods, and see what’s happening; but a liver scan is a good idea to see if there are any masses or other focal pathology detectable.
my Lab who is 3.5 years old of late reduced his in take of water.
and since yesterday has also reduced his intake of food.
we did a complete blood work
his Serum Total Bilrirubin is 0.5.
alt /sgpt is 426
ALKP is 573
AST / SGOT is 218
GGT is 0
RFT tests
BUN = 22
Creatinine = 1.0
the doctor has started him on a syrup called Jetepar and on ORS ( for dehydrataion). we are due to do his retest 10 days from now.
he also told us in 3 days if there is no change, they will start him on drips
i am anxious has his intake of food to has reduced now..
not sure what to do – deeply stressed
i dont know the root cause of this – so i dont know why I am dealing with.
his diet is boiled chicked with boiled rice and pumking
I’m afraid that without the reference ranges for that particular assay, the exact numbers aren’t that helpful!
If there is a suspicion of liver disease, the next logical step would be either a bile acid stimulation test or a liver scan, and hopefully that would give some answers.
Good morning , my almost !3 year old has recently been diagnosed with DM and is on Galiprant and gabapentin . Her ALT has been rising since around march . Currently at 173. tried denamarin and it rose slightly to current levels. Could medications be causing this? Would you subject her to a biopsy when she has DM and we dont know her life span? Does leaving her on the medications if they are effecting her liver out way any help they are giving her?
It could be due to the medications, that’s certainly true. The good news is that DM is usually very manageable if it’s not complicated by Cushing’s disease. I’d suggest having a chat with your vet about how well controlled her DM is; if it’s under good control, then a biopsy is a good start to see what’s going on. Alternatively, you could try changing her to another medication mix, but without knowing exactly what’s happening, that isn’t what I’d recommend.
At the end of the day, if her medication is giving her a good quality of life, I personally would consider that to be the key.
Hello my 3 year old miniature dachshund ate around 40 sugar free chewing gum yesterday with xylitol in .. I rushed him to the emergency vet and they still have him .. he is on fluids and his levels were up to 600 today, they were 500 when they tested him last night .. We are so worried about him .. They are going to do his bloods again in the morning and we are praying his levels have gone down .. Will he be ok ?
Without knowing the strength of the gum or the size of each piece, it’s hard to tell – but if the liver enzymes are improving, that is a good sign!
My beloved 5 years old Bichon Frise has elevated liver readings – ALT -787 (down from 1105 – 4 weeks ago) ALKP >2000 ( up from 1248 – 4 weeks ago), GGT -153 (up from 85 – 4 weeks ago). His LIPA has come down from 3248 to 1905. He is quite well in himself – still running to the door when guests, postman arrives etc, but he is drinking excessively (4 /5 pints each day) and is ravenously hungry. His bowels have been normal but yesterday and today he’s had bad diarrhoea.
The vet has offered no explanation other than prescribed Denamarin, The ultrasound showed no abnormality of the liver. Any help would be so appreciated.
Unfortunately, there are a LOT of things that can go wrong with the liver, and they can be really hard to get to the bottom of!
The increased thirst suggests that this is a real issue, rather than a blip; supplements like denmarin are widely used but take a while to work.
In most cases, we never find out what the underlying cause was, but the liver heals itself and gets better. In this case, though, with some of the levels still rising after 4 weeks, I think it would be worth talking to your vet about a bile stimulation test (to check the liver’s function, rather than just markers of damage), and potentially even to consider a liver biopsy to try and work out what’s going on. Good luck!
My 3 year old mix had routine blood work and we were told his liver enzymes were high 300’s. We did an ultrasound which came back normal. He was put on Denamarin for 30 days and had his blood work rechecked. It stayed the same. He is not showing any symptoms at all. He is on Fluoxetine 20mg but the vet said the enzymes were elevated even before he was on it (even though they never told me this then.) They now want to submit the blood work for further testing for minerals and proteins and they want to do a bile test. They said if hey still can’t figure it out he will need a liver biopsy. I’m just so confused what it could be. Like is this something he can still live a long healthy life? Could it be cancer or liver failure. I’m getting frustrated they can’t figure out what it is.
Hi,
Did you figure out what is happening witj your dog? My Yorkshire is almost 2 years old and her blood test is showing high alt as well but she’s feeling fine.
There are lots of options; if the bile acid test is normal, then there’s a good chance it’s not going to cause him any serious issues: good luck!
Hi, my Daschund had high alt liver enzymes but acting completely fine.. been tracking her blood and the keep up now in the 600. Did all the bike tests everything is fine, other than the alts are high. They went to do a liver biopsy but wondering if that’s too much? She is fine. Other than picky eater .
These are really frustrating cases! The probability is that the biopsy won’t pick anything up, in which case you can just watch and wait with some confidence. However… there’s always the possibility that there’s something serious going on, in which case the biopsy gives you the best chance of an early diagnosis and definitive treatment. There’s no right answer here, I’m afraid… but I must admit, I would probably want to know.
My 3yr7month pug had blood work done and came back with ALT of 308 as well as a UTI. Vet did an ultasound and found 3 10mm bladder stones. They refused a change in diet and said surgery was best. 30 hours after the surgery she was in the ER, never recovered. She was healthy, all blood work and no symptoms of any other issues. I am trying to get an opinion on if surgery on a dog with those numbers was the best choice.
It does depend on the type of stones, as some are very slow to dissolve even if the diet is changed – or do not change at all. Even if they can be dissolved, those are big and would take a long time to do so – and the risk of an obstruction (which is a potentially lethal emergency) gets bigger every day while you’re waiting. So yes, in a dog of that age, I would probably have said that cystotomy is definitely the best choice. An ALT of 308 is elevated, but if there are no other blood changes, in most cases an isolated elevated ALT with no ALKP changes is usually a false positive (no test is 100% accurate, sadly). The other thing is that a high ALT doesn’t on its own indicate liver failure; if the albumin, clotting factors, and bilirubin are all normal, then the liver is coping with whatever’s going on.
It’s a tragic loss and I’m so sorry for you – but from what you’ve said, I don’t think the vet did anything wrong. It’s just one of those terrible things that happens and we don’t always know why.
Did you get a post-mortem to see what had happened?
7 year old Morkie with AlT in the 800’s last fall, did a liver biopsy and it showed copper storage disease and grade 3 liver, started our dog on penicillamine and had labs done in January to see if meds are working, got ALT down to 200’s, labs again yesterday and back up to 788, what else can we do?
You probably need to talk to your vet and potentially consult a board certified veterinary nutritionist about a low-copper diet, as well as the liver therapy.
My 10 year old catahoula had a bout of pancreatitis 9 months ago. With meds and change of diet she recovered well. About a month after her ALT levels were slightly raised about 156. She took denamarin for several months and about 3 months ago she was down to 118. She now has a cyst in her eyelid that grew quite large over the course of a week. She had the same thing happen to her other eye 4 years ago and had it removed. She was scheduled for surgery this week and right before blood came back with ALT at 171 so they decided not to sedate and proceed with surgery. She’s on denamarin again and said we’ll reevaluate in 1 month but if mass keeps growing and seeming like it’s becoming a problem for her eye then they can get her in and just go ahead with the surgery. I would like to wait and get her ALT levels back to normal if that will be the safest for her going under anesthesia but I don’t want to wait too long if the cyst gets much bigger and affects her eye. My question is are ALT levels in the 170 range considered too risky for sedation or are they being overly cautious? All of her other bloodwork came back great in the normal range and they even did a bile acid test and said the results looked good. Just wondering if her levels were just slightly elevated at 170 would pose a huge risk for anesthesia and how safe it would be to go under with levels like that. I’m hoping I can hold out a few more weeks and with the denamarin her levels can drop to a safer level for surgery. Also was wondering if her eye got worse soon and we decided to just do the surgery regardless of the higher ALT is that something inherently risky or dangerous to go under with those levels? Ultimately I think her vet has been great and I’ve always trusted his opinion but any extra advice would be appreciated.
The trouble is, we don’t know what those ALT numbers are caused by – all it’s telling us is that there is some active liver damage somewhere. If the mass on the eye can be delayed by a few weeks, I think that’s not a bad call; but as you say, the time may well come when you have to risk the liver issues. You could perhaps talk to your vets and see if a liver scan would be an option, to try and see if you’re dealing with damage across the whole liver (which is more of an issue), or a focal lesion (which is less of a problem for anaesthesia, but might be something nasty).
My 10yo mixed breed had a bout of pancreatitis and mildly elevated liver enzymes. An ultrasound then revealed a 4cm mass near the liver. She was put on SAM-e and milk thistle and her enzymes went back to normal after 3 weeks. She has no clinical symptoms. Re-did ultrasound and the mass measured 3 cm. Consulted 2 vets – 1 pushing for biopsy, the other wait and see with supplements and diet change. Have you ever encountered a shrinkage of a liver mass or could it just be different angles/sonographer? Her liver enzymes are holding steady.
It would be lovely if the mass was shrinking, but my immediate thought is that a different angle seems more likely… And we don’t know what it is yet! Personally, I’d be inclined to go for the biopsy; however, a third option would be to rescan in another couple of weeks; if it’s down to 2cm then you know it really is shrinking; if not, then you know you need to biopsy.
My 16 yo maltipoo started vomiting 2 days ago and also quit eating. Took her to the vet and they ran blood work that showed significant increase in ALT from the blood work done 6 months ago (didn’t get a number, but they said they had to dilute it so it would read). Got a radiograph done and it didn’t show any major changes from the previous images about 9 months ago (they’re sending it to a radiologist just to confirm). Gave her anti nausea meds and liver support enzyme but she still hasn’t eaten 7 hours later. Can you explain how a liver scan is different from a radiograph, or are they the same? Thank you!
A radiograph uses X-rays, which will show us the rough shape and size of the liver but nothing else. It is however easy and quick to perform.
A liver scan uses ultrasound to look inside the liver and see if there are any internal changes, which don’t show up on an X-ray. It’s more complex and difficult, but also much more detailed and useful.
An analogy might be that the radiograph is like a camera that takes a picture of your house from the outside – it’s easy. but it doesn’t tell you what’s going on in any of the rooms, unlike the ultrasound.
My 1 year and 3 monthold frenchie May, threw up once and become extremely lethargic, her gums became a white, took her to the emergency vet and they are claiming it was due to an anaphlatyic reaction, she was given steriods and medication, Her ALT LEVELS came back to be 800 and a quick ultrasound was performed stating that her gallbladder was a bit thickened wall. Prior to this incident she had no problems and eating, pooping and drinking as normal. I t has been 2 weeks since this incident, she is on denamarin and liver and kidney supplements. but her energy levels are not like before, she plays and eats normally. But sleeps alot more than before. Many are saying that maybe she has gotten anxiety due to the stress the incident put on her., Any thoughts on this??? I just want her to get better.
Secondary behavioural problems are definitely a possibility, but there might be something else going on – it might be worth a follow-up blood test to see if there has been any organic injury to the liver.
Same thing just happened to my dog. ALT 1300. She threw up,once a bunch of frothy spit. Gums never turned pale, but energy is gone and she walks very slow. Ultrasound shows nothing going on with liver or gall bladder or pancreas. Small mass on/in spleen, but it is not cavitated, so hopefully benign. My dog is 16 years old and I do not want to have any surgery on her at this point.
So they are saying maybe infection or anaphylaxis. So she is on Denamarin and Baytril. She is still lethargic. She moves around a bit more today than yesterday, but not her normal amount of energy. I am seriously worried. Any suggestions or opinions? She stayed in the hospital overnight and had IV fluids and antibiotic shot. Oh, and she was also tested for pancreatitis – negative.
At that age, lots of supportive care and aggressive medical treatment – which it sounds like she’s having – are the best option if surgery to determine the underlying cause isn’t an option (which sounds very reasonable!). So it’s really a question of time, and hopefully the supportive treatment will let her rally. Good luck with her!
Thanks for your response. She is doing better. Within a week her ALT went from 1300 down to 400. However, then her kidney values were high when they weren’t the week before. I think the Baytril caused AKI. So she is off of that now and her appetite is back and she is showing signs of more energy, better appetite, and is engaging in playing with her toys again. It has been a long haul but this almost 16 year old girl is not done yet! I hope she has now turned the corner and is going to fully recover.
OK, that’s great news!
My 16 year old Pom/Eskimo mix, Lacey, went in for a wellness exam this week where we did bloodwork. We also did a round of bloodwork prior back in January. Her bloodwork came back with super high liver enzymes this time. I have a bi-cavity ultrasound scheduled for her on March 30th (to look at her newly diagnosed heart murmur, see what’s causing the liver enzymes to be high, abdomen, and a possible nodule on her lung (or what they said could have been a defect in their machine) to be checked…) But, I’m just really scared and confused how in just 2 months it jumped so much. Could this have been prevented? Can this be remedied?
Her high levels I’m seeing are: Globulin is at 3.8, AST (SGOT) 700, ALT (SGPT) 988, ALK P 135, BUN 61, BUN/Creat Ratio 51, Magnesium 2.6
In January they were much lower. She is super energetic and has her usual zoomies, has an appetite, and is her usual happy self. I am terrified to be honest, and have no real idea of what’s going on or what to expect.
It sounds like you’re doing everything right: you’ve found a possible problem, and now you;’re doing a full investigation to find out why it’s happening. At that age, I’m afraid that some sort of abnormal growth is quite a high possibility – and tends to present like this. However, there are other possibilities, including cholangitis, pancreatic disease causing cholestasis, or even a progressive hepatopathy (which may not cause her any “real” problems for a long time).
The key thing is to take a look and see what there is, so you know what you’re dealing with. Good luck on 30th!
We’ve been monitoring my 3-year old dog for 6-months after his annual blood work indicated high ALT levels. Yesterday, after 3-months of taking denamarin, we found out his ALT level has increased to 527, and now his AST level is high at 77 and Amylase is high at 1,158. Besides for his bloodwork, he has been acting completely normal – still a voracious appetite, normal water consumption, normal bathroom behaviors, and normal sleep/play behavior. We’re bringing him in for an ultrasound on Friday, but do you have any advice on how we should handle or what could be causing these levels to increase? I just want to make sure we’re doing everything we possibly can for him to ensure he’s healthy and happy. Thank you.
There are loads and loads and loads of possible causes, I’m afraid! I definitely think that a liver scan is the next step, and potentially even a liver biopsy (if his clotting factors are all OK) to work out exactly what’s going on. Unfortunately, the bloods can tell us that there is liver damage or leakage (not quite the same thing), but not necessarily why… good luck!
My nearly 14 year old dog has high ALP >2000, high ALT 273 and high GGT 61.
I took her for dental check but now they recommend a ultrasound and possible biopsy. I’m not sure whether this will change any potential treatment at this stage of her life and don’t want to make her life more uncomfortable. Would you do the ultrasound and or dental?
An ultrasound is non-invasive and painless, and after that, you’ll have a much better idea of what you’re dealing with – whether it’s something that he can live with comfortably, or whether he’s coming to the end of a long life and it’s time to say goodbye. Personally, I’d do the ultrasound to try and find out what’s going on, because it might be something quite benign.
My 12 year old Chihuahua Bella has been showing most signs of Cushing’s for > 6 months. I was afraid to know but I finally took her in yesterday. Her results are listed below. She is having decreased vision in her left eye and hearing in noticeably diminishing. She is scheduled for more testing next week. I am thinking with test results this abnormal it is fairly clear the it has progressed. Is more testing really needed at this point? With liver enzymes that elevated is she already in acute liver failure?
ALB = 3.6 g/dL 2.2 – 3.9
ALKP > > 2000 U/L H 23 – 212
ALT = 139 U/L H 10 – 125
AMYL = 1187 U/L 500 – 1500
BUN/UREA = 24 mg/dL 7 – 27
Ca = 10.9 mg/dL 7.9 – 12.0
Chloride = 116 mmol/L 109 – 122
CHOL = 312 mg/dL 110 – 320
CREA = 0.9 mg/dL 0.5 – 1.8
GGT = 8 U/L 0 – 11
GLU = 103 mg/dL 70 – 143
LIPA = 1744 U/L 200 – 1800
PHOS = 4.4 mg/dL 2.5 – 6.8
Potassium = 5.6 mmol/L 3.5 – 5.8
TBIL = 0.4 mg/dL 0.0 – 0.9
TP = 7.8 g/dL 5.2 – 8.2
Sodium = 155 mmol/L 144 – 160
GLOB = 4.2 g/dL 2.5 – 4.5
OSM calc = 314 mmol/kg
ALB/GLOB = 0.8
BUN/CREA = 26
Na/K = 28
SDMA = 7 ug/dL 0 – 14
Diagnostic Interpretation for TT4 4.0 ug/dL High 2.1 – 5.4 ug/dL
Immunoassay results from IDEXX VetLab In-clinic
TT4 = 0.5 ug/dL L 1.0 – 4.0SNAP Assays results from IDEXX VetLab In-clinic
Test Result Reference Range
HW = Negative
Lyme = Negative
AP_spp = Negative
EC-EE = Negative
Test Result Reference Range
BASO = 0.00 K/uL 0.00 – 0.10
EOS = 0.37 K/uL 0.06 – 1.23
HCT = 40.9 % 37.3 – 61.7
HGB = 14.0 g/dL 13.1 – 20.5
LYMPHS = 1.78 K/uL 1.05 – 5.10
MCH = 21.7 pg 21.2 – 25.9
MCHC = 34.2 g/dL 32.0 – 37.9
MCV = 63.5 fL 61.6 – 73.5
MONOS = 0.75 K/uL 0.16 – 1.12
MPV = 18.8 fL H 8.7 – 13.2
RBC = 6.44 M/uL 5.65 – 8.87
WBC = 8.19 K/uL 5.05 – 16.76
%LYMPHS = 21.7 %
%MONOS = 9.2 %
NEUT = 5.29 K/uL 2.95 – 11.64
%NEUT = 64.6 %
%EOS = 4.5 %
%BASO = 0.0 %
PLT * * 237 K/uL 148 – 484
Retics = 141.0 K/uL H 10.0 – 110.0
%Retics = 2.2 %
RDW = 17.8 % 13.6 – 21.7
PDW – –.– fL 9.1 – 19.4
PCT = 0.45 % 0.14 – 0.46
RETIC-HGB = 25.6 pg 22.3 – 29.6
I’m not in a position to give you a second opinion on these – your own vet is much better placed to advise you having seen her! – but I would say that this elevation in liver enzymes in’t that unusual in Cushing’s.
The thing to remember is that it’s not just liver damage that can elevate alkaline phosphatase (ALKP) – the steroids in Cushing’s trigger excessive production of the enzyme, which means the numbers can be scary high, without there being any significant liver disease at all in some cases.
So don’t assume that just because that enzyme is very elevated that she has liver failure!
Good luck with her!
My 7 month old puppy had ALT of 202 for the routine blood work on the day before her spay surgery. She had the spay surgery and the vet had her on Denamarin (for 30 days) and with her pain medicine (for 5 post surgical days). We had another blood work a month later, her ALT went up to 332. I’m very concerned. I used to feed her lots beef liver treat and other organ meat for training before. Not sure if that’s the cause. Sometimes chicken feet, I heard it’s fattening. She was very intelligent, so she gots more treats than her regular meals. But after the first blood work on the day of spaying, I strictly monitored her meals and she had only been eating regular food with small amount of fresh cooked proteins as toppers. She even gained 1 lb after the 30 days. Her other numbers in blood work including other liver enzymes came back in the normal range. She’s drinking and eating normal with energetic mood as always. But the vet says she may have PSS or micro vascular dysplasia. I feel so sad when I heard this after I found out dogs with these congenital conditions can only live up to a few years. I’m hoping this comment will give me some comfort and hope. Could it be something else?
It could be, but remember a congenital PSS is a very treatable condition – after surgery, most dogs go on to live a normal life, and many asymptomatic dogs with suitable medical care alone also live out a normal lifespan.
I think you need to know what’s going on here – and that means more investigations – before worrying about the long term!
I know that ALT is not a diagnosis. But wanted to get different opinions based the elevation level and rate. I just wanted to know if there could be other common causes for young dogs to have mild ALT elevation. I don’t know if diet, frequent meal changes, anesthesia, spay surgery stress, pain medicine, or simpatrica trio will be the causes. Right now one vet recommend bile acid testing and X-ray, the other recommend monitor for another month since she’s not having symptoms. I’m giving her milk thistle supplement. Hope that will help her recover.
OK, so stress and dietary changes are not common causes of liver issues; anaesthesia could in theory be, but it’s pretty rare unless she was profoundly hypotensive during surgery. Medications can occasionally cause rises in liver enzymes, but it isn’t a recognised issue with Simparica Trio. It can sometimes occur with some analgesics – but not normally in a young and otherwise healthy dog.
There are a lot of different causes of liver damage and hepatitis out there, and most of them we never get a firm diagnosis, they just fade away with treatment. Sometimes they don’t, and then we need to do further tests – starting with ultrasound and bile acid stimulation tests, potentially escalating to include a liver biopsy.
However, we do occasionally see young dogs who seem to have naturally high levels of one liver enzyme – unfortunately, we need to rule out all the other causes before we can say it’s that!
My 1 yr old Toy Poodle had his pre surgery blood test come back with ALT level of 240. He acts fine is wild and happy he plays and wrestles with his dachshund “brother” eats well normal bowel movements. His surgery for his bilateral cryptorchidism neuter was canceled. How concerned should I be? He is on milk thistle now (the little blue pills that start with a D). I feed him Lotus Herring and Sardine. I am changing him over to Lotus turkey. I really need him neutered and I really need him to live a long and happy life. I am just not sure what else I cam do to make this better.
See what happens after a few weeks on the supplements: most raised liver enzymes are temporary blips, as the liver has a fantastic ability to regenerate and heal itself. If it’s still elevated, time for more investigations to see what’s going on!
Born Jan 2020 female spayed
Health issue: Diagnosed with IBD via biopsy in 2021
Meds:
Azathioprine (stopped Oct 22)
Prednisone (temporarily until appetite became stronger)
Budesonide
Tylosin
Psyllium to counteract very loose stools
Ursodiol
Food: Royal Canin Hydrolyzed Protein ONLY after IBD diagnosis
ALT issues begins in October 2022:
ALT Range = 18-121 U/L
Mar 22 result 29
Oct 22 result 179
Nov 22 result 184 (started Ursodiol)
Dec 22 result 228
Jan 23 result 185
Feb 23 (fasted blood draw) result 295
Feb 23 ultrasound scheduled
Any additional opinions would be appreciated
I think you’re going to need to see what that ultrasound comes back with – IBD can lead to cholangitis and potentially progressive hepatitis, but it’s much less common in a dog than in cats. Definitely time to see what’s going on structurally, and then maybe consider a Bile Acid Stimulation Test to see whether you’re dealing with a functional impairment or regenerative tissue damage. You may well end up needing a liver biopsy to get to the bottom of it. These cases can sometimes be really hard to get on top of – good luck.
I have a 10 year old 18 lb mixed breed rescue. We went in for a yearly dental cleaning, and the blood test prior to cleaning flagged slightly elevated liver enzymes. They didn’t proceed with the dental cleaning, but instead prescribed Denamarin for a month. We went back to test and the levels didn’t change too much other than going up a smidge. They’re encouraging an ultrasound. She acts like her normal self and is pretty active so I’m confused. Is there a holistic approach we can take at home? Should we also proceed with an ultrasound?
The problem is that at the moment, we don’t know what’s going on – or even if it is a problem. She might be one of the 0.1%-ish of dogs who naturally have high liver enzymes – however, an ultrasound is non-invasive and at that age I’d really want to rule out a liver tumour before I made any decisions.
My 13 month old shih tzu was scheduled for a neuter and they canceled the surgery because of a heightened ALT on his pre surgery blood work. We are going to give him denamarin and an antibiotic for 2 weeks and re check his value. Having had lost 2 senior dogs in the past year I am sick about this news as I never would imagine something wrong with my one year old boy. He is showing no symptoms at all. His ALT level is 950.
Hi! I’m having the same issue 🙁 any update on what happened with you shih tzu?
These blips in liver enzymes aren’t that uncommon – and most of the time they resolve on their own with supportive treatment in a few weeks. If they don’t, then it’s time to investigate and try to work out exactly what’s going on and why. So no reason to panic right now!
Hello. About two weeks ago my 8 year old mini poodle mix (healthy weight) went in for a teeth cleaning. They called me back and said her ALT was at 877 and recommended not doing the teeth cleaning, and seeing our regular vet. In the meantime they recommended Denamarin which I got. Two weeks go by and we were at her regular vet (she had been on the Denamarin for about a week at that point) and her blood was tested again. They said it was in the 1000s at that point (but didn’t say the specific number) two days later I had her in for a bile acid test. They said it didn’t look good. Im now being recommended to a specialist for ultrasounds and most likely a liver biopsy. Shes been acting completely normal. About five months ago I had changed her to a high protein Beef and salmon food. Could this be what’s suddenly causing this? I went out and bought a new low protein turkey breast food in the meantime. Also I heard its better for her liver to get 3 to 4 small meals a day instead of her usual 2? Hoping to get her in to see a specialist ASAP I’m very concerned.
Iv just had ny 5 year old Bedlington terrier in and his alt is over 1000 he had a bile acids test yesterday….How’s your pooch doing
Bile Acids Pre were 133.6
Post prandial (I believe that means after she ate) were 85.0
Just a little more info. Trying to gauge how concerned I should be. Thank God for pet insurance. Hoping we caught this in time to fix her up. I have a strong goal for her living until 18, and barely 8 is far too young.
I agree that a specialist for a full workup is definitely the best thing to do here – this isn’t a grumbly medium liver enzyme level, this is high and rising quite fast. I very much doubt that the diet you had her on caused this; however, lower protein – and ideally a prescription liver diet – can definitely help protect the liver. I think the key thing at this point in time is to work out exactly what’s going on, and what to do about it.
All the best, and good luck with the specialists.
My 10 year old dachshund has had very high ALT and ALP levels. She eats well, plays often, has no bathroom issues, is at a healthy weight, and happy. About a year ago we had ultrasound done and it was determined that she had sludge in her gallbladder however there was no obstruction. We started her on Ursodiol, Denamarin, and vitamin E. A year later she is still happy and seems healthy. However her levels are still very high. Do you have any thoughts or suggestions?
These are often frustrating to deal with! Personally, if all the tests have come back normal except that, your options are either to do a liver biopsy, or to say “let’s keep an eye on it”!
Thanks so much for your response! Our original vet suggested elective gallbladder surgery even though she has not one symptom. Her thoughts were my dog is healthy and strong now dont wait until you have an issue. However I brought my dog to another vet for a second opinion and he said that he would advise not to have the gallbladder remove since she is not showing any signs or symptoms (which seems to make sense to me). The surgery seems pretty serious. Any thoughts? Thanks again!
I’m not an internist, but gall bladder removal is a slightly controversial surgery: some surgeons claim great results and others say they don’t think it’s worth it most of the time. The theory is that inflammation of the gall bladder and/or sludge in the bile duct contribute to low grade liver problems. I don’t pretend to be an expert in the procedure, but I would think long and hard about going through such an invasive procedure if you’re not fairly confident it will help.
I’m really sorry I can’t give you a definitive answer – if you have 2 vets who disagree it’s usually pretty good evidence that there isn’t a solid answer!
My 2 1/2 year old female French bulldog started acting like she was in pain in July 2022 and we thought she might have injured her back so we took her to the emergency vet , the vet said it was probably a soft tissue injury but he was more worried about her elevated ALT levels in 800. After a few days on pain meds she recovered from the injury and we followed up with her regular vet to recheck her ALT and it was lower but still in 500 so we thought it could be from trauma but still proceeded with a bile acid test , the pre bile acid was 1.3 and post was 4.4 but her ALT was still 454 but slowly going down so we thought we would give it time since all her other labs where normal and she was acting fine. Last week she seemed to have something bothering her again because she wouldn’t jump up on anything but nothing hurt when pressed on or manipulated so I made an appointment but by the time she was able to get in she was acting normal again so we rechecked her bloodwork and she still has an elevated alt of 378 . All other labs are still within normal range, the vet said she wants her to start taking Denamarin and follow up in a month or two and at that time we could also do an ultrasound. I guess I’m confused what could be causing this ? Everything I have read about raised ALT is that if it is genetic (like a shunt) wouldn’t she have had issues well before 2 1/2 years old , and if it was due to kidneys or pancreas would her other labs be off to? They checked her T4 and it was 2.6 (within range). Can it still be her thyroid causing it ? Is it possible it could still be elevated from what they thought was a soft tissue injury in July ? Her Alt is going down every time checked but still elevated. Should I wait until her follow up or just ask for the ultrasound now ? Lastly, are there any other test you would recommend to have done ? Thank you for your time , I truly appreciate it .
These grumbly elevated liver enzyme cases are really frustrating – there must be a cause, but it isn’t immediately obvious, especially when the other labs are fairly normal. It’s coming down which is great; and if it was ALKP I would be more inclined to think you were seeing a musculoskeletal injury that was gradually healing. However, in this case, I think getting an ultrasound scan if it doesn’t resolve is probably the best option, it looks like your vets have done all the standard labs so if it continues to grumble along then taking a look to see what’s happening is the next logical step. Hopefully not necessary, but worth checking! Good luck!
My 10yo mixed breed has his gall bladder removerd enzimes werr over 1000 after surgery enzymes dropped to approx 300 level Over the last 4 months had 2 blood test between 500 and 600.. would you recimenr an ultrasoind?? Im feeding him royal canine low gi dry and low fat gastro canned from royal canine What do you suggest?thank you
Personally, yes, I’d want to know what’s going on in there! It does depend which liver enzymes we’re talking about here, as you often get a raised ALKP after removal of the gall bladder (a rare procedure that isn’t often needed – stones aren’t common in dogs so you were really unlucky!) – but I wouldn’t expect it to gradually go up again.
My senior dog (13 yo male terrier mix, prob Yorkie or Silkie) is behaving normally but has had increased ALT numbers for a few years – 399 was the reading in Dec 2021. The last bloodwork taken last week showed significant elevations of the ALT number (911) along with an AST of 76 and Alk Phosphatase of 470.
He has vomited intermittently over the past 2 weeks or so, maybe a total of 3 times that we’ve noticed – a bit of yellow bile along with small amounts of kibble. He’s still eating but his water intake has increased significantly.
He had a chocolate episode about a month ago, got into a bar of dark chocolate and took him to the ER to get him to vomit it up. Seemed to be fine after we brought him home, but since then has developed a bit of incontinence. The first night home he peed in the bed, we chalked it up to getting IV fluids and then sleeping so soundly from exhaustion he just didn’t wake up. But since then it’s happened a few more times, so we’re waking him up and taking him outside in the early morning.
Part of me hopes that the spike in ALT is residual from the chocolate episode, his doctor put him on Denamarin and referred us out to an internal medicine specialist. But that doesn’t explain why it was already elevated to begin with.
I’m really, really hoping it’s not cancer. His weight has been stable and he doesn’t seem to be in discomfort or pain.
Sounds like you’re doing everything by the book… but I wouldn’t normally expect the ALT to be elevated a month after a chocolate exposure. I think you definitely need that specialist appointment to try and get to the bottom of what’s going on in there – possibly a liver scan by your primary vet might shed some light in the meantime, if there’s a long wait? But high liver enzymes with clinical signs consistent with liver problems do need investigating… Good luck with him!
Hi
We have been through the mill with our just 9 yr old sheltie. Walt had a mucocele gallbladder and was admitted into hospital for an emergency cholysystectomy .He became jaundiced and was very lethargic, his bowels are loose and his urine was obviously bright yellow. He has made an amazing recovery , he had an oesophageal foid tube for a week, but is now eating , chicken , fish and rice. Unfortunately today his bloods show his liver to still be not right . His liver enzymes 2 weeks later continue to be raised in the 500s. He has had liver biopsies and we are waiting on the results. Just want our pooch to be well again , so we can have a few more good years with him. We need to find the best liver prescription diet for him , to support his liver in the future. Any ideas?
I think the key thing is to wait and see what the liver biopsies come back with. If he’s eating and seems OK in himself, then there is probably time to play with in getting things sorted.
Hello! Indeed it can; it sounds as though you are in consultation with your vet about this, so it’s well worth having a chat about it with them. Good luck with the lump testing, however you decide to carry it out. As you know, biopsies in general deliver a lot more information than an FNA, but the trade-off is that anaesthetic. Do let us know how you get on! – Liz Buchanan
My 13-year-old Maltese has an ALT of 312 she’s had 2 seizures back to back. She’s now wandering around aimlessly. She no longer uses her pads. The vet is suggesting an MRI and a bunch of other tests but even then they’re advising me that they still may not know what is going on. So far, I’ve been to the ER where she has prescribed anti-seizure medication, and to her primary vet where they’ve done blood work and prescribed medication to try to bring the ALT levels down. Not to mention after the seizures and ER visit she was barking/howling nonstop as if she was in paint. I need to know what I should be preparing myself to do? I am almost out of funds and spending money on guess work isn’t feasible.
Without knowing the specific lab’s reference range, it’s hard to interpret, but this does suggest some liver pathology. However, in a dog of that age, liver disease plus seizures tends not to have a good outcome without a really solid diagnosis of what’s going on – and not always then, either. The MRI would tell you if there’s a mass in her brain, but not necessarily what it is or how to manage it. The other option to remember is that seizures and that sort of “vacant” wandering is not uncommon in animals with severe liver disease (it’s called hepatic encephalopathy). So it might be worth talking to your vet about getting a bile acid stimulation test and a liver scan – this is usually much cheaper than MRI and they can be done in most vet practices. Put together the two tests will give you a better idea of what’s going on in the liver and if it’s likely to respond to treatment or not.
That said, only you can decide when you’ve done enough for her – all the best with a difficult decision.
This was helpful, thank you. Our 13 year old pit mix has elevated ATL of 388,from 125 in June. He has mast cell cancer but we never had scans done to see how spread out it was. He definitely has had an increase of MANY lumps under and on his skin. He’ll be going in for an ultrasound this week. He is just starting to be very uncomfortable. His allergies are uncontrollable. He’s now allowed three doses of benadryl a day.
Hi, My 14 1/2 year old standard poodle was fell over and had all of a sudden has trouble getting up, he is not eating well and is drinking a lot. Had tests done and his ATL came back at 6000 what does this mean.
Do you mean ALT? If so, this suggests some sort of ongoing liver damage: at that age there are lots of options, but the next logical step would be a liver scan to see what’s going on in there. Good luck with him.
Hi there! My 3 year old Chinese Crested Powderpuff has an ALT just over 1,000 and an elevated AST as well (189). Her bloodwork showed elevated reticulocytes and bands as well as lowered monocytes as of August 2022. She had an ultrasound and it came back completely normal. She is on a daily dose of Denamarin and seems to be feeling better, but she occasionally throws up still. She has an appointment to recheck her bloodwork next month at a new vet as our old vet was not giving us any answers. What could be the cause of this? Should I be worried? I worry this will negatively impact her lifespan. Thank you!
It’s odd, and it does suggest some sort of liver dysfunction. I’m afraid to say, though, that in the majority of these liver “blips” in younger dogs, we never learn the exact reason. The most likely causes are infectious agents – while leptospirosis and infectious hepatitis are rare due to widespread vaccination, we can and do see bacterial cholangitis resulting in liver dysfunction not uncommonly, or even a heavy parasite burden (although this again is rare in dogs that are regularly wormed). Definitely see what the results are like at the recheck, but if she’s doing well, that is probably all we have to go on at the moment!
Thank you so much! I should probably mention that she had positive titers for Leptospirosis in May 2021. My vet says it’s highly unlikely that it’s related to that as she was fully treated for it. I’ll take this info to our vet at our appointment next month. I really appreciate it!
My indoor living 5-year-old rat terrier was taken to the vet for dental cleaning this morning. Doctor called at 12 to tell me that his ALT was 1607 over 10 times the norm and asked did I still want them to do the dental cleaning. I said yes. Doctor said the elevated numbers could be from trauma or toxins. I know of neither. I’m just worried. Do you think Oreo will recover from this?
A single high enzyme reading is very hard to interpret without any other data. I think once he’s had a chance to get over his dental work, you need to have a chat with the vet about repeat blood tests and then, if there are still high liver counts, a liver workup to see what’s going on. The great news is that whatever it is, clearly it isn’t bothering him yet – so even if it’s a problem, you’ve caught it early! And most liver issues are much more manageable if caught early on, before scarring of the liver occurs.
My 6 month old golden retriever alp is 800 up from 600 a month ago
Vet recommends ultrasound
Could this mean copper syndrome?
It’s possible, but it is fairly unlikely, as the breed isn’t at particularly high risk. I think a scan is a good option; one of the issues Goldens are prone to is liver shunts, and at that age, any liver issues could be a sign (ALP levels are very variable with this condition, sometimes normal, sometimes high, sometimes low, which can confuse things!). The other thing to consider is that high ALP levels can be due to bone disease, not necessarily liver problems, so a full workup by your vet seems a sensible plan. Good luck with them!
My 11yr old Havanese had blood work recently and both liver enzymes were in the 1,000’s. Vet is suggesting a ultrasound. My dog does not show any signs of liver failure. He seems pretty much healthy. Would it be worth it to wait and repeat bloodwork or rush to have the ultrasound which is quite expensive?
Without knowing the units the lab used, or seeing him, I can’t give you a specific answer: however, liver enzyme counts that high would usually be a matter of significant concern, especially in an older dog. Waiting for more blood tests might allow something rather nasty to get established, rather than locating it and potentially being able to deal with it at this earlier stage. Personally, I’d be recommending the ultrasound, to be honest, so you have some idea what you’re dealing with.
It may well be nothing – a transient bug with a “taste” for liver cells; but it could also be a tumour or an abscess that really needs early staging: and without more diagnostics, we’re not going to know which.
It’s a hard decision, I know – good luck!
My dog got 4 high things on a recent blood test. Total Protein 9.7 (Normal range 5.5-7.6) Albumin >6.0 (normal 2.5-4.0) GGT 160 (normal 0-14)
Total bilirubin 5.6 (normal 0.0-0.5)
My questions are.. could the first two be because he didn’t have food or water for 10 hours before getting surgery? if not, do all of these things point to a potential same issue? I am going to take him to a vet ASAP, but money has been tight so I have to make do with internet research for a couple more weeks.
A high TP and albumin usually mean quite severe dehydration: not what I’d expect from not drinking for a few hours, so I’d be suspicious that there’s some underlying disease process causing ongoing dehydration, or stopping him from coping with short-term water deprivation. Liver disease is a distinct possibility as a cause (dehydration is often seen in liver problems), but there’s no way to know for sure without more tests, as sometimes liver tests can “false positive” if triggered by other disease processes.
Either way, yes you’re right, he needs a veterinary examination and a formal opinion as soon as you can get him one. I’m surprised that the vets didn’t give you any interpretation or advice based on those bloods, though, as over here normally we’d only run bloods if we had a specific reason to, and then interpretation would be part of the service.
Hi my dog is 11 years old and she is in good health but her sgpt is 140 and Sgot 125 and ALT is 425 , she is eating regularly , she is a bit lethargic but her sgpt and sgpt lever is always in this range only , I take her to check up every month do the regular test but her sgpt and Sgot level never seems to come down and I am worried about her will she be alright? I thought of taking her to walk everyday atleast for 20 min
These markers are just telling you about hepatocellular stress – they’re not telling you why that’s the case. You’d need to get more workup done to determine what’s going on and whether these elevations are relevant: probably a bile acid stimulation test and a liver ultrasound, to try and find out if it’s a real problem or just a personal quirk of her physiology!
My almost 10 year old male Kees hound has been diagnosed with both Cushing disease and copper storage disease. His Cushing is well controlled but the copper storage disease is another story. He could not tolerate the penicillamine so I’m going to try to make him his food! Any suggestions?
Its very, very difficult to home-formulate such a specific diet at home: if you’re going to try, I strongly advise getting in touch with a board certified specialist in veterinary nutrition.
Hi there, we have 12 year old female Boston terrier and we just took her to the vet because she came to eat and just smelled and turned around, so we took her to vet and they did few tests. Vet came and told us that her ATL was >1000. Basically her liver is damaged. What’s your suggestion? Our vet told us that there’s nothing really we can do at this point since she’s 12.
It’s difficult to know what to advise without more information on what’s caused the liver damage, whether the liver can heal itself, if there are any other problems, and whether the liver damage is actually impacting liver function or not. A most terriers aren’t that old at 12, and unless there are other health issues that make it a moot point, I think it would be worth talking to your vet about further workup: liver scans and a bile acid stimulation test, for example, would give a lot more information about what’s going on in there than a one-off blood reading. Alternatively, you could talk to the vet about a referral to a specialist internal medicine or gastroenterologist vet, who would have access to more advanced diagnostic tests and would have more experience in dealing with liver problems than most first opinion practitioners. Good luck with her!
My 7 month old Havapoo went to the vet for spay and revision of umbilical hernia. Her pre surgery labs came back with high ALT. They did not do surgery due to it and did a 12 hr bile acid test which also came back high.
The vet stated it is very unusual in a young dog and is referring her to a specialist as ‘thinks’ it is PSS.
They changed her to special liver disease food.
She is acting ok now, but has not been eating well for a few weeks and had a odd bowel issue and threw up twice in that time as well.
She’s also had full anal glands that needed expressing a few times which the vet also feels is unusual in young dog.
The only thing that changed is a few weeks ago her last heartworm and flea/tick both brands they changed based on her weight.
I wonder if there is a connection to that and liver damage or possibly she has the congenital issue.
Awaiting getting scheduled at specialist and I am stressed/concerned.
Any thoughts? Similar situations out there?
Any unexpected liver issues at that age I’d be thinking about a shunt too… acute liver damage from medication can occur, but is pretty rare in dogs, to be honest.
Thank you for replying. I am still trying to find a specialist that is willing to schedule an appointment. I have been pushed to December from two so far. My vet cannot diagnose or do anything for her and is not very concerned.
I got her lab work from her chart today. I need someone to scan her liver and find out what is happening to this sweet pup!
ALT 275 HIGH (range 10m to 125)
PDW 8.6 LOW (range 9.1 to 19.4)
NEU 1.74 LOW (range 2.95 to 11.64)
It’s difficult to decide how significant those finding are, given that she seems otherwise pretty healthy. Clearly your primary care vet isn’t that concerned, as this isn’t an urgent referral; I think it’s worth having a chat with them about the findings though, in particular the elevated ALT and mildly reduced neutrophils. If she seems clinically well now, it’s likely that this is a low grade issue that, while it does need investigating, is not urgent; if she is showing other clinical signs, though, it might be necessary to bump up to a more urgent referral.
I’m not sure how the system works where you are, but here in the UK, it’s the primary care vet who is responsible for arranging referrals, and will give the referral hospital an idea of the urgency involved.
Hi my dog has had heat stroke well we think that she is in day 5 her liver on the bloods have gone up today I need some help and advice to see if there anything we can do she is in the vets
If she’s in the vets then she’s in the right place. Sadly, heatstroke often leads to internal organ damage, especially to the liver, as the excess heat causes the cells to break down. In many cases it will heal, but with so many other organs struggling, the prognosis is worse than for simple liver inflammation. However, you’ve already done the best thing for her: getting her to the vets!
My pug sgpt values are increased to 122.6 and serum creatinine is increased to 6.9. will my dog get cured if it has liver nd kidney issue. My pug is 4 yrs old
It depend what the underlying causes are – and for that you’ll need to follow-up with your vet!
My 10 year old schnoodle seems in good health aside from being more sleepy, which I attribute to age and the dog days of summer. I had her blood work done to be safe and a few weeks prior she ate ( swallowed whole:/ ) a tree frog.. The office called and said her labs looked great, no worries. I got a copy and I see her alk phosphatase is 226 ( 0-175 is normal range) but her alt is 63 ( below 130 is normal range) and her ast is 19 ( below 60 is normal range) So I’m a bit confused- I see her trygliserides are high as well 214 ( 21-140 is normal range) .. I am not sure why these two levels are high on their own, wondering if you could explain what steps I should take if any.. I see other post and levels are in the thousands so maybe I’m worried for nothing. I feed her Blue Buffalo wet food so many to much fat 🤷♀️ Any guidance is appreciated. Thank you PS could the frog have anything to do with this or did that cycle through her system 3 weeks ago?
Very mild elevations in alkaline phosphatase – like this – are fairly common in older dogs, but there are a lot of possible causes, ranging from low-grade chronic stress to mild liver impairment to Cushing’s disease to a benign tumour somewhere. However, in many cases we never find the cause and it may be “normal” for her, being very close to the normal ranges.
Mildly elevated triglycerides are typically because the dog ate less than 12 hours before the blood test (!) and are in any case quite common in the older dog.
Either way, if the vet who knows her and has seen all her other results isn’t worried, then I wouldn’t be too worried either! If you are concerned, it might be worth having a chat to your vet about ruling out some of the more common causes such as early Cushing’s – although the probability is that you won’t find anything.
My dog’s SGOT is 125 units and SGPT is 296 units. She had a stroke of some kind today where she was partially conscious, her heartbeat was very fast and her tongue was out. Is this due to some sort of diet? I am very confused as to why her levels increased soo much.
I think you need to work with your vets here as there’s clearly some very significant problem; it could be that some liver disease is causing seizures (this is common and is termed hepatic encephalopathy); or that a seizure has raised her body temperature to the point that her liver has been damaged; or there may be a toxin or other condition causing both liver and neurological damage. In any case, she clearly needs fairly intensive veterinary workup and care: good luck with her.
Our vet has just told us our golden retrievers liver count has increased from 2000 in March to 4000 he has Epiphen and potassium bromide for his Epilepsy. Which are in the correct therapeutic level. We are being referred to a specialist vets but he has list energy, drinks and wees alot hiw worried should we be. We are now out of insurance till end September so cant afford lots of tests and things plus we dont want to put him through more scans and tests. He had the gastric bug that was going about back in march and spent a week in hospital on an iv drip. He is only 6 but the last 4 years has been one thing after another
Epiphen (phenobarbitone) is well known to hit the liver quite hard; sometimes, raised liver enzyme levels can be due to the liver adapting to the drug, but sometimes it can be due to direct liver toxicity. I would advise talking to your vets about alternative treatments – there are now a wide range of other anti-epileptic drugs on the market, so just because he doesn’t tolerate phenobarbitone, it doesn’t mean there’s nothing that can be done!
My 4 lb Chihuahua has an ALT of 3000 we noticed that she was not acting right, was not eating and when she sis eat, a few hours later she threw up. The food was not digested. 4 days before this she was given We toook our Chihuahua to vet 5 days after she received a Pro Heart 6 month injection. She has been on an IV pumping medicine and fluids since Monday and her ALT levels were at 3 K and dropped to 1770. We decided to take her off the intravenous medicines and give her orally since she started acting like her old self. Her ALT went up to 1900. Her liver looked normal in an x-ray. She is 12 years old and there doesn’t seem like there is anything else we can do other than let her live her last few days under oral treatment and to keep her comfortable. I am not doing an ultrasound nor a biopsy due to the cost. I have already spent close to 2K keeping her hospitalized. I don’t know what else we can do. We will euthanize her when she has a bad episode again. I feel it will be right around the corner. If you have any ideas or thoughts, they would be most appreciated.
I’m so sorry to hear that; unfortunately, raised liver enzymes are a symptom, not a cause of disease, and so without further tests, it’s not usually possible to determine what the underlying issue is. I think deciding to prioritise her quality of life, though, is absolutely the right thing to do in the situation – well done.
My Indian spitz female is 13year she is not eating since a week when she eats without vomit tablet she is vomiting sometimes she is very active we tested her ALT level yesterday she got 2610 and we did it again in yesterday it shows 4046 cannot understand our vet starts treatment he gave injections please help me is she can recover?
The ALT enzyme is just telling you that there is increased leakage of ALT enzyme into the bloodstream. This usually means damage to liver cells; however, other conditions such as some drugs or muscle diseases can also trigger a rise.
However, it is NOT telling you how well your dog’s liver is working, or what the cause is. Further diagnostic tests would be needed for that, such as a bile acid stimulation test to measure liver function, ultrasound scans to look for liver lesions, and ultimately liver biopsies to determine the exact disease process.
Without knowing WHY your dog’s liver is unhappy, it’s difficult to say whether it’s a treatable condition or not! The liver is very good at regenerating and repairing damage, so conservative treatment (treating the symptoms) is often effective; if however it isn’t, then the underlying cause needs further investigation. Good luck!
My dog has a very mysterious issue. She originally tested about 400 something on her ALT. We waited a month and re-tested (she wasn’t having any symptoms but we had done comprehensive blood work). We did a bile acids test, it was normal. We did an ultrasound, it was normal. We put her on a month of antibiotics and liver supplement and her ALT was 95. We then took her off of everything and in two weeks, after she had a massive vomiting incident, I had her ALT tested again and it was 195. We got her tested again two weeks later and it was 160.
What could possibly be going on with her? Have we just been unlucky by testing her when she had an infection or does she have an actual liver problem? I don’t want to spend nearly $1000 more down a rabbit hole and get her liver biopsied – she is only a year old!
Any update on your pup. Mine is experiencing the same thing. She is having an ultra sound tomorrow.
It might be worth talking to your vet about other liver function tests – ALT and ALKP don’t actually test how well the liver is working, just how much enzyme they’re releasing into the bloodstream.
Both my little yorkiepoos have liver problems…. What is a normal liver count for a dog a year and half old?
It depends what you mean by “liver count” – there are lots of different enzymes that can be used, and every reference laboratory uses a slightly different reference range, which may be breed-specific, plus different labs use different numbers. The numbers on their own aren’t that useful without knowing the reference ranges for that specific test!
If your dog has 56mg in glu and 196 in U/L what does that mean.
Hi! My dog was diagnosed just 3 weeks ago with Ehrlichiosis. She took up a Doxyclycline as well as Prednisonefor 2 weeks. And when we returned to our vet for her follow up check up and CBC. All results are normal. My dog’s doctor told us to just continue with vitamins at home and just message them if something abnormal happens to my dog. But I insist on getting blood chemistry test for my dog and we found out that her ALT is 583 U/L and ALP of 616 U/L and other than that, all are within normal range. She got an xray also but still no enlargement or anything abnormal. My dog’s doctor just prescribed a liver supplement for 2 weeks but still thinking of a possible things that may be the reason on why does this enzymes are so high while other tests are normal. Did you guys have any hint or thought about this? I am already asking for some doctors and still waiting akso for their answers. Hoping for your response as well, Thank you!
Hiya Sophie! There are lots of reasons for ALP and ALT to be elevated; sometimes (to put it simply) ‘because they’re working harder than usual’ eg because of something the pet ate, or because they’ve been on certain drugs etc. It is possible that your vet is trying to work out whether this was one of those cases, or whether there is something more serious going on. It therefore makes sense to look after the liver for a few days and then retest. In many cases, high ALT in it itself isn’t a problem and will simply come down again with time, but if it remains high then this may imply an ongoing insult to the liver or something else that needs investigating.
My 6 month old golden doodle puppy has an ALT of 642. What should I be feeding her while we sort this out?
ALT is usually (although not always) a marker of liver damage, but doesn’t really tell us much more about the cause, without further investigations. In general, if there is a suspicion of a liver disease, I would suggest a Hepatic diet, but that is a decision for the treating vet to make: I would advise having a chat with them about their recommendations! Several manufacturers make suitable diets that are designed to support liver function and minimise the metabolic workload, so definitely see what their recommendation is.
Can alt be treated at a young age? My poodle is 18 weeks. I got his embark and it says he has alt.
Hi Christy. that’s an interesting case. High ALT isn’t a disease; it’s a symptom. The question is now, why has the high ALT arisen / what has caused it and is it something that needs further investigation and treatment? – this is a question for your vet to answer.
ALT isn’t a disease condition – it’s a particular enzyme, made in the liver. The Embark test measures the statistical probability that his normal ALT (ALanine Transferase) enzyme level is towards the top, middle, or bottom of the normal range for dogs. This might allow your vet to more accurately measure his liver health at some time in the future, but it isn’t a disease and doesn’t need treating!
My year and a half old chihuahua came back with a high liver enzyme reading, ALT 263. She seems healthy in every way, and I was shocked by this finding. Why would such a young dog have this result? Should I be concerned?
hey i have a chocolate lab who just turned 5 and he was limping from playing outside so i brought him to the vet and they did some blood work on him to see what medication they can give to him for his soreness. With that his blood results came back with high liver enzymes which was shocking because he is acting very normal , eating his meals wanting to play fetch and walk and very alert ect.. but we did a catskan and they did not notice anything and a month went by and they took another blood sample and his liver enzymes went down a little from the supplements we been giving him but there still elevated enough for concern and so are some other enzymes slightly…. they mentioned something about testing again for his gentics to see if his copper intake is to extreme from a diet but if not that possibly a liver biopsy. Anyone have any other suggestions or similar cases? Thank you and god bless
There are lots and lots of possible causes of raised liver enzymes, but I would strongly advise you to follow your veterinarian’s advice as to the significance (if any). Among other causes, certain medications can raise the levels, so you might want to have a chat with your vet about any meds she’s on or has been on, in case they might be associated. If not, it might be appropriate to do some further workup e.g. bile acid stim tests (to check liver function), ultrasound scans (for structural abnormalities) and possible a repeat blood test to make sure it wasn’t a “blip”.
Fimel Minipincher, 2.90kg, 10 years old. Blood test shows Alt a d AST high level. Dog looks healthy, good mood, no problem with eatinģ
Q what can be wrong with her liver?
Lots of possibilities. ALT measures hepatocellular damage, primarily, although it can be triggered by other conditions. The next step is usually further tests to look at liver function, rather than just cell leakage. Good luck!