Finding out your senior dog’s blood work showed a high ALP can be confusing and concerning. Thankfully, integrative veterinarian Dr. Julie Buzby is here to help you make sense of high ALP in dogs. She explains what it is, why it can sometimes be elevated, and what the next steps might be.
Sampson, a 12-year-old Jack Russell Terrier mix with a zest for chewing sticks and chasing squirrels, was in to visit me recently. During a particularly vigorous stick chewing session he had cracked a tooth. As a result, he needed a dental procedure under anesthesia to remove the damaged tooth and clean the rest of his teeth.
I always recommend some basic bloodwork prior to any of my older doggy patients going under general anesthesia. Pre-anesthetic lab work helps ensure a dog isn’t at an increased risk for complications with anesthesia or the specific procedure. It also has the added benefit of occasionally picking up on medical issues before they become a bigger problem. That was how we found that Sampson’s ALP, while normal on his last yearly bloodwork, was now moderately high.
Sampson’s dog mom, Sarah, was the proactive type and had many questions about ALP. I answered her questions in detail before we formulated a plan.
What is ALP in dogs?
The abbreviation “ALP” stands for alkaline phosphatase, which is an enzyme many routine blood panels may measure. Primarily, the liver produces ALP, though there are other sources too. We will come back to this later in the article because it is important.
Within the liver, ALP is found along the outer layer of the liver cells. Even more specifically, it is associated with the liver cells that line the bile ducts. Alkaline Phosphatase’s normal job in the body is complicated, and actually isn’t critical to understand here. But what is important to understand about ALP is that it is a sensitive indicator of liver or gallbladder dysfunction.
A brief physiology lesson
The liver is an amazing organ that has, by many estimates, over 500 critical jobs in the body. To name a few, the liver is responsible for:
- Removing toxins from the bloodstream
- Regulating blood sugar (along with the pancreas)
- Taking old red blood cells out of circulation
- Releasing clotting factors
The liver is also responsible for making bile, which flows through ducts in the liver to the gallbladder. Bile is then released from the gallbladder into the GI tract where it helps with digestion.
With all these important functions, it would only make sense that keeping tabs on your dog’s liver is an important part of keeping him or her healthy. This is where ALP liver enzymes (among other liver enzymes) comes in.
How would the vet detect high ALP levels in dogs?
When your veterinarian performs general wellness blood work on your dog, either as part of a yearly exam or as part of a pre-anesthetic check-up, chances are the blood work will include a chemistry panel. This test measures protein and electrolyte levels. It also includes values that can offer clues about the function of the liver, kidneys, and pancreas.
For a chemistry panel, the vet or vet nurse will draw a small amount of blood from your dog and place in a test tube. Then, your veterinarian may sometimes perform the blood tests with an in-house laboratory machine. Alternatively, he or she can send your dog’s blood to an outside veterinary diagnostic lab. If your veterinarian runs these tests in-house, your results may be ready the same day. But if your vet sends the blood out, it can take several days for the final results to be available.
Liver values
The markers related to the liver on a chemistry panel include ALP, ALT, GGT, and total bilirubin. The liver also makes glucose, cholesterol, albumin, and BUN. These levels can give clues to how well the liver is functioning.
ALT, or alanine transferase, is what is known as a “hepatocellular” liver enzyme. When the cells of the liver are damaged, this enzyme leaks out into the blood. Elevated ALT is often more worrisome than high ALP to veterinarians since it indicates ongoing damage to the liver cells.
ALP and GGT are what are known as “cholestatic” enzymes. This means that elevations predominantly occur if there are issues with the flow of bile, either within the liver, or as it leaves the gallbladder.
Forms of ALP
Earlier we touched on the fact that the liver makes alkaline phosphatase (ALP), but other places in the body make it too. The three most important forms are ALP from the liver (L-ALP), ALP made in the bone (B-ALP), and ALP that is released in response to excess levels of corticosteroids (C-ALP). A chemistry panel measures all three of these forms together as ALP. Therefore, based on the chemistry panel alone, it is not possible to determine which form is contributing most to an elevated ALP.
Liver ALP
As the name implies, L-ALP elevations are often related to issues with the liver. This is the focus of much of the rest of the article.
Bone ALP
Increased ALP activity is common in young dogs who are growing rapidly because normal bone growth releases B-ALP. Generally, these dogs are less than a year old. In a young dog, a mild elevation in ALP is not a worrisome finding if the remainder of the liver values are normal and the dog is otherwise feeling well. However, conditions that cause ongoing damage to the bones, such as bone cancer (i.e. osteosarcoma) or infections within the bone (i.e. osteomyelitis), can also cause elevations in B-ALP levels.
Corticosteroid ALP
The liver produces corticosteroid-induced ALP in response to elevated blood steroid levels. These high C-ALP levels can either be due to the body producing increased amounts of steroids, as with Cushing’s Disease in dogs, or they can be from oral or topical steroid-containing medications.
What causes high ALP in dogs?
Many times, a vet will find high ALP in senior dogs. In fact, it is one of the most common lab work abnormalities in older dogs. An elevated ALP is very sensitive in its ability to assess for hepatobiliary disease (i.e. diseases affecting the liver, gallbladder, or bile ducts) in dogs and cats.
This means that most dogs with significant liver disease will have an elevated ALP. That sounds like great news, right? If that’s the case, an ALP blood test should be the perfect way to help decide if your dog has liver disease.
Unfortunately, it is not quite that simple. While a high alkaline phosphatase level is very sensitive, it is not also a non-specific finding. This means that lots of other conditions aside from liver disease can cause an elevation in ALP. The list of conditions that can cause an elevated ALP includes:
Liver or gallbladder conditions
Any disease that causes a back-up of the flow of bile (i.e. cholestasis) will cause increased serum ALP levels in dogs. Cholestasis can be due to primary liver disease in dogs. Structural problems that block the flow of bile out of the liver, into the gallbladder, or from the gallbladder into the intestinal tract, can also cause a high ALP in dogs. Finally, secondary liver diseases (i.e. other conditions that cause ongoing damage to the liver) also will cause an elevated ALP level.
Primary liver diseases include:
- Infectious hepatitis due to ascending bacterial infections, Leptospirosis (lepto in dogs), etc.
- Chronic active hepatitis
- Copper storage disease
- Benign nodular hyperplasia
- Vacuolar hepatopathy in dogs
- Hepatocellular carcinoma (i.e. a type of liver cancer)
Gallbladder diseases include:
- Cholelithiasis (i.e. gallstones)
- Cholecystitis (i.e. gallbladder infection)
- Gallbladder mucocele in dogs
- Bile duct carcinoma (i.e. cancer of bile ducts)
Other medical conditions
Many medical conditions that are unrelated to the liver itself can also cause a high ALP. They range from non-worrisome to very concerning. Some of these include:
Endocrine diseases:
- Diabetes mellitus
- Hypothyroidism in dogs
- Cushing’s disease
- Hyperparathyroidism
Non-liver cancers:
- Lymphoma in dogs
- Pancreatic carcinoma
- Osteosarcoma (i.e. bone cancer)
Other diseases:
- Pancreatitis in dogs
- Gastroenteritis (I.e. inflammation of the stomach and intestines from various causes)
- Osteomyelitis (i.e. bone infection)
Toxins
Any toxins that cause substantial liver damage can also cause a high ALP in dogs. However, these elevations will not normally be as significant as the increases in ALT levels. Some toxins that cause liver damage are:
- Xylitol toxicity in dogs
- Cycad palms (i.e. sago palms)
- Zinc
- Aflatoxin
- Amanita mushrooms
- Blue Green algae toxicity in dogs
Breed-related elevations
Certain dog breeds can have increased ALP levels without it being a problem. The most common breed-related cause of increased ALP is Benign Familial Hyperphosphatasemia in Siberian Huskies. Scottish Terriers can also have a similar condition.
Medications
Some medications also are connected with elevated ALP in dogs. Two of the most common are:
Phenobarbital
This is a common medication vets use to treat dog seizures that can benignly increase L-ALP levels. However, phenobarbital can also occasionally cause damage to the liver. This means that if a dog taking phenobarbital has a high ALP, it can be hard to determine if the ALP elevation is no big deal, or if it might indicate a bad reaction to this medication.
If you find your dear dog in this situation, your veterinarian will likely start by evaluating how your dog is feeling. He or she will also look at the levels of the other liver values on the chemistry panel. In cases where the ALP elevation is severe, your dog is feeling poorly, or your dog has other liver enzyme elevations, then your veterinarian may recommend additional liver function testing.
In some cases, dogs will need to stop phenobarbital due to concerns about liver damage. The good news is that in most dogs, the liver values quickly go back to normal when the vet weans them off phenobarbital and onto one of the other medications available to help control seizures.
Steroids
Oral steroids, like prednisone for dogs, commonly cause moderate to severe elevations in ALP. Higher doses of steroids, such as those used for immunosuppression in cases of IMHA in dogs or other immune-mediated conditions, tend to cause higher ALP elevations.
Luckily, the increase in ALP from steroids does not generally correlate with long-term liver damage or liver dysfunction. However, it is important to know that once the dog stops taking steroids, it can take much longer—up to several months—for the ALP levels to normalize.
If your dog has an elevated ALP level, ensure you tell your veterinarian about all the medications your dog is taking or has recently taken. Some eye and ear medications and skin sprays or ointments contain steroids. Even these topical steroids can lead to ALP elevations during or after treatment.
Is a higher ALP automatically worse for dogs?
You may be wondering if you can use the degree of ALP elevation to tell you how bad the underlying problem might be. It would be easy to think that if a dog has a very severely elevated ALP, her or she might have a worse prognosis. Happily, this is not always the case.
Some benign and completely reversible issues, like taking high doses of steroids, can cause very severe elevations in ALP. However, if there is not an obvious reason for the high ALP (like taking a course of steroids), then your veterinarian may use the degree of elevation to help decide how aggressive to be with additional diagnostic testing.
What are the next steps for a dog with a high ALP?
If your dog has a high ALP, your veterinarian will start with a detailed medical history and thorough physical examination. In many cases, clues from the exam and history can help point your veterinarian to the next best diagnostic test to perform.
Every case is different, but the most common and least invasive next step is often to perform full lab work. This typically includes a CBC (i.e. complete blood count), full chemistry panel (if the ALP elevation was found on a “short” panel), T4 level, and urinalysis. If the remainder of your dog’s lab work is normal, he or she is otherwise feeling well, and the physical exam reveals no major concerning changes, then your veterinarian may elect for the “watchful waiting” approach.
With this approach, your veterinarian would hold off on performing any additional diagnostic testing right now. He or she will repeat lab work periodically to monitor trends in the ALP and other liver values. If the ALP improves or remains mildly elevated, then together you may elect for continued “watchful waiting.” If the ALP elevation gets worse, repeat bloodwork shows other abnormalities, or your dog develops any new medical symptoms, then your veterinarian will likely recommend additional diagnostic testing.
Liver function testing
One additional non-invasive lab test that your veterinarian might recommend is a liver function test which measures bile acid levels. Bile acids are made in the liver, stored in the gallbladder, and released into the intestines to help digest fat after you, or your dog, eats a meal. If the liver is working well, these bile acids are pulled back out of the bloodstream to be recycled and used again. However, if the liver is not functioning well, it is unable to remove the bile acids from the bloodstream and the bile acid levels will be high.
Your veterinarian can measure bile acid levels by taking two blood samples and sending them to an outside veterinary diagnostic lab. Your dog must have fasted for 12 hours prior to the first blood draw. Then your veterinarian will feed your dog a small snack, which should cause the gallbladder to release bile acids. Next, the vet will take another blood sample two hours later to see if the liver was able to remove the released bile acids from the bloodstream.
Elevated bile acid levels tell your veterinarian that your dog has a significant problem with his or her liver. But it does not provide any information about the underlying cause of the liver problem. If your dog has elevated bile acid levels, your veterinarian will likely recommend additional testing or referral to an internal medicine specialist.
Imaging
Your veterinarian may also recommend some liver imaging. In general, X-rays and ultrasound are the two most common types of imaging offered in veterinary medicine. While X-rays are a useful tool for many issues, they have limited ability to evaluate the liver.
An abdominal ultrasound is much more useful in this regard. An ultrasound can evaluate for masses or nodules in the liver and can also assess the gallbladder for signs of infection, gallstones, or a mucocele. Plus, ultrasound can help determine if there might be other medical conditions like pancreatitis or Cushing’s disease that are causing a high ALP.
Liver sampling
One limitation to ultrasound is that while it can determine if the liver looks abnormal, it cannot definitively pinpoint the underlying cause of masses, nodules, or other abnormalities. Some nodules are benign changes, while others represent cancer. There may be clues on ultrasound that a mass or nodule is benign or malignant. But to know for sure the vet must take a sample of the liver. The two ways to sample the liver are fine needle aspiration or biopsy.
Fine needle aspirate
If your veterinarian finds nodules, masses, or other liver abnormalities, he or she may recommend a fine needle aspirate as the next diagnostic step. To perform an aspirate, your veterinarian will use an ultrasound probe to guide a small needle into the area of concern in the liver. Once the vet gathers the cells in the hub of the needle, he or she will squirt them onto a glass microscope slide. Then your vet will submit the slide to a veterinary pathologist for review.
In veterinary medicine we often start with fine needle aspirates over biopsies. This is because this testing is less expensive, less invasive, and the vet can do it while your dog is awake or with just mild sedation. The drawback of aspirates is that they do not always yield a diagnosis. If results are inconclusive, the vet may still recommend a liver biopsy.
Liver biopsy
A liver biopsy is the most definitive way to determine the underlying cause of liver enzyme elevations. However, it is more invasive than many of the other tests. To perform a liver biopsy, the vet will remove a small piece of the liver and submit it to a veterinary pathologist. Your vet may obtain the sample through an open abdominal surgery or laparoscopic surgery. Alternatively, your vet may use a large needle tool (i.e. the Tru-cut biopsy technique) which is significantly bigger than the needle for a fine needle aspirate.
Unlike a fine needle aspirate, which your vet can do on an awake dog, the vet will always perform the biopsy under general anesthesia. Although it may raise the question in some dog parents’ minds of “Is my dog too old for anesthesia,” a biopsy can be a very useful tool. It allows the vet to submit an actual chunk of liver tissue for evaluation. This can give a clearer idea of what is going on in the liver than a fine needle aspirate can.
Since biopsies are a more aggressive test, they may not be warranted in cases of mild or even moderate ALP elevations where the dog isn’t symptomatic and/or doesn’t have elevations in other liver enzymes. However, every dog and every case is unique. Your veterinarian will take your furry family member’s medical history, exam findings, and full lab work results into account when making his or her recommendations.
Back to my patient, Sampson
I am sure at this point you are wondering what happened to Sampson. We did perform full lab work, which aside from the ALP elevation, was beautifully normal. Apart from his sore tooth, Sampson was his normal squirrel-chasing self. He was energetic and had a great appetite.
We knew that his tooth was uncomfortable. Together his mom, Sarah, and I decided it was best to go ahead with his dental procedure. I am happy to report that the procedure went great. Sampson recovered uneventfully and is back to enjoying his crunchy dog biscuits and even the occasional stick (although sticks are not on my list of safe chew toys for dogs).
We rechecked lab work a month after his procedure and the ALP elevation was still there. Since Sarah is the proactive type, we decided to schedule an ultrasound for Sampson. The radiologist reported changes in the appearance of his liver that looked consistent with benign nodular hyperplasia, which was good news
I let Sarah know that benign nodular hyperplasia is very common condition in many senior dogs. It causes benign nodules to form in the liver and a mild to moderate ALP elevation without an elevation in the ALT. Changes on ultrasound can make the radiologist suspect this condition. But ultimately it would take a liver biopsy to rule out more nefarious causes of nodules.
After weighing the pros and cons, Sarah decided to continue monitoring for now. Sampson will come back in a month to monitor his ALP value. And then in a few more months he will have another ultrasound. I have a hunch that this is just going to be a blip on the radar for good old Sampson, and that the local squirrels won’t be able to rest anytime soon.
Talk to your vet
If like Sampson, your dog’s blood work showed a high ALP level, the best thing you can do is have an in-depth conversation with your veterinarian. Sometime being presented with all the different diagnostic options can feel a bit overwhelming. But at the end of the day, you and your trusted vet should be able to work together to create a plan for your dog—be it a “watchful waiting” approach or further diagnostics—that you feel confident about.
Hopefully, the elevated ALP will turn out to be nothing significant for your senior dog. But even if it does indicate a more serious problem, remember that your dog has a great ally in you and your veterinarian. Together, you can tackle whatever the future brings and keep making memories in the process.
Has the vet ever found a high ALP level in your senior dog’s blood work?
Please comment below to share your dog’s story.
Dexter, my 12 yo soft coated wheaten terrier recently had some elevated, and rising ALKP levels over the past year. After a level of 571 vet recommended milk thistle, and he had a recheck and remained elevated (slightly more so into the 600 level for ALKP). The ALT levels have remained steady at 188. I have decided to proceed with an ultrasound next week. 1) should I be worried regarding the procedure since there is sedation involved? 2) is this a moderate or extreme elevation? 3) are there any other tests I should be asking to have done? Dexter is eating and drinking normally, and his allergies as a matter of fact have been the most under control they have been in YEARS, but the rising liver levels worry me! I hope all goes well with my guy – are there any other things I should be doing or questions I should ask the doc?
Thanks!
Hi Corey,
I understand your concern with these elevated liver enzymes in your senior pup. Dexter is lucky to have you advocating for his health and wellbeing. I would not be worried about the sedation for the ultrasound. This is generally very light sedation and can usually be reversed if needed. It is hard to say if these elevations are considered moderate or severe. I have definitely seen much higher numbers than what Dexter’s labs are currently showing. There are many more tests that can be done to evaluate the liver and rule out potential causes, but I too would recommend starting with the ultrasound. Wait to see what the ultrasound results reveal, and then further testing can be better tailored to your dog’s specific needs. Also, you always have the option to schedule a consult with a veterinary internal medicine specialist. I hope you receive positive results from the ultrasound and can figure out the best way to help Dexter with his liver issues. Wishing you both the best. Feel free to leave an update if you have a chance!
My female 14yo Mini Schnauzer’s bloodwork showed ALT 824 (251 in early June), ALP 1680 (62 in early June), GGT 23 (normal in June). She’s been drinking a lot, peeing more, loves to eat, and going on sniffaris. She’s her usual self.
Vet sent referral for ultrasound.
Please, how would you explain these elevations, and how would you proceed?
Thank you!
Hi Andrea,
You are right to be concerned about your Schnauzer and these recent changes to her bloodwork. Since I haven’t examined her myself, it is difficult to make specific conclusions and recommendations. I think your vet is on the right track and an abdominal ultrasound would be the best next step in making a diagnosis. There are many diseases and issues that can cause an elevation in liver enzymes. I think the ultrasound results will help to narrow things down and then other lab work or diagnostics can be recommended based on the new information obtained. Best wishes and feel free to leave an update if you have a chance.
A couple of things…..
I have a 13yr old female poodle Shitsu mix. ALP 677 with a normal range of 5-160. My vet prescribed her Danamarin for 30 days and a retest. Good call?
Also, is there prevention either by diet or exercise or do some dogs just get it and others don’t?
Thx
Hi Mike,
Yes, Denamarin is great! Sometimes we will try a supplement to see if it can correct the issue before moving on to more advanced and costly testing. Please know that the testing can be pursued at any point. So, if you are concerned about the effectiveness of the Denamarin or just want to have more answers, your vet can move on to the next step if needed. If the supplement does not help to reduce the ALP, they will probably recommend additional blood tests and possibly an abdominal ultrasound. While there are some toxins and diseases that can affect the liver and cause an increase to the ALP, some dogs just get it, and we don’t know why. I assume genetics are to blame but we don’t know for sure. I hope the Denamarin will be the solution to your senior girl’s problem. Best wishes and good luck!
Hi I have an 8 yr old cockapoo. Just been to have a routine op to remove two small lumps. This was cancelled as routine bloods showed ALP 521 and ALT at 180. Urine showed blood. Liver scan on Thursday and antibiotics for ? UTI. Meg ate a full Easter egg about 6 weeks ago and had medically induced vomiting! She has no other symptoms at all. How worried should I be. I’m a sensible dog mum but she is my world!
Hi Jen,
I understand your concern about Meg and these new abnormalities that have developed on her lab work. I would not be overly worried about the UTI at this point. As long as the bacteria that is causing the problem is sensitive to the antibiotic that was prescribed, it should clear up within a few weeks. As for the elevated liver values, it could be cause for concern, but you won’t know for sure until the testing is completed. It could be something simple that can be resolved with a special diet and a supplement. I am praying that the ultrasound on Thursday reveals positive results and a treatment plan can be started. Feel free to leave an update if you have a chance. Wishing you and Meg the best.
Rocky, my 5yr old pure bred Beagle has a high ALP on his blood work. He has severe allergies so he is on apoquel a d 2 benadryl daily and on Ultamino science diet for almost 2 yrs now. He was throwing up one nigtht and anorexic for almost 2 days so I decided to let him to the vet, his Vet assessed him and his blood got tested. All his other liver enzymes are normal, only the ALP is above 600. Doc prescribed Denamarin 2 tablets daily. How will Denamarin help? Will that reverse his high ALP? How long should he be taking denamarin? Could the apoquel be causing his high ALP count? How about his ultamino?
My dog is also overweight, is that something that can elevate his ALP?
His Vet is great and has known my Rocky for a long time.
Thank you!
Hi MG Rob,
I understand your concern for Rocky and this recently elevated ALP. I am glad you were able to have him evaluated by your vet and get some answers. I really like Denamarin and have seen great results in my own patients. Denamarin is a liver protectant and helps with liver health and repair. At some point, I am sure your vet will recheck Rocky’s lab work. If the ALP has returned to normal, your vet may allow you to discontinue the supplement. Apoquel is supposed to be safer for the liver than other anti-inflammatories, so I would not think this was the cause of the elevated ALP. Diet and weight also should not cause an increase to liver enzymes. You may never know for sure what caused this liver insult. If the supplement does not show the improvement your vet is hoping to see, they may recommend additional lab work or even an abdominal ultrasound to look at the liver. I hope you see positive results at Rocky’s next recheck. Best wishes to you both.
My 9 year old Maltese had senior panels done and almost all levels were normal with the exception of the ALP and cholesterol. The ALP was well over 6,000. They are going to do a 12 hour fasting test in 3 weeks. He has year round allergies, is overweight at 18 pounds, and is on 5.4 apoquel and cytopoint shots every 3 weeks. He always been a huge water drinker. He tends to pant heavily quite frequently. Any thoughts on the 6,000 ALP? I can’t find any other reference of such an extremely high level. I would like to know what food or supplement could help his liver function. I feed him only grain-free foods, both dry and wet food. Thank you!
Hi Cathy,
I know how concerned you must be about this elevated liver enzyme on your senior boy’s blood work. Try not to get too worried at this point as it could turn out to be nothing at all. I have definitely seen levels this high (and higher) resolve with little to no intervention. I am glad your vet has a plan in place for follow up testing. I am curious to know what the results will be. There are several good supplements available that help with liver function such as Denamarin. Your vet probably has one they like and recommend and would be willing to prescribe. I would love an update once the testing is completed if you get a chance to write back. Praying your sweet boy continues to feel good and gets positive results.
I have a 14 year old dog with a ALP of 800 in May and in October jumped to 1000. All over blood tests came back normal. Some weakness in legs. Has been thirsty and can’t hold urinating more than two hours. His spleen was removed 5 years ago, spotty and enlarged. The Vet says I could do more testing why the ALP levels are high, such as an ultrasound and biopsies. I am not convinced that will find anything. Suggestions for over the county remedies and thoughts of diagnosis? Thank you!
Hi Finn,
I understand your concern for your senior dog with these increasing liver enzymes. Unfortunately, without further testing there is no way to know what the cause could be, and it is hard to make specific conclusions. I do like to start my patients on a liver supplement that helps protect the liver from further damage and can help restore function. Denamarin is my favorite, but you can also just use Milk Thistle. I encourage you to discuss this with your vet and they can help you figure out the appropriate dose. Here is an article with more information that may offer additional guidance and advice: High Liver Enzymes in Dogs: A Vet Explains What It Means
Hoping your sweet boy has many happy days ahead and I wish you both nothing but the best!
Hi,
My 14-month old 43 pound mini bernedoodle has had significantly elevated ALP levels for the past 6 months. His most recent test it was around 2700 and had slightly elevated white blood cells. He has been fully grown for a few months now.
He is clinically healthy and not showing any signs of not feeling good. We put him on a liver supplement for 30 days and the ALP level was higher than his previous test. We have also done an ultrasound which did not show anything.
We are going to do a blood test that they should should help isolate why the level is elevated….liver, bone or muscle.
Has anyone experienced such high levels or these types of numbers in such a young dog?
Hi Nathan,
I am sorry you are dealing with such difficult issues in your young pup. It sounds like you have a good partnership with your vet and a plan for further testing. Unfortunately, this may be a long road ahead before you get a diagnosis. Don’t forget you always have the option to consult with a veterinary internal medicine specialist. They may be able to offer additional information or pursue more advanced imaging/testing that might not be available in general practice. I hope you can find the answers you are looking for. Praying your sweet boy can turn this around and live a long happy life. ♥
My 12 year old 7kg dachshund Chihuahua mix Sophie just measured 2577 for her APL (her vet told me 131 was normal). Her ALT was 150 so a bit above normal. She needs dental work done including cleaning and this was caught on the pre anesthesia blood work. She has degenerative heart valve syndrome, a grade 3 heart murmur and has been on vetmedin 1.25mg for the last 6 months for that. She has a history of interverbial disc disease and had surgery 2015 to correct paralysis from that. The high APL came out of nowhere. 6 months ago when I found out about her heart condition I changed her food to a mix of hills prescription diet kidney care wet food and hills prescription diet digestive care dry food. She’s going to have an ultrasound in a month to see if there’s a tumour or something. Everything else with her is good, I did add in the greenies tooth brush chews to help with her teeth a month or so ago and she is not good with changes to her diet so had some diarrhoea issues but had the fortaflovia (spelling may be wrong here but the powder on her food). I’m panicking a lot since we don’t know the worst/best case scenario but this 2577 with 131 as a normal range seems really bad 🙁
Hi Courtney,
I understand your concern for your senior girl with these high liver values. Fortunately, it sounds like your vet is staying on top of things and has a plan to follow up with ultrasound. Dental disease by itself can cause increased liver values which may return to normal after a thorough dental cleaning has been performed. Yes, your girl’s ALP is quite high, but I have seen them even higher and still return to normal after making a diagnosis and starting the appropriate treatment. So, I do think you need to keep running tests and looking for answers but don’t forget to stay positive and hold onto hope for a good outcome. Wishing you and your pup the best.
My 6 year old male schipperke just got bloodwork done and they found slightly elevated ALP levels, but nothing else seems to be wrong. He is on a liver supplement now and we will retest in a month. In the meantime we are just really hoping it turns out to be nothing. Very worried about our not-so-senior boy. He’s always been so healthy. Not sure where we went wrong.
Hi Kelly,
It doesn’t sound like you have done anything wrong. In fact, I applaud you for having routine wellness lab work done! This allowed your vet to catch this early and intervene on your little guy’s behalf. It is quite possible that everything could be normal on his recheck labs and this was all just a “fluke”. I hope the liver supplement does its job and all the worry will be over soon. Best wishes to you all.
I have a Mini Schnauzer 16 lbs who will be 12 next month. She had bladder surgery at 1 and has been on Hills CD since. Last September (after eating approved treats from a new vet at our same office) she started a new stone and was quite ill. At that time xrays were done as well as extensive blood work and medications. She recovered. Although her liver ALP was elevated. In November she had another blood test and it was up to 431 and she started taking Hipaticlear. Yesterday she had blood work in prep for a dental on 2/14 and again her ALP was elevated to 617. The vet (the young one who suggested the treats is no longer there) said she is good for the dental and we will do another blood test 30 days after. She suspects her teeth may be causing the increase although she did have a cleaning last year as well. My question is the number (I did find ant info on the actual numbers) and whether she is in any danger.
Hi Kathie,
I am glad to hear your girl recovered from her most recent bladder stone episode. I am amazed that she hasn’t had any other issues with them in the past 11 years! Your vet is correct that dental disease can cause ALP to be elevated. Many times, the ALP will return to normal or decrease after the dental procedure is completed if the dental disease is the underlying cause. Since I haven’t examined your dog myself, I can’t make specific conclusions or recommendations. There are additional ways to check liver function such as more advanced blood testing and ultrasound. You won’t find specific information about ALP numbers and their correlation to what is happening in your dog’s body because a high ALP doesn’t point out a specific issue or disease process, but rather gives you a broader picture that something is off. And just because the ALP is high doesn’t tell you if the underlying cause is life threatening or rather benign. If you have any concerns about your girl’s risks with anesthesia, make sure to discuss them with your vet. I hope you can find the answers you are looking for to help make a decision you are comfortable with. I wish you and your sweet girl the best.
My senior dog (16 year old cockapoo) has an increased ALP from October (2300) to January (7000). Her ALT was slightly elevated.
My dog is having trouble with her back legs, having accidents in the house (both) and just starting to look like she is failing.
Dr. would like to do ultrasound, however, whatever is found, we would not seek treatment, so we are taking the wait approach.
Dr. gave us a number of things it could be but just wanted to know if you have any insight as to whether this increased level mean she is dying.
Thank you.
Hi Diane,
I am sorry your senior girl is starting to struggle with her back legs and having accidents in the house. I understand how frustrating it can be to see your dog decline and not know how to help. As for your question about the high ALP and the possibility of it being fatal, I think this is exactly why your veterinarian was recommending additional testing. Without getting a definitive diagnosis there is really no way to know what the prognosis is or what the future may hold. There are many reasons for ALP to become elevated, some are pretty benign issues while others could be life threatening. If you need more information or want to better understand what is happening with your girl, I highly recommend you talk with your vet and consider going forward with the ultrasound. Best wishes to you and yours.
My dog 11 year female had a slightly high ALP – 248 in Nov 24 and started Livox Liver Supplement
2nd Jan she suddenly started vomiting and CBC was normal but ALP – 237, ALT – 62. Vomiting was stabilized by 4th Jan
4th Jan – ALP – 676, was even higher. Started Livox Liver Supplément and N-Acetyle L-Cysteine Tablet and low fat diet
7th Jan – ALP – 817 gone up even higher, Continue – Livox Liver Supplément, N-Acetyle L-Cysteine Tablet. Started – Ursodeoxycholic Acid Tablets 300 mg and Augmentin 375 mg
7th Jan – 1st Ultrasound – showed mixed echogenic irregular growth on lift cranial liver lobe. Dia 2 cm and hyperechoic ring target sign. However no facilities to do any further investigation.
12th Jan ALP – 499, ALT 83 – Stopped Augmentin but continued the other three medicines
25th Jan ALP – 1967 – Started Augmentin again
27th Jan ALP – 1793, ALT – 275, CBC – normal
29th Jan ALP – 1278
01 Feb ALP – 1054
05 Feb ALP – 887 – Stopped Augmentin as no infection and continue other medicines
7th Feb – 2nd Ultrasound. Exactly same as the Ultrasound on 7th Jan. No increase or decrease
23 Feb ALP – 1215 – gone up again, ALT – 232, Urine analysis normal
The doctor is puzzled as CBC is always clear. However, it seems she only responds to Augmentin Antibiotic but there is no infection shown on the CBC
She eats normally and normal appetite
She has lost weight in the last 4 weeks, probably due to strict bland low fat diet.
Can you please advice why the ALP could be responding to antibiotics when there is no infection or any other things we should look at
Hi Kushan,
I am sorry your senior girl is having these ongoing issues with her ALP. Unfortunately, without playing a personal role in her medical care it is hard to offer specific conclusions or recommendations on how to proceed. Since you still have more questions than answers despite all the testing and treatment you have tried, it may be time to ask for a referral to an internal medicine specialist. Hoping you can find the answers you need to ensure your girl has many happy days ahead. Feel free to keep us updated as things progress. Best of luck to you both!