High liver enzymes in dogs can have a multitude of causes, and the outlook may vary significantly. To help you sort through your dog’s liver enzyme elevations, integrative veterinarian Dr. Julie Buzby explains the four main liver enzymes (ALT, AST, ALP, and GGT) and discusses the causes, diagnosis, treatment, and prognosis for high liver enzymes in dogs.
I remember during my second year of veterinary school being a bit discombobulated by the alphabet soup that is the liver enzymes. ALP, ALT, AST, and GGT…Oh My!
Luckily, with 25+ years of experience under my stethoscope, I can now look at chemistry panel results and not bat an eye. It has become almost second nature to interpret high liver values and counsel my worried clients on what we should do next.
I know, though, that even most knowledgeable dog parents can feel overwhelmed if their veterinarian discovers their beloved canine companion’s liver enzymes are high. That’s why I wanted to share some of my expertise and insight with you.
Hopefully, this information will help you confidently advocate for your pup as you work closely with your family veterinarian to navigate the slightly murky waters of elevated liver enzymes in dogs.
- What are high liver enzymes in dogs?
- What does the liver do?
- What are the common liver enzymes in dogs?
- How do vets interpret high liver enzymes?
- What causes high liver enzymes in dogs?
- How worried should you be about high liver enzymes?
- What diagnostics will my vet use if my dog has elevated liver enzymes?
- How do you treat elevated liver enzymes in dogs?
- Will my dog need long term care or monitoring?
- What is the prognosis for elevated liver enzymes in dogs?
- Work with your veterinarian
- What was the cause of your dog's high liver enzymes?
What are high liver enzymes in dogs?
First, let’s get some terminology down. When your vet says that your dog has “high liver enzymes,” this isn’t a specific diagnosis. Instead, elevated liver enzymes (i.e. an increase in ALT, AST, ALP and/or GGT on bloodwork) are merely a symptom that can point to quite a long list of diseases or conditions.
These conditions can be things directly affecting the liver. But they are just as likely to be diseases in other parts of the body altogether. And to add to the confusion, there are many factors to consider when determining if elevated liver values are no big deal, or if they might indicate a serious problem.
Think of it this way. While high liver values are not inherently “bad,” they are still something you and your vet should take seriously. Elevations in liver enzymes can sometimes serve as an early warning sign of liver problems or other health issues. And as with other conditions, the sooner your vet finds and addresses the problem, the better the outcome usually is.
We’ll get to the nitty gritty of the liver enzymes and what they might mean for your dog in a bit. First, a primer on the liver will be helpful.
What does the liver do?
The liver is one of the larger organs in the body. And it sits tucked up in your dog’s abdomen under the ribs, snuggled between the diaphragm and the gastrointestinal (GI) tract. The liver is a powerhouse organ that performs literally hundreds of tasks. So it is no wonder it needs to take up a fair bit of space in the abdomen.
Among other things, the liver:
- Filters toxins from the blood
- Processes the nutrients from the food your dog eats
- Stores leftover energy from food for later use
- Makes proteins needed for vital processes like blood clotting
The gallbladder
The liver also has a buddy—the gallbladder—which is a small, pear-shaped organ tucked into the liver. The gallbladder’s main job is to store bile, a fluid the liver produces to aid in digestion.
More specifically, bile is essential for digesting fats. When your pup eats a meal that contains fat, the gallbladder contracts. This squeezes a bit of bile through the common bile duct and into the small intestines. There, bile helps break the fat into smaller pieces that the GI tract can absorb. Then, as blood from the intestinal tract flows through the liver, the liver pulls out some of the bile components to reuse them again.
The gallbladder and all the bile ducts (i.e. pathways the bile follows through the liver tissue) make up the biliary system.
Liver enzymes
Additionally, the liver contains many enzymes. Enzymes are like tiny, special workers in your dog’s body. Imagine them as little helpers that do specific jobs to keep things running smoothly.
Since the liver has so many jobs to do, there are lots of different enzymes that work within the liver. These enzymes are typically detectable in the bloodstream at levels that fall into a “normal” range. But in some situations (e.g. liver injury or disease), liver enzymes leak out of the liver and into the bloodstream in higher amounts than normal.
A chemistry panel can pick up on these increased enzyme levels, alerting the vet to the fact that the dog has high liver enzymes.
What are the common liver enzymes in dogs?
Typically, when your vet says your dear dog has high liver enzymes, he or she is talking about alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP) and gamma-glutamyltransferase (GGT). These are the liver values that a common blood chemistry panel usually measures.
Sometimes a dog will just have an elevation in one liver enzyme. But in other cases, all the liver enzyme levels may be higher than they should be. Which liver values are elevated can give clues to the underlying cause, so it is worth understanding a bit about each enzyme.
Alanine aminotransferase (ALT)
ALT (alanine aminotransferase) is an enzyme that is found primarily inside liver cells (i.e. hepatocytes). However, muscles, the kidneys, and red blood cells also contain small amounts of ALT.
When the liver is healthy, ALT levels in your pup’s blood are low because most of the ALT stays inside the liver. However, if something is wrong with your dog’s liver, such as liver injury or inflammation, the liver cells can release ALT into the bloodstream. This makes ALT a sensitive marker of injury to liver cells, especially since, out of all the liver enzymes, it is the most specific indicator of a problem within the liver itself.
Since ALT is fairly liver-specific, there really aren’t many other issues besides liver damage that can cause elevations in ALT. Occasionally, severe muscle damage may cause ALT values to be high. But if this is the case, usually your veterinarian will see other obvious changes on the chemistry panel, such as a concurrent severe elevation in a muscle enzyme known as creatine kinase (CK).
Also, it’s worth knowing that the body clears ALT from the bloodstream quickly. This means if ALT is high, then the liver has suffered a recent injury or insult. This trait also makes ALT especially useful when monitoring a dog’s recovery after an acute liver injury because ALT levels decrease quickly once liver damage ceases.
Aspartate aminotransferase (AST)
AST (aspartate aminotransferase) is another enzyme that is found inside liver cells. It also occurs in moderate amounts in several other types of cells, like those within the heart and the muscles. AST generally increases in parallel with ALT. However, AST is less specific for liver injury than ALT because AST levels can also rise due to an insult to the heart, muscle, or from red blood cell destruction.
AST levels stay elevated in circulation for an even shorter time than ALT. This means AST levels will go down and (hopefully) normalize even faster than ALT levels in patients who have suffered a sudden and severe insult or injury to their liver that has now resolved.
Alkaline phosphatase (ALP)
ALP (alkaline phosphatase) is an enzyme found in liver cells too. But only certain liver cells—those that line the bile ducts within the liver—contain ALP.
While an elevated ALP in dogs often indicates a problem with the liver, gallbladder, or the flow of bile, it is not nearly as specific of an indicator of a problem in those organs as some of the other liver enzymes. Bone also produces ALP, so growing young dogs often have a mildly elevated ALP. Plus, ALP elevations also occur in patients with bone infections or bone cancer (i.e. osteosarcoma in dogs). And since high steroid levels can cause ALP levels to rise, dogs with Cushing’s disease in dogs and those receiving oral or topical steroids also commonly have increased ALP values.
This is just a snapshot. Many disease processes, both within the liver and in other parts of the body, can cause high ALP values. And mild to moderate ALP elevations can even be present with several age-related benign conditions.
So if your pup only has an elevated ALP, take a deep breath, check out my high ALP in dogs article, and know that the odds are in your favor that your furry family member will have a favorable prognosis.
Gamma-glutamyltransferase (GGT)
GGT (gamma-glutamyltransferase) is also present in the liver cells lining the ducts where bile flows. It specifically works within the outer lining, or cell membrane, of those cells. Just like ALP, elevations in GGT are a marker of a problem with the flow of bile. The issue usually occurs either as the bile flows through the liver or as it exits the gallbladder.
In dogs, GGT is more specific for disease within the gallbladder or liver than ALP. And its levels are less likely to be high from other non-liver or non-gallbladder-related problems.
How do vets interpret high liver enzymes?
Often a chemistry panel will measure all four of these liver enzymes (plus many other values too). Being able to look at the ALT, AST, ALP and GGT at the same time is helpful for the vet because there are several patterns of enzyme elevations that can provide clues about the source of the issue.
1. Hepatocellular pattern
A hepatocellular pattern happens when the main elevations are in ALT and AST. Since both of these enzymes live inside liver cells, concurrent elevations in ALT and AST levels suggest that something has damaged the liver cells themselves.
2. Cholestatic pattern
In a cholestatic pattern, enzymes like ALP and GGT are higher than the ALT and AST levels. This pattern tends to indicate that there is a problem with the bile ducts or the flow of bile from the liver to the small intestine. This bile flow “traffic jam,” which can be caused by conditions like gallstones or a blockage in the bile ducts, is also called cholestasis.
3. Mixed pattern
However, sometimes things are not so cut and dry. Dogs may have a mix of liver enzyme elevations, including both hepatocellular (ALT and AST) and cholestatic (ALP and GGT) enzymes. This can suggest a combination of liver cell damage and issues with bile flow.
What causes high liver enzymes in dogs?
There are some specific diseases and conditions that tend to cause each pattern of elevated liver enzymes. This makes the pattern method useful when searching for the reason for the increased liver values.
However, there is also a second, equally useful approach to organizing the causes of increased liver values in dogs. It involves separating them into problems that are directly related to the liver and/or gallbladder (i.e. hepatobiliary) or that are not a primary liver or gallbladder problem (i.e. extra-hepatic). With the extra-hepatic causes, the liver enzyme elevations are due to the secondary effects of a disease or illness in another organ system.
Using a combination of both approaches, let’s take a look at the various causes of high liver enzymes in dogs.
Causes of a hepatocellular pattern
As a review, in a hepatocellular pattern, the ALT and AST are more elevated than the ALP and GGT.
Hepatobiliary causes
Some common hepatobiliary causes (causes related to liver disease in dogs or gall bladder problems) of a hepatocellular pattern include:
- Chronic hepatitis
- Cholangiohepatitis (i.e. inflammation of the liver and biliary system)
- Copper hepatopathy
- Infectious causes
- Leptospirosis
- Infectious canine hepatitis
- Histoplasmosis
- Toxins
- Sago palm
- Blue green algae toxicity in dogs
- Amanita mushrooms
- Aflatoxins
- Xylitol toxicity in dogs
- Heavy metals
- Hepatotoxic Medications
- Ketoconazole
- Azathioprine
- Carprofen for dogs
- Acetaminophen
- Certain chemotherapy medications
- Congenital portosystemic shunts (i.e. abnormal blood vessel that connects the liver and systemic circulation)
- Microvascular dysplasia (i.e. congenital abnormality of the microscopic blood vessels in the liver)
- Liver cancer in dogs
- Systemic cancer
- Lymphoma in dogs
- Histiocytic sarcoma
- Mast cell tumors in dogs
- Any cancer that has metastasized to the liver
Extra-hepatic causes
Some common extra-hepatic causes of a hepatocellular pattern are:
- Pancreatitis in dogs
- Gastroenteritis
- Congestive heart failure
- Dental disease in dogs
- Inflammatory bowel disease (IBD in dogs)
- Anaphylaxis
- Sepsis
- Seizures in dogs
- Trauma
Causes of a cholestatic pattern
In a cholestatic pattern, remember that the GGT and ALP are more elevated than the ALT and AST.
Hepatobiliary causes
Some common hepatobiliary causes of cholestatic pattern include:
- Nodular hyperplasia (i.e. a benign condition that is common in older dogs)
- Vacuolar hepatopathy in dogs
- Cholangitis (i.e. inflammation of the bile ducts)
- Gallstones
- Gallbladder mucocele in dogs
- Liver or gallbladder cancer
Extra-hepatic causes
Common extra-hepatic causes of a cholestatic pattern are:
- Medications like steroids (i.e. prednisone for dogs) and certain anti-seizure drugs
- Pancreatitis
- Inflammatory bowel disease
- Diabetes mellitus in dogs
- Hypothyroidism in dogs
- Cushing’s disease in dogs
However, real life is often messier, and not every dog reads the textbook. So it is important to remember that these categories are not hard and fast, and that many dogs will have a mixed pattern of enzyme elevation.
How worried should you be about high liver enzymes?
When looking at this huge list of causes, it can be easy to start to worry or feel overwhelmed. However, while high liver enzymes in dogs shouldn’t be ignored, it will hopefully ease your mind to know that there are some causes, like benign nodular hyperplasia, that really are no big deal. And there are even more conditions that affect liver values, but once identified, are easy to treat with no long-term negative consequences.
Here’s are some factors to consider when you and your veterinarian are deciding how concerned you should be about elevated liver enzymes:
The magnitude and persistence of the elevations
If your dog’s liver enzymes remain consistently elevated over multiple vet visits, this is a cause for concern. And so is a “significant elevation” in the liver values. Generally, the consensus is that if the value is more than three times the high end of the reference range, this counts as a “significant elevation.”
In short, a single mild elevation may not be alarming. But ongoing or significant increases in liver enzyme levels should prompt further investigation.
Your dog’s symptoms (if any)
Often, the vet may find high liver values on routine bloodwork in dogs who are otherwise feeling fine. This is typically less concerning than if the dog is showing signs of illness.
As a point of interest, high liver enzymes themselves don’t even cause symptoms that you can observe directly. Instead, the symptoms you might notice are usually related to the underlying cause of the elevated liver enzymes.
High liver enzymes that are accompanied by the following clinical signs are concerning. And they may indicate a more serious health issue.
- Jaundice (i.e. yellowing of the eyes, gums, or skin)
- Vomiting
- Diarrhea
- Being a lethargic dog
- Loss of appetite
- Increased thirst in dogs
- Abdominal distention (i.e. a pot-bellied dog appearance)
It’s important to note that these symptoms are not specific to liver disease and can occur in various other health conditions. If you observe any of these symptoms in your dog, especially if they persist or worsen, it’s crucial to consult with a veterinarian.
Pre-existing conditions
Dogs with pre-existing health conditions like diabetes, Cushing’s disease, or inflammatory bowel disease may be at a higher risk of liver problems. Elevated liver enzymes in dogs with these or other underlying health conditions should be closely monitored and promptly addressed.
Changes in behavior
If liver disease progresses to liver failure, this can manifest as neurologic changes like confusion, disorientation, dull mentation, or even seizures. Therefore, you should always discuss any significant changes in your dog’s behavior with your veterinarian.
Age and breed
Your veterinarian will always consider the age and breed of your furry family member when deciding how concerned they are about elevated liver values. For example, puppies can have a mildly elevated ALP because they are growing. This isn’t a cause for concern.
Additionally, some dog breeds are more prone to certain liver conditions. For instance, Yorkies are the poster children for both portosystemic shunts and microvascular dysplasia. And Labradors are known to have both chronic hepatitis and copper hepatitis. Thus, if you have a breed with a known predisposition to liver issues, your veterinarian is likely to recommend being more proactive about working up any elevated liver values.
Follow your vet’s guidance
Your veterinarian will discuss these factors with you and make recommendations about how to proceed. Sometimes the answer might be to recheck the values in a few weeks or months. And in other situations, the vet may feel it is important to dig deeper to find the cause of the elevations right away.
What diagnostics will my vet use if my dog has elevated liver enzymes?
If your dog’s bloodwork shows high liver enzymes and the vet recommends investigating further, the good news is that despite the daunting list of different causes of liver enzyme elevation, the steps involved in the diagnostic work-up are relatively similar across the board.
Blood tests
If your vet has not already done so, he or she may recommend a chemistry panel, complete blood count (CBC), and urinalysis as the first step. The veterinarian will likely pay close attention to certain values on the chemistry panel, such as bilirubin levels, BUN, albumin, cholesterol, and glucose. All of these numbers can help assess liver function (which is not something the ALT, AST, ALP, and GGT levels can tell you about).
The vet may also recommend a bile acid test. This is another non-invasive laboratory test that checks for liver dysfunction. With this test, the vet draws a blood sample before and after the dog eats a small meal. The bile acid numbers before and after eating give the vet an idea of how well the liver is able to recycle and process bile. If the bile acids levels are high, this indicates the liver is not functioning optimally.
Additionally, if the vet suspects an infectious disease like leptospirosis, he or she may perform specific blood tests to check for antibodies or the presence of the infectious agent.
Finally, since liver disease can affect blood clotting, the vet may recommend performing a coagulation profile. This blood test can assess clotting times and ensure the liver is producing the necessary clotting factors. (However, a coagulation profile requires special tubes, handling, and a special machine, so it may only be available at certain veterinary hospitals.)
Imaging
Imaging of the liver is almost always helpful in cases of elevated liver values. An abdominal ultrasound tends to provide more diagnostic information than abdominal X-rays. Ultrasound has the advantage of being able to evaluate the size and shape of the liver and check for abnormalities like tumors, gallstones, or blockages in the bile ducts. Plus, ultrasound can reveal subtle changes that might suggest that other underlying conditions, like pancreatitis or Cushing’s disease, are at play.
Additionally, in some complex cases, for instance if the vet suspects a liver shunt, he or she may recommend a CT scan. This can be a good way to provide more detailed images of the liver, blood vessels, and surrounding structures.
Sampling the liver
Obtaining a sample of tissue from the liver can help the vet look for cancer or inflammation, or for the build-up of copper seen in dogs with copper hepatopathy. There are two possible sampling methods.
One is a fine needle aspirate (FNA), which involves using a small needle to pull some cells out of the liver under ultrasound guidance. The other is a liver biopsy, a procedure in which the vet obtains a small piece of liver tissue for evaluation.
Many veterinarians start with liver aspirates before considering liver biopsies. This is the case because the vet can often perform the FNA with only mild sedation, and it is generally considered to be a low risk procedure. FNAs are good at checking for certain cancers and are non-invasive. But they don’t provide a large enough sample to assess for inflammation or to check copper levels.
On the other hand, liver biopsies provide a larger sample of tissue and are often the best way to determine exactly what is going on in the liver. However, they are a more intensive diagnostic. A liver biopsy comes at a higher cost and has an increased risk of bleeding, as well as the need for general anesthesia.
Work with your veterinarian (and possibly a specialist)
The specific tests that your veterinarian recommends will depend on your dog’s history, physical exam, and lab work. Often the veterinarian can perform some of the preliminary testing in-house. But there may be times when your vet may refer your beloved canine companion to a veterinary specialist near you for additional testing, procedures, or follow-up.
How do you treat elevated liver enzymes in dogs?
After reaching a diagnosis, your vet will work with you to formulate a plan.
Remember that high liver enzymes are a symptom of some other problem—either within the liver or in another organ system. Thus, the treatments can vary widely depending on the suspected cause of the elevations and your dog’s situation. As discussed above, your veterinarian will take into account which values are elevated, the magnitude of the elevation, and the dog’s symptoms, age, and breed, when creating the plan.
In some cases, benign neglect and monitoring are enough. But in other cases (for example, where values are consistently and significantly elevated), finding and addressing the root cause is essential.
When it comes to treatments, some of the options that might be on the table include:
Special diet
In some cases, dietary changes can help support liver function. Your veterinarian may recommend a special prescription diet formulated to support liver health. These diets are designed to reduce the workload on the liver and provide necessary nutrients.
Medications
Medications for liver disease tend to fall into one of three categories—medications to treat the underlying cause of the disease, medications to support liver function, or medications targeted toward any unpleasant symptoms your dog is experiencing.
Some examples of the different medications in each category include:
Treating the underlying condition
- Antibiotics to treat bacterial infections
- Immunosuppressive medications to treat certain inflammatory or immune-mediated liver diseases
- Chemotherapy medications to treat cancers affecting the liver or gallbladder
Supporting the liver
- Antioxidant medications like Denamarin®, Milk Thistle, and SAM-E to help support liver function
- The medication ursodiol to improve the flow of bile
Managing symptoms
- Anti-nausea medications to treat nausea or vomiting
- Appetite stimulants for dogs to improve a poor appetite
- Pain medications for painful conditions like pancreatitis
- Fluids to improve hydration in dogs who are not eating and drinking or who are losing fluid from vomiting or having diarrhea
Management of the underlying condition
If the high liver enzymes are related to another health issue, such as diabetes, Cushing’s disease, or pancreatitis, treatments aimed at managing those underlying conditions are crucial.
Surgery
In certain situations, surgery may be necessary to address issues like liver tumors, portosystemic shunts, gallbladder mucoceles, or bile duct obstructions.
Will my dog need long term care or monitoring?
During the treatment period (and beyond), working closely with your veterinarian and following his or her recommendations is so important. Depending on the situation, this may mean giving medications or a special diet, potentially long-term. And your vet will probably instruct you to monitor your dog carefully at home and report any changes or concerns promptly.
Additionally, chances are good that your vet will want to recheck your dog periodically. This is an important way for him or her to track your dog’s liver enzymes and make changes to the plan as needed.
What is the prognosis for elevated liver enzymes in dogs?
When your veterinarian tells you that your dog has any blood work abnormality, it is normal to feel concerned. Elevated liver values don’t have to be scary, though. There are many treatable causes. And to add to the good news, the liver has some regenerative capacity. This means that even if your dog’s liver is severely damaged, there is a chance that, with appropriate treatment and time, your precious pup can regain some of the liver function he or she lost.
However, occasionally, despite prompt diagnosis and aggressive treatment, the underlying cause of a dog’s liver disease is severe enough to carry a grave prognosis.
Some of the factors that can affect prognosis include:
Underlying cause
The most crucial factor in determining the prognosis is the specific cause of the elevated liver enzymes. If the cause is something treatable, like a bacterial infection or a negative reaction to a medication, the prognosis may be very good with prompt treatment.
The degree of illness
If your dog has severe elevations in liver enzymes and is feeling extremely sick at the time of diagnosis, the prognosis may not be as favorable as in cases where the elevation is mild and caught when the dog is still asymptomatic. Plus, if there are other health issues or diseases present in addition to the high liver values, this can negatively impact the prognosis.
Work with your veterinarian
Now that you know the ABCs of high liver enzymes in dogs, you are equipped with the knowledge you need to advocate for your pup. Hopefully, you can breathe a little easier knowing that in many cases, with the right diagnosis and treatment, dogs with high liver enzymes can improve and lead long and healthy lives.
As discussed, your veterinarian will be your best source of information regarding your pup’s specific case and prognosis. He or she can work closely with you to develop a treatment plan and provide guidance on how you can best support your furry friend’s health. Together, you can help your dog keep living his or her best life, despite high liver enzymes.
What was the cause of your dog’s high liver enzymes?
Please comment below.
My dog has had consistent high ALT values. We have done ultrasounds, fine need aspirates etc. she has been on milk thistle, her er I’m trying to add Sam E. I got done denamarin but is that enough milk thistle AND Sam E? I’m honestly at a loss. I’ve read so many different things regarding dosages for liver disease. My girl is 60 pounds.
Hi Christine,
I am sorry your girl is having these ongoing issues with her liver. Unfortunately, without playing a personal role in her medical care I can’t give specific dosing advice for these supplements. I have had great success with Denamarin and it has a flavor that seems to be well liked by most of my patients. I hope you can find a way to get these liver problems under control. Wishing you and your sweet girl all the best and praying for many happy days ahead.
When I took our rescue (Staffy/Cattle dog mix adopted at 5 years old, so there’s a lot we don’t know about his hx) to the vet last year for his check up the vet said he had slightly elevated liver enzymes but nothing to worry about. We started him in Milk Thistle just in case. This year (he’s now 8.5 years old) at his check up we got these results. AST 181, ALT 1484, ALP 425. Everything else was normal. The vet said he was in surprised because of how well our dog was doing otherwise. We started him in Denamarin 2 weeks ago. He is now drinking more water and his urine volume has greatly increased. He had diarrhea this morning, but he has always had some intestinal issues whenever we change something in his diet. Otherwise he is still behaving normally. No other symptoms..
We are supposed to go to get him checked again at the end of the month.
1) Because of his increase in water intake/urine, and recent diarrhea (so far only once) should we make an appointment for sooner? 2) Could his Fluoxetine be the cause?
Hi Rose,
I understand your concern for your pup with these elevated liver enzymes. I wish I could offer some great insight but without playing a personal role in his medical care it is hard to make specific conclusions and recommendations. I like to err on the side of caution, so if you have any lingering concerns about how things are going, I would go ahead and contact your vet. How are things today? Hoping you were able to get the answers needed to ensure your boy was properly treated. Wishing you all the best and praying for a positive outcome.
Our beautiful 3 days following a liver issue, I didn’t really even understand how sick he was. Money stopped me from helping him survive his illness. I didn’t know something could hurt so much.
Dear Mark,
I am sorry for the loss of your beloved boy. Praying for healing for your heart and wishing you comfort and peace.
My 7 year old Lab’s ALP levels have increased steadily in the past three months. They were in the 700’s in May and the vet gave her anti inflammatory meds&antibiotics for two weeks. She responded well but her levels had increased within that time. Her bloodwork was sent out to check for leptospirosis and prescribed denosyl. Leptospirosis was ruled out. In June her levels had once again increased to over 800 and the vet recommended dropping the denosyl and trying a liver specific diet. As of yesterday, her levels have increased to 993. Our vet is supposed to be in touch for follow up on Monday. Was just wondering what steps you’d recommend that we take or what questions to ask at this point? Thx so much!
Hi Bev,
I understand your concern for your Lab with this increasing ALP. I am glad you aren’t facing a leptospirosis diagnosis as it is very contagious to humans. Without playing a personal role in your dog’s medical care, it is hard to make specific recommendations. The next steps may include an abdominal ultrasound or even a consultation with an internal medicine specialist. Hoping your vet was able to offer guidance and praying for clear answers. Best wishes to you and your sweet boy and feel free to keep us updated on how things are going!
Hello my I have a frenchie 6 years old she recently had a UTI and been giving antibiotics and anti inflammatory medications we just had her blood work and her enzymes liver are super high the vet recommended to go to an hospital to do further testing. I was googling too and it saying that the levels can be high because of the antibiotics and anti inflammatory she is taking. Do you recommend waiting after she is done with the medication and have her test her blood again or should I be concern now?
Thank you
Matt
Hi Matt,
I am sorry your Frenchie is facing this unknown issue with her liver. While it may be due to some of the medications she has been taking, I would hate to assume this and end up allowing her condition to worsen by waiting. If your vet thinks this needs to be investigated, it may be best to go ahead and schedule a consultation with the other hospital. Ultimately, you have to trust your intuition as you know your girl better than anyone. Hoping you can find the advice you need to make the best choice for your sweet girl. Wishing you both the best of luck!
Hey Julie, so I took her to another vet (the one she was treated for the UTI) I shared with her the blood test results after she saw the results with the elevated liver enzymes she prescribed her to be on Clavamox antibiotic ( after she is been on that for 8 days to treat her UTI) for another 4 weeks and also Denamarin supplement for liver support. And re test her blood again after she said if the level will still be high the next step is to do ultrasound for the liver and put her on steroids.
I guess now my questions is it normal for her to be on antibiotics for 4 weeks? Especially after she been on it for 8 days already
Meaning total of 5 weeks. In this point I want to trust the vet but I’m also concerned about my dog being on that antibiotics for so long :/ any advice
Hi Matt,
I am glad you had your girl evaluated by another vet and they were able to recommend a new course of treatment. It is normal to do long term antibiotics if there is any indication that a UTI may be difficult to clear or there is suspicion of an unknown source of infection. I really like Denamarin and think that was a good addition to your dog’s medications. Hoping the next recheck will show improvement and wishing you and your sweet girl all the best. Keep us updated on how things are going if you have a chance.
Hello,
Our dachshund has been found with elevated ALT values (approx 2200) when feeling lethargic. He was in hospital for 2 days and then released as he was stable. As he got out, we diagnosed another issue related to his legs (pretty much stopped working), so we took him back to the hospital and they then diagnosed a hernia in his back through a CT (which was risky because of the anaesthesia). After many back and forth, we decided to operate. The operation went really well and he covered well. Despite the anaesthesia, his liver value went down to 900.
A week later, he threw up some liquid 3 days in a row and we decided to take him back to the hospital. His ALT value got elevated again to 1800. I am completely at loss with trying to figure out what it is and same thing for the doctors with are working with.
The ultrasound drew the doctors more towards a suspicion of an acute toxic
hepatopathy. But now that it has been 2 weeks and the liver is not improving, I believe we are missing something. He was also tested for Addison’s disease but is negative for that too. The positive thing is that his liver seems to react well to IV fluids.
What can we test for in your opinion? What could be something rare that our doctors are missing?
Thank you so much for your help.
Dear Louisa,
I am sorry your Dachshund is having these recurring issues with his liver. I wish I could offer some insight but unfortunately, I am just as puzzled as you and your vet. If you haven’t thought about asking for a referral to an internal medicine specialist, this may be a good time to pursue something like that. Is your boy taking any liver supplements such as Denamarin or milk thistle? Has he been tested for tick borne diseases or leptospirosis? Hoping you can find the answers you need to ensure he gets the right treatment and medical care. Wishing you all the best of luck and praying for a positive outcome.
Thank you for this very educating post. We have a mini dachshund, she is only 2 and is experiencing high liver enzymes. We have been feeding her only farmer’s dog for the last few months. She also eats her own feces, we try to stop her but it’s hard when we aren’t home. Her ALT is 453 and her AST is 60. Her Potassium is 5.6 and Na : K Ratio is 27 so those were elevated as well. And then it says “Hematocrit” is 57.4. We are getting an ultrasound on Friday to do some further testing. I am trying to stay calm but I am very worried. She is very young so I don’t know why she is having these issues so I hope it is nothing too serious. We are being very proactive about this and will follow the vet’s orders, but any other advice/peace of mind is appreciated!
Dear Hallie,
My heart goes out to you as you face this unknown situation with your young pup. I am glad your vet is planning to pursue further testing and I think an ultrasound is a great next step towards getting a diagnosis. Hoping you get the answers you need to find a clear path forward. Wishing you all the best and praying for favorable results.
Hallie I had a very smart vet recommend feeding my dog some crushed pineapple to stop the eating of feces. This was many yrs ago I cant recall if it worked. Worth a try .I would first ask ur vet tho. As I recall it was a common thing, something about the dog was lacking certain enzymes that caused the behavior and the pineapple HAS those enzymes. As I very vaguely recall, the suggestion was about 1 Tablespoon for my 50ish lb dog. I would suggest perhaps trying a LEVEL 1/4 teaspoon or 1/2 teaspoon for a 10lishb dog. Similarly maybe LEVEL 1/2 teaspoon or 1 teaspoon for 20-30 lb dog, these are mere guesses tho so best to try the lower amounts and if ur pup is struggling w/liver stuff its really best to check w/ur vet, although they may not know the crushed pineapple thing. If ur vet doesnt know, since its just crushed pineapple & ur dog already eats human food, it may be worth the risk to try a tiny bit of pineapple. I think it was a daily dose thing as obviously once the pineapple leaves the system then ur pup would again be lacking the enzyme and be out of balance again w/the urge to eat the feces again. Also u may want to consider trying Just Food For Dogs, Im researching to switch from kibble and noticed they have a liver support formula they also offer custom options, you can find these both at top of their web page under SHOP – Specialty . I also like and am considering Bibim Paws ORGANIC that small biz owner seems very thorough with the material/info she offers on her site and has a health story that inspired her brand. She seems to also work w/holistic vets to use supplements in her line, offers FREE make at home recipes, many various options which is unique. Hope this helps and best of luck w/the health issues!
Thank you for this detailed information. My 15 yr old mixed breed (normally a bit overweight 37lbs) has been found on arecent ultra sound to have enlarged liver with apparent mass on one lobe. Blood panels have shown her to have elevated liver values for the past 4-6 years, but not extremely so. It was never considered a cause for concern, just something to watch over time.
She now has a bloated abdomen, lethargy, decreased appetite, and has begun to have limb tremors when resting. I’m waiting on the results of another blood panel from today’s clinical exam. The info you’ve shared here will help me as I discuss the results with her vet and make decisions about her (probably palliative) care going forward. Much appreciated.
Dear Anne,
My heart goes out to you as you face this difficult situation with your senior girl. I am glad your vet is being thorough with testing and hope you will get some answers soon. Praying for clarity in your decision making. Bless you and your sweet girl.
Hello, my 5 months old puppy ate half the soap bar, i took him to vet they induced the vomit. His bloodwork showed ALT level 291 u/L and GGT 4 U/L. Do you think this could be because of soap and rhe levels will fall back to normal? Thanks
Hi Ansh,
I am sorry your puppy has caused you so much trouble! There is no way to know if the soap caused these changes to the liver enzymes, but it is definitely possible. Hoping your vet is planning to recheck labs again soon and praying for good results. Wishing you both the best of luck and give your sweet boy a hug for me.
my 9-year-old Maltese has torn his cruciate ligament upon doing blood work pre-surgically we found his Alt at 685 his calcium was also High they did an ultrasound and a very specific blood panel that got sent off to another country at a special University to be examined those results came back wonderfully in that no visible tumors were seen and has calcium had returned to normal brought him in for one more blood panel to check those liver enzymes again before booking the cruciate ligament surgery and suddenly within 12 days his alt has gone up to 8:05. I keep insisting it must be the medication he’s on in the beginning he was on medicam we took him off of that and put him on gabapentin the vet is insisting Gabapentin does not get filtered through the liver but everything that I’m reading suggests otherwise
.. he has a history of crashing under anesthesia and I don’t want to do a massively invasive biopsy prior to doing his cruciate ligament. I cannot stand watching him hop on three legs in pain and I don’t want to potentially kill him with a liver biopsy with his history. I’m so confused and I don’t know which way to turn
Hi Tee,
I understand your concern for your little pup and can see why you are conflicted about how to proceed. Your vet is correct that gabapentin is not filtered by the liver but rather by the kidneys. It is possible that the Metacam could have caused some liver issues initially and now you are just seeing a progressive worsening of the liver dysfunction that is unrelated to the gabapentin. Of course, without playing a personal role in your dog’s medical care it is hard for me to make specific conclusions. It seems as though you are more worried about the liver biopsy than the cruciate surgery. But I would say that with the elevations in this liver value, it could make your boy too big an anesthesia risk to proceed with the cruciate surgery without more in-depth investigation. It may be time to get a specialist involved to discuss what options are available. Your vet should be able to make a referral or schedule a consultation if needed. Hoping you can get the answers needed to find a clear path forward. Wishing you all the best of luck and praying for a positive outcome.
I have full CBCs every 4 months on my dogs and track all the results in Excel so I have years (7 years in this case) of data at a glance which helps me notice trends in changes more easily. It was clear when, over the years, his Kidney values were increasing (below need for dietary changes, but trending towards the fact I would need to at some point). On 4/18, his last blood test, his liver values were the same as always, low and diagnostically insignificant. I spend a week reviewing bloodwork and then have the regular exam so I can bring educated concerns to the table with my vet. On 5/16, I noticed he was “not himself”. Nothing really major, just those things a pet parent knows. I got in for another look with my vet. Liver values were off the charts (oddly, kidney values had actually improved slightly). After further investigation with Ultrasound, it was found that he had an actively bleeding tumor on his liver. On 5/20, there were still no changes (clinically), but physically, he had gone downhill (was struggling to stand, moved in labored and small incremental strides (kinda like old people when they fear taking too large of a step because they do not want to fall) and lethargy had become noticeable to even the most unobservant eyes.
He is no longer suffering.
My question is…WHY put in the cost and effort of such frequent CBCs (I mean, they are $227) if they are not going to help with diagnostics of something so major? There was ZERO indication of even thinking about his liver health just a month before this aggressive, bleeding liver tumor reared itself.
There was, beyond a doubt, no injury, no ingestion of something forbidden…no indications whatsoever. He ate a species appropriate diet (formulated by a veterinary nutritionist) of the greatest quality (all of his food was of a quality that many Americans cannot even afford to feed themselves, his protein/animal sources were highly varied).
He was well cared for, thoroughly evaluated for lumps and bumps, minimally vaccinated and never received chemical treatments for, well, anything. Proper lump/bump checking, daily tooth brushing, proper grooming with nothing but safe soaps. Do not treat my yard with synthetic poisons-45% vinegar is about as toxic as I get for yard chemicals-and do not clean with toxic products-regular 5% vinegar or diluted 7% peroxide. I live out in the country with 12 acres of fresh air and exercise is plentiful.
I could go on, but I think you get the point.
But back to my question…WHY go thru the expense and research of all this if in the end, it does not help with signs of development/progression of diseases before it is too late?
Paws Up!
Dog Momma
Hi Jacob,
I am sorry for the loss of your boy. I understand your frustration with how things progressed. I generally do not recommend blood work this often for my patients. The only time I have lab work performed this frequently is if there is already an issue that is being treated and I need to monitor things closely. Even though lab work can’t catch every disease in the early stages, it does allow us to find some problems before symptoms arise. It is better to be proactive and know that it isn’t 100% effective than to give up all together. It is normal to ponder all the “what ifs” while working your way through grief. I hope with time your heart will heal and I pray for your comfort and peace. Keep up the good work and don’t lose hope!
My 5 year old girl Blueberry Muffin (half aussie half cattle dog) has elevated ALT (883) and GGT (21), bilirubin (2.4), and cholesterol (389). I brought her into the emergency vet 2 weeks ago—that’s where I got these numbers from. She was acting lethargic and she threw up some foamy yellow stuff. They gave her fluids, anti nausea meds, and sent us home with denamarin and something else I think it was a probiotic. She finished her two week treatment of denamarin (425mg tablet once a day) two days ago. Now I’m supposed to have a follow up panel done with our regular vet. I don’t know if I’m being paranoid, but tonight she seems to be a little weird. A little off. She still wanted to go on a walk, and happily accepted her daily treat (small milk bone treat) from our neighbor. She hasnt touched her dinner, but she didn’t eat her breakfast until this afternoon around 3 or 4 (despite it being in her bowl since 7am) so maybe that’s why she hasn’t touched her dinner yet. But. I asked the vet to send me her results so I’m going over them now and wondering what the vet suspected based on her levels. When I brought her in two weeks ago (May 23)Everything else looked good. She had an ultrasound and they didn’t find any abnormalities. Our regular vet can get us in, in a week. But should I do an urgent care appointment instead and get her in, like today or tomorrow? Instead of waiting a whole week? I worry easily but I believe I know my dog and I am taking every precaution. Thank you for reading this. This page about the specific liver enzymes and their function has been really informative.
Hi Sarah,
I am sorry your girl is exhibiting these worrisome changes to her behavior, and I understand why you are concerned. Without examining your pup myself, it is hard to know if this is an emergency or if it is ok to wait a week for the appointment. Generally, I like to err on the side of caution and would rather you get her evaluated sooner rather than later. Hoping all is well and praying for clear answers. Bless you and Blueberry Muffin. ♥
Thank you for this information and forum to address issues with our Fur babies. We have an 8 1/2 yo spayed female lab mix with elevated liver enzymes (ASP highest at 1195 dx’d 9/23) and as of todays date is still elevated at 800). ALT at 124 from 137. She has biliary sludge and a splenic tumor (visualized via US). She has been on Denamarin, Ursodiol since diagnosis as well as a round of ABX. Our vet referred us to specialty surgeon to remove splenic tumor, however, we are struggling with putting her through such a surgery with a possible poor diagnosis and subsequent prognosis. Our “gut” feeling is hemangiosarcoma with mets. However, is there something else we could be missing. Thank in advance for your consideration.
Hi Kathy,
I am sorry your girl is having so many issues at once. It sounds like you have been very thorough with testing, and I feel like you are on the right path. I cannot think of anything else to rule out at this point and understand why you are conflicted about whether to pursue surgery or not. It is ok if you decide to focus on comfort care and choose palliative services instead of treatment. Unfortunately, in these situations, there truly is no one right or wrong answer. I encourage you to trust your intuition as you know your girl better than anyone and to go with the choice with which you can be at peace. Try to make the best of the time you are gifted. Bless you and yours. ♥
Thank you for this article. My 11 year old mixed breed dog (20% miniature Schnauzer) started feeling ill in November. She had elevated ALT and ALK Phosphatase. We did an ultrasound and saw gallstones. We thought that was the cause and started her on Ursodiol. A month later she refused to eat and vomited. Her ALT was incredibly high and Alk as well. She was hospitalized with fluids and started antibiotics and Denamarin. She got immediately better. We took her off the antibiotics and it went right up again. Then we thought it could be Leptospirosis. We did another round of antibiotics for 6 weeks. She got a lot better and we determined it wasn’t leptospirosis. However, after taking her off antibiotics the second time, she had to be hospitalized again with the elevated ALT and Alk. She’s back on Clavamox and Metronidazole and we are going to an internist in two days. However, I am afraid that this time the antibiotics are not working as well, as she was eating unenthusiastically this morning. Do you have any ideas of what it could be? Right now our veterinarian thinks it is a bacterial infection of the gallbladder. In the last two ultrasounds, the gallbladder doesn’t look “smooth” is what I was told. I’m just wondering if it is the gallbladder or what other issues it could be.
Dear Ellen,
I am so sorry your senior girl is facing this unknown issue with her liver. Unfortunately, I am at a loss as to what could be causing these problems. I think a visit with a specialist is the best next step to getting a diagnosis. Hoping you were able to get the answers you needed to find a clear path forward with treatment. Praying all is well and feel free to leave an update if you have a chance.
My 3 year old Australian Shepherd has epilepsy. He had a one hour seizure when he was one year one month old, He had a $10,000.0. dollar work up at MS State University vet school and is taking Levetiracetam ER 1,000mg and Phenobarbital 97.5mg BID. We have had no seizures since that and is a 80lb thriving dog. We have perfect PHBR level 26.6 up/ml but now 3/30/2024 : GLOB 4.7 g/dl, ALT 134 U/L and TIBL 1.3 U/L. .Before that normal 3/28/2023 it was GLOB 3.7 g/dl ALT 81 U/L and TBIL o.8 U/L. My vet believes it is the Phenobarbital that is causing it and wants to start us on another medication. Denamarin. They do not want to “rock the boat” and take him off the phenobarbital which they think is causing the problem. Any thoughts on or an alternative option for the best out come for my beloved pup?
Hi Teresa,
I am sorry your young dog is living with epilepsy but what a blessing she responded to well to the medications and things seem to be under control. I understand your concern with these rising liver values. It can be tricky to weight the benefits verses the risks when it comes to seizure medications. While there are a few other options for seizure medications, I agree it may not be best to “rock the boat” at this stage. The specialists at MS State are amazing and I would definitely defer to their expert advice. Hoping you can find the best way to maintain your boy’s quality of life. Wishing him all the best for many happy years ahead.
my 5 year old dog was injuried when hit by a car. He suffered no fracture/broken bones but did bruise his lungs, and when examined his blood work, his liver enzymes were high,. He’s on carprofen and needs his C rechecked on Friday. will he have liver problems or will they return to normal.
Hi Suzanne,
I am sorry your pup has endured so much over the past few weeks. Unfortunately, there is no way to know if the liver issues will resolve or turn into a chronic problem. Did your dog have lab work prior to the car accident that showed his liver was functioning normally? The reason I ask is just because these enzymes were elevated after the accident, doesn’t mean it was necessarily caused by the accident. It is possible this liver dysfunction was present prior to your boy being hit by the car. Hoping his recheck shows an improvement in liver function and this will all be a thing of the past. If, however, his lab work has not improved, I would recommend some follow up testing (more lab work, ultrasound, etc.), adding in a liver supplement such as Denamarin, and maybe discontinue the carprofen or switch to something more liver friendly. Wishing you all the best and praying for a positive outcome.
We adopted our female lab/German shorthair pointer/Pyrnees mix from a shelter 3 years ago when she was 10 years old. Her teeth were in horrible condition. A pure black wall surrounded all the teeth (could not see where one tooth started and another began side side-by-side). Her breath was unbelievable. Before we picked her up, the shelter cleaned her teeth and pulled 4 teeth. Within a year, she had to have 6 more pulled. Her first wellness check after adoption showed ALT at 400 and it has gone up ever since. Vet has her on prescription Science Hills Digestive Dog Food (low in fat)., and Galliprant. We also had her on Denamarin from day one but vet felt this wasn’t helping so took her off a few months ago. ALT still continues to climb and is at 1400. She eats well, drinks normally, stools and urine all normal looking. She is now 13, very active and weighs 80#. .Could she have had periodontal disease caused these high ALT numbers and/or the Galliprant have affected her?
Hi Calista,
I understand your concern for your senior girl with this ongoing issue with her ALT. I wouldn’t expect Galliprant to be a problem as it was designed to be used in senior dogs that can’t take other NSAIDs because of renal or liver insufficiency. Periodontal disease can definitely affect the liver and other internal organs. While lasting effects are possible, I usually see an improvement in these levels after a thorough dental cleaning is performed. The fact that your girl’s ALT is remaining high despite a diet change and Denamarin makes me think more in-depth investigation is warranted. It may be time to talk to your vet about abdominal ultrasound or lab work to check for tick borne diseases. A consultation with a specialist is always an option as well. Don’t hesitate to advocate for your pup and make your concerns and wishes known. Hoping for answers and a clear path forward. Wishing you both the best as you navigate this unknown path.
Our dachshund Leah will be 11 in September. Last week we noticed she had been drinking and urinating a lot. Seemed like she was having to urinate every 30 minutes. I thought it was diabetes and brought her to the vet, and turns out she as elevated liver enzymes, but I don’t know which enzymes or the values. She seemed like she gained a lot of weight over the winter months, and just seems uncomfortable and lethargic. However, when she’s outside she’s still enjoying exploring and seems a bit more like herself. The vet suggested we start her on medication, but we’re still waiting for it to come in. Over the weekend she started getting diarrhea and seems like she has an upset stomach. Should we be concerned about her prognosis? Or will medication and a diet help us get a few more years with her?
Hi Ashley,
I am sorry your Dachshund is experiencing these worrisome symptoms. Without having a diagnosis or knowing what medication Leah is taking, it is hard to say if the treatment or a diet change will be beneficial. Has your vet mentioned anything about Cushing’s disease? If not, I would encourage you to bring up the topic and see if they think it could be a possibility. Here is a link to another article with more information: Cushing’s Disease in Dogs: Symptoms, Diagnosis, Medications
Hoping you can find the answers you need to ensure your sweet girl has many happy years ahead. Wishing you all the best of luck and feel free to keep us updated on how things are going.
My almost 13 year old “puppy-like” chihuahua Brittney has been fine and having a blast… however on Wednesday, very suddenly with no signs of illness prior began to vomit this went on for several hours and she appeared very lethargic. I took her to the emerg and they have kept her since Tuesday (it is now friday) her liver enzymes were about 3800! and she has refused to eat for them however I was able to visit and got her to eat about half a packet of moist food last night and she brightened up to her normal self.
Her “jaundice levels” (cant remember the formal name – were also a bit up however she is not yellow, eyes, gums or skin. And her white blood cells slightly elevated as well. Otherwise her other vitals and pancreas are fine. I am not certain that they ran the test for the mold/bacteria yet (cant remember the name for that) and she has an ultrasound done yesterday and waiting for results to hopefully come today.
She has never shown any sign of being ill up until that very moment at 6pm on tuesday evening and has had many blood tests completed in the last few years for teeth removal several times and spading etc. So I am hopeful to think this was something she got into or rolled in… she is not the type of dog to put things in her mouth that isn’t her own food or treats. But she is the type of dog to roll/rub her face in weird smells in our backyard. Which is about 3/4 an acre. Often comes in covered in bird poop and mysterious muck on her face and body. That same day she got ill, this was also the case. They will likely do another blood test in the coming days to see if the enzymes have dropped. Of course the $$$ is just going up and up and up… and I know it is important to rule out cancer and grave diseases however is there a point at all that some tests may be unnecessary and would you happen to have any input at all on the situation or pattern of circumstance rather?
Thanks in advance!
Hi Courtney,
I am so sorry Brittney experienced this worrisome liver crisis. I honestly have no idea what could have caused these severe symptoms especially with such a sudden onset. Of course, a toxin or poison is high on the list. I understand your concern with the financial aspect. Unfortunately, I don’t know any other way to proceed with treatment besides what your vet has already recommended. How are things today? Was Brittney able to recover? Hoping all is well and praying for a positive outcome. Feel free to leave an update and let us know how she is doing.
My 10 year old Pomeranian recently had very dark bright yellow urine. I was concerned and called the vet immediately. Her ALT is around 4000! She had other sky high values but I cannot recall which ones! One was over 2500 and the other was 11. She is otherwise asymptomatic eating drinking etc. she came home on antibiotics anti nausea and denamarin. She is scheduled for an ultrasound this week but I’m thinking this needs to be done like today!
Hi Colby,
I understand your concern for your Pomeranian with these abnormal results on her lab work. I know it can be hard to remain patient and stay calm while waiting for testing to take place. You are doing a great job in advocating for your senior girl. Hoping a definitive diagnosis can be made and there is a clear path forward. Wishing you both all the best and praying for complete healing.
What was the outcome?
Oreo is a 13 yo cattle dog mixed. shes been on phenobarbital, zonasamide and topiramate since she was 2 yo. We have been using denamarin the same time around. Her ALP has been on a higher level which we expected (300++ but never above 400). Her pheno level is between 25-29. However last year her ALP was 799 but all the other three AST, ALT and GGT were normal per usual.
A week ago we did another routine blood work. Her ALP went down to 526 but her AST went from 29 to 68. Her ALT is 103 (last year was 55) and her GGT is 1 and it was 6 last year.
She became very picky in the morning. she refused to eat her breakfast unless if i add something she likes (salmon, eggs) but no problem at dinner time. her energy level is still pretty good considering her age and she has a ruptured ACL. still very playful. she goes on walks 3x a day.
are these signs on early liver disease?
Thank you for taking the time to read and hopefully I’ll get a reply.
Hi Theresia,
I am sorry your senior girl is facing this difficult situation with her liver. It is hard to make specific conclusions about her liver function just off of these lab work results. It may be time to consider a referral to a specialist or discuss more in-depth testing with your vet. Does your vet have access to ultrasound? Abdominal ultrasound is a great way to get a look at the physical characteristics of the liver itself and could help rule out several potential causes. Hoping Oreo will be able to keep fighting and wishing her all the best for many happy days ahead. Feel free to leave an update if you have a chance.
My 8 year old chi-weinee was healthy until the vet gave her 9 mg of depomedrol (she is 9 pounds) 7 weeks ago. She still has extreme thirst and extreme hunger. Earlier this week, her blood work shows ALT of 817, ALKP of >2000 and GGT of 125 and cortisol < 0.5. My vet gave me denamarin and I am supposed to get recheck of blood work in 2 weeks. My vet will not agree with my feelings that it was too much depomedrol for her and that is what has changed my beloved girl. I am praying that she recovers from this. If she does, I am finding another vet to take care of her.
Hi Diane,
I am so sorry your little pup is having trouble with her liver. Unfortunately, without playing a personal role in her medical care it is hard for me to make specific conclusions. What did her liver values look like on her blood work prior to the depo injection? What issues was she experiencing that the steroids were being used to treat? Hoping the Denamarin will be able to work its magic and her liver enzymes will have improved at the next recheck. Wising you all the best and praying for a positive outcome.
Hi Dr. Buzby,
Excellent article! The best I’ve found on the subject after spending hours researching.
My 15.5 year old dachshund was recently diagnosed with Cushings and we started him on Vetoryl about two weeks ago. His bloodwork on 3/21/24 showed ALT of 167, ALP of 522, GGT of zero and Bilirubin of 2.5. Prior to his Vetoryl, his values from 2/7/24 were ALT of 77, ALP of 601, GGT of 5 and Bilirubin of .1.
It appears his ALT and Bilirubin went up and the other values went down. I interpreted these results that it was trending in the right direction. However, the vet thinks he has an additional liver or gallbladder disease. In addition to Cushings. We are starting him on Denamarin. The vet wants him come back for more bloodwork and an ultrasound on April 4.
How would you interpret these results with certain values increasing and others decreasing? How long would the Denamarin take to start to work? Should we wait longer to do bloodwork?
Thanks so much for your expertise!
Hi Holly,
I understand your concern for your Dachshund and applaud you for taking such an active role in advocating for his health and well-being. I think these numbers are enough to be suspicious about other liver issues but there truly is too little information at this time to make specific conclusions. I think your vet’s plan to continue monitoring liver values sounds good and trying a course of Denamarin is reasonable and what I would have recommended as well. Since Denamarin is not a medication but rather a supplement, it can take several days to weeks for it to have full effect. Denamarin doesn’t work in every case, and it really depends on what is causing the issues to begin with. Hoping the recheck showed favorable results and there is a clear path forward with treatment. Feel free to leave an update if you have a chance. Best wishes to you and yours!
Hi Dr. Buzby,
Thanks so much for this great article! Our pup Scruples has an elevated ALT level of around 250 that’s been persistent over two vet visits a couple of months apart. He’s also had periodically recurring chronic GI issues that present as frequent has build-up (occurring at least once most days during an episode), enough that his abdomen becomes visibly distended until he’s able to pass gas several times (we’re extremely careful to watch for any signs of GDV and keep him from exerting himself during these times). Our vet has previously said that IBD could be a cause of his GI issues, and I see you list IBD as a possible cause of elevated ALT as well. We’ve tried a 100% hydrolyzed protein diet to no avail. She now wants to perform a prophylactic gastropexy, and at the same time take biopsies of both his intestines and liver. Does this course of action sound good to you? Is there anything else you’d recommend?
Thanks again!
Hi Bryan,
I understand your concern for your pup with these chronic GI issues he is facing. Without playing a personal role in his medical care it is hard to make specific recommendations. It may be time to ask for a referral to a GI or internal medicine specialist. Before proceeding to invasive procedures, has your boy had an abdominal ultrasound? While biopsies may be the best way to get answers, there could be other testing that a specialist would want to have done first. I completely understand why your vet is pushing for the gastropexy. I would hate to think that something could have been done to prevent GDV and yet it was passed over. Honestly, Scruples is a bit of a complicated case and I’m not sure there is truly a right or wrong way to proceed. This is when I like to defer to a specialist! While you wait for answers, I would highly recommend you try a probiotic supplement if that is not included in his prescription diet. Hoping you can get a definitive diagnosis and there is a clear path forward with treatment. Best wishes and good luck!
My 1.5 year old toy poodle, Bentley went in to get neutered today. His bloodwork came out perfect with the exception of his ALT. His ALT was high: 303 (reference range given was 10-125 U/L). I opted to do a bile acids test and his test result was “HIGH” again. I took home denamarin and scheduled an ultrasound, the soonest I could get one is in a week. He is behaves completely normal, plays, runs, eats and drinks normally so it was a shock. My vet assured me that he will be okay and I that I need to take it one step at a time. I’m terrified that I will have to say goodbye to him.
Hi Sierra,
I understand your concern for Bentley with this elevated liver value on his blood work. Your vet is absolutely right, you have to take it one step at a time. It sounds like they are being very thorough with testing. I am hopeful you will get the answers needed to find a clear path forward. Wishing Bentley all the best and praying for many happy years ahead.
Hey Sierra! How is Bentley doing? I’ve experienced something very similar with my 7 month old puppy. She is scheduled for an ultrasound next week.
My 5 year old Boston went into the vet for a limp on her front leg. Was prescribed meticam for 7 days. The vet tested her blood before giving her the meds and everything was good. Gave meticam off an on for a month but every time she came off it you could tell she was sore and had trouble going up and down stairs. Took her back to the vet a month later and she had a fever of 40.5 and her Alp was over 2400 u/l. Alt was 461 u/l ALB was low 20 g/l and TBIL was elevated 15 umol/l. Vet treated her with an antibiotic and liver diet and a liver support denamarin. We retested in a week and her levels were even higher. Also did a bile acid test which came back normal. Just had an X-ray done and vet thinks she had arthritis in her shoulder and potentially her spine has injury as you don’t see any gaps between some of bones on her spine. Had a few vets look at her blood work and nobody seems to have any ideas. She is healthy otherwise but is sore and in pain with her back and leg issues. Would meticam increase her liver enzymes?
Hi Jennifer,
I am sorry your Boston is having these issues with her liver, and I understand why you are concerned. Yes, Metacam is an NSAID which all have the potential to affect liver function. Now, without some more in-depth testing, there is no way to know if the Metacam is to blame or if there is something else contributing to this problem. It may be a good idea to talk to your vet about an abdominal ultrasound or scheduling a consultation with a specialist. Hoping you can get some answers and proceed with the recommended treatment. Wishing you and your sweet girl the best of luck and praying for a positive outcome.
My 13-year-old pup just got his teeth cleaned and got a verrrrrrrrry mildly elevated ALT value of 131 (reference range given was 10-125 U/L). We just recently changed his diet and I wonder if that might be the cause? He’s asymptomatic and I don’t know if I ought to re-check those levels in a month, three months, six months, or get all concerned now and go talk to my vet about it! He’s our baby. =)
Hi SW,
YES…. I encourage you to talk to your vet! They may be able to offer insight that would give you peace of mind. Was the elevated ALT on the pre-anesthetic lab work? If so, just having your boy’s teeth cleaned and resolving any dental disease could be enough to bring the liver enzymes back down to a normal level. Dental disease can cause issues with the liver and other internal organs. I do think rechecking lab work in a month or two is wise. This way you can take action quickly if the levels have increased further. Also, you can talk to your vet about the possibility of starting a liver supplement. Supplements such as Denamarin can be very helpful in restoring liver health and function. Your pup is lucky to have you taking such an active role in advocating for his health and well-being. Wishing you the best of luck and keep up the good work!
My dog was diagnosed with pancreatitis, but wasn’t improving after a couple of days. I took her to the emergency vet because she wasn’t peeing or drinking. So they ran some bloodwork and found her alt and alp were EXTREMELY HIGH. Like in the thousands. He also gave her an ultrasound which indicated liver inflammation. He started her on denamarin, two antibiotics, and cerena. So far she’s acting completely herself. The weird thing is her bilirubin levels were normal and she’s not jaundiced at all. Her daytime vet isn’t super concerned and started her on 30 days of denamarin as well. He will check up on her at the end of the last dose to see if the liver enzymes have went down. Any advice or clue as to what is going on? She’s a 5 year old golden retriever and she does have seizures but it’s completely unrelated to this.
Hi Abby,
I understand your concern for your Golden with all of the issues she is facing. Because of where the pancreas is located and since it helps with digestion, it is not uncommon for it to cause issues with other internal organs when it becomes inflamed. I can’t say for certain that the liver problems and pancreatitis are related, but it is possible. I think your vet’s recommendation to recheck lab work after finishing the Denamarin is a good idea. If the liver enzymes are still elevated or have not improved, it may be time to think about more in-depth testing or a referral to a specialist. Hoping all is well and your girl is living her best life. Feel free to leave an update if you have a chance.
One year old Kirby, Cockapoo has high liver enzymes ALT OF OVER 960? The vet prescribed antibiotics which did not help. Kirby is picky about what he eats and only will eat human foods.
The AlT went from 425 to 460 and now it is over 960. The vet will order a scam to see what is going on in my young puppy. He has not signs of illness whatsoever. I am so very worried about my puppy as he is very unusual and sweet and acts like a human little boy and is very, very intelligent. The creatin was a little elaivated.. Worried to death. I pray alot and so does several friends in the neighborhood. He does not have that Lep disease however.
Jennifer A.
Dear Jennifer,
I am sorry Kriby is having issues with his liver at such a young age. The ultrasound is a good idea and I hope it will offer some definitive answers. Feel free to leave an update as new information comes to light. Praying for your strength as you navigate this hard path and healing for Kirby.
We have a 9 month old wheaten terrier that just came back with 960 ALT. Very worried. She’s having an ultrasound on Wednesday. Prayers please.
Dear Kathleen,
I will be praying for your young pup! Hoping for answers and a clear path forward. Feel free to keep us updated as new information is available!
my pitty threw up Thursday night, seemed a little blah the next day. atr really well last night. woke up to pee and poop this am… not sure which dog did it. would not eat this am. very lethargic. vet at 11:30. nxrays show possible mass on liver. liver enzymes 2000 for the one that is supposed to be 150. very low white cell count. gave her subcutaneous fluids, anti nausea and gapapentin for pain.. wants ultra sound monday. she might have also got into so.e onions the night she threw up. I hope her condition does not worsen, but it also sounds like she’s a very sick dog with not much hope to get better. I’m heart sick.
Dear Kim,
I am sorry your girl is facing this unknown liver issue. I can only imagine how worried you must be. I am glad your vet is recommending more in-depth testing and think an ultrasound is a great idea. Hoping you were able to get some answers and make a plan for how to proceed. Feel free to leave an update if you have a chance. Praying for comfort and peace.
My baby girl, Zuzu Bailey, is only 1 year and 3 months with an elevated ALT of 208. Last month she was in the normal range at 98. She has been checked several times over the past year because it fluctuates between normal and elevated. Our vet just put her on an antibiotic. Although she is asymptomatic, I am absolutely terrified that this won’t work and that something else is very wrong. We just love her with all our heart!
Hi Heather,
I understand your concern for your young pup. Has your vet discussed the possibility of trying a liver supplement? I have seen great results in my own patients with Denamarin. Also, it is ok to be honest with your vet about your worries. If you are wanting to pursue more in-depth testing, make sure they are aware of your wishes. It may be a good idea to run additional blood tests or even think about an abdominal ultrasound. Hoping you can get the answers you need to ensure your sweet girl remains happy and healthy. Wishing you and Zuzu Bailey all the best!
Thank you so much for the article. I have a 2 year old chihuahua mix Rose. Routine blood work showed elevated ALT 158. Doctor put her on medication for a month and we repeated bloodwork. The repeat result was almost the same ALT 160. Doctor said to stop medication and now we are going for ultrasound. The doctor is puzzled as to why such a young dog would have this issue. She did not get into anything toxic. We give her fresh food. My question is what could be causing elevated ALT only? No other enzymes are elevated. The only thing I notice that GGT was not on the bloodwork panel. Would it make more sense to do the ultrasound with aspirate? I am reading a lot of these comments and ultrasound is not showing much. Rose is doing well otherwise. The only thing I notice is maybe excessive drinking?
Hi Alla,
I understand why you are concerned for your pup with this strange abnormality on her lab work. Without playing a personal role in her medical care it is hard for me to make specific conclusions and recommendations. I do think the abdominal ultrasound is a good next step. Also, I am curious about the possibility of your girl having Cushing’s disease. This could be good to discuss with your vet and get their expert opinion. Hoping you are able to get some answers and find the best way to ensure your girl remains happy and healthy for many years to come. Feel free to keep us updated as new information comes to light.
My little buddy is 12 1/2 years old. He is a cancer survivor, anal gland cancer, had surgery to remove gland involved, all margins were clear, and underwent 5 months of chemo, later developed heart failure, now has leukemia. I know he is slowing down. He has been having some poop problems, often times poop is very soft, but formed, and then in process of evacuation , poop is very loose and mucousy, and is often times difficult to completely empty his bowel. His poop yesterday was really off colored, a little bit gray but not still brownish. I also noticed this past week something was off, and monitored and treated his symptoms, and even took him to the vet to get, help. He had started limping and his head is tilting to one side. I did mention this to the doctor on call. Of course, I am thinking the worse, that the cancer has returned to another part of his body, as it has been 4 years since the anal gland cancer diagnosis. It is too early to tell, but the vet did say th gait that he exhibited looks more skeletal, arthritis , than perhaps a neurological issue. He was put on vetprofen, and only took one pill. After several hours he became very sick. We rushed him to the emergency vet hospital and bloodwork indicated very high liver enzyme levels. He was treated overnight with fluids and an antibiotic drip metronidazole and was sent home with pill form of med. We are praying for the best, but are not sure what to do. He doesn’t seem to be in any pain today, but is very lethargic. I will be taking him to his own doctor tomorrow for a follow-up. I guess, my question would be, when will we know it is time to make that dreaded decision to have him put down. We don’t want him suffering and do realize that having to make this decision is a great act of love. We are at a loss, as to know what to do; should we wait and see, or continue to try to keep him healthy and productive. I am not sure which liver enzyme was elevated so, we are not sure what is going on with the liver. How long would his life expectancy be if it were liver related, not cancer and not relative to other underlying organ illnesses?
Dear Glenda,
I am sorry your pup has endured so much in his lifetime and is now facing a new issue with his liver. Unfortunately, without playing a personal role in your dog’s medical care, it is hard to make specific conclusions and recommendations. As long as your boy is not suffering, it is ok to give this some time to see how his body will respond. Your vet will be able to tell you if they think he is suffering and if saying goodbye is the most loving option. Without a definitive diagnosis for this liver problem, there is no way to know what the prognosis is or what you should expect moving forward. I am hoping the visit to your vet tomorrow will offer some answers to your questions and put your mind at ease. Praying for a positive outcome and wishing you both the very best.
Hi, I just had a blood test done on my 10 year old Husky/Heeler mix who is scheduled for her dental cleaning on Feb 6th.. The blood test shows she has a high ALP of 229. The rest of her results were all within normal range with the exception of her Cholesterol which was 370. Even tho she is 10 years old, she gets walked every day, sometime twice a day. I can say that she has slowed down which I attribute to her age. She will be going in for her Dental on the 6th which they say she will be fine. They said the high ALP might be due to her age. They are recommending maybe doing a fasting blood test to check again. Should I be concerned. Should she have an x-ray or ultrasound of the liver or is this only a minor concern since all her all other levels are fine.
Thank you.
Hi Tara,
I understand your concern for your girl with this abnormal result on her lab work. While more in-depth testing may be needed at some point, for now I would not be too concerned with only the ALP being elevated. Many times, dental disease in itself can cause this mild elevation and you may see this resolve after the dental cleaning is performed. My best advice is to recheck lab work in another month or so and see if there have been any changes. Wishing your girl good luck with her dental procedure on Tuesday!
Hi Dr., My pup Jet had alt of 780 when we went to ER on New years eve due to diarrea not going away (no vomit) they infused her for dehydration, x-rays and BW. i followed up with my vet the following tues days bc she hadnt pooped for 2 days. i was told the metro pill they gave her could stop her bowel movements. I then came back to vet as recommended for a new panel of bloodwork on 1/16 later and was told due to the ALT enzymes being so high and to check gallbladder. Yesterday was ultra sound and i breathes easier bc no masses were found or inflammation. My vet mentioned biopsy liver and hepatatic things, i was shaking as he spoke to me and cant remember it all. I did tell vet that at ER her ALT was 780 but the new BW they did just a little over 2 weeks later it was down to 629. He didnt know that s he said thats a great sign. the only thing changed was taking kibble out of her diet, He put her on denmarin bc i didnt want to put her back on metro as it comatosed her and made her not herself for the few days i let her be on it. Is there any foods that i can add to her food that will help then also go down. i know about milk thistle but the denmarin has that already i believe. im just wondering if theres a superfood to add. if you are able to respond, thank you .
Hi Melissa,
I am sorry Jet has been through so much over the last month. I am glad her blood work is slowly improving and nothing abnormal was seen on the ultrasound. I am not sure of any foods that are specifically beneficial for liver problems. I think Denamarin is great and glad to hear that is already part of your dog’s treatment regimen. Hoping Jet will continue to improve and praying for a full recovery. Wishing you both the best of luck and keep up the good work.
hello my 2yr old great Pyrenees suddenly dinner eat dinner nor breakfast had one episode of emesis then I took him to the vet. his liver enzymes ALP 293 and ALT was 2000 rest of chem panel and CBC was normal. 30 days later his ALP is 85 and ALT is 657 but now BUN is 26. Although much better should I still be very concerned. My vet had not actively tx him I put him on milk thistle? any thoughts?
Hi Donna,
I understand your concern for your young pup with these elevated liver enzymes. I am glad the milk thistle seems to be helping! Without playing a personal role in your dog’s medical care, it is hard to make specific conclusions and recommendations. You may want to consider pursuing more in-depth testing to try and get a definitive answer. I would talk to your vet about tick borne diseases and leptospirosis. Also, an abdominal ultrasound could be helpful if these values remain abnormal. Hoping this issue will correct itself and praying for a positive outcome. Best wishes to you and your sweet boy.
Hi- our Border Terrier, Waffles, just passed this past Saturday. I’m struggling w/ being the one that had to make that decision and I guess I’m just hoping that it was the right decision. He’s been lethargic, sleeping, and slowing down for the past several months and stopped eating about 3 weeks ago. After 1.5 days of not eating, we took him to the vet and they did a full blood work-up and his liver enzymes were “off the chart”, well over 800. He did 2 full days of hydration IV and after 3 days of still barely eating, his liver enzymes hadn’t gone down at all. The vet did a ultrasound to check for tumors and there were none. She was baffled and started mentioning “quality of life”. We started some meds to help his nausea (what he did eat he threw up) and we just babied him and waited to see what would happen. He continued to decline. He had lost a lot of control over his bowels and his mobility was rough, hard time getting up off of the ground. We decided it was time. It was a beautiful passing at home w/ loving vets and his whole family present….but man, I’m struggling with this. Did I make the decision too quickly? Could he have recovered somehow? I just didn’t want it to become an emergency situation where we were rushing and had no control- I’ve done that w/ a kitty and it was awful. I’m really not sure why I’m writing this novel, but thank you if you happened to get to the end of it.
Dear Jill,
I am so sorry for your loss of Waffles. I know you would have done anything you could to restore his health, but I do think you made the right decision in saying goodbye and offering your boy peace and rest. What a blessing his passing was smooth and peaceful. I am certain your presence in his final moments was a comfort. May his memory live on and continue to be a source of joy in your life. Wishing you all the best as you continue life’s journey. ♥
Our 9 year old Havanese is currently hospitalized since Monday. Hoping to bring him home today or tomorrow. He started turning away treats last week and by the weekend was eating anything and vomited twice on Sunday. We took him to the veterinarian on Monday. Blood work showed alkaline phosphate 1500, ALT 3000 and GGT 31. He’s now in the hospital on IV and meds. Doctor didn’t see any stones on gallbladder or tumors on liver on ultrasound. The doctor told me this morning he’s still not eating so she may give him an appetite stimulant and will redo labs today. No fever, vomiting or diarrhea which is good. I’m trying to figure out the case. Can a bacterial infection raise liver enzymes this much? End of December he developed a cyst on eyelid (chalazion). It got larger within a couple weeks and week before last must have ruptured as it’s gone. Then the following week (last week) is when he started to turn away food. I’m wondering if maybe he developed a bacterial infection when it ruptured? I wish we had taken him to the veterinarian when we first noticed the cyst on eyelid. He’s the most intelligent and sweetest dog I’ve ever had and the thought of losing him in very painful to my family. I pray that he starts to eat and labs some improvement.
Hi Brent,
I understand your concern for your boy and wish I had some answers. Unfortunately, without playing a personal role in your dog’s medical care it is hard to make specific conclusions. I can assure you this liver problem did not come from the eyelid cyst. In order for something like that to cause a problem with the liver it would have had to cause sepsis and also affect other internal organs or would have to be a metastasis from a primary liver cancer. If an eyelid tumor was infected to the point of causing sepsis you would see massive changes and problems to your dog’s face and eye. It may be time to think about scheduling a consultation with an internal medicine specialist. Also, has your pup been tested for tick borne diseases or other blood parasites? Any chance he got into something toxic or poisonous? These are just what come to mind as things that should be ruled out. Hoping you can get some answers and pursue the appropriate treatment. Wishing your sweet guy the best of luck and praying for a positive outcome.
Hi Brent
My dog has had the same numbers last september and was in hospital for a whole week, even had a feeding tube put in. She recovered from that, which was a relief. The vet could not tell if she had a bacterial infection or toxicity – only a liver biopsy would tell and we decided against it as it would not change the treatment course they were giving her.
Yesterday we had another blood test as she has been a bit up and down, and the enzymes are very high again. Not sure what is causing it, but I am thinking an underlying condition.
Hang in there! Its so stressful when they are sick.
All the best
Hi Roberta,
I am sorry your girl has had so many issues with her liver over the past year. Hoping you can continue to partner with your vet to find the cause and decide on the best course of action. Thank you for offering encouragement and support to others. Best wishes to you and your sweet girl. ♥
My whippet bitch, 9.5 years old have got a very elevated ALT 686 U/L but is showing no signs of illness. We did an ultrasound scan to see what is going on in the liver, and found no abnormalities there. However, the vet found something on the gallbladder she is unsure of, and is going to discuss with some other vets. I am of course very worried, and is fearing cancer.
The dog is on a special diet because of kidneys ( SDMA is 22 but CREA and UREA is still showing normal levels). She gets Onsior or other antiinflammatories occasionally because of back problems, but only the prescribed dose, and not more than a few days at a time.
She has a very good appetite, drinks normal and is not bothered with diarrhoea or nausea. She looks good, no potbelly. I can see she has lost some muscle, but I guess that is normal as she is on a low protein diet, and is a lazy type.
Hi Cathrine,
I am sorry your pup has these abnormally elevated liver enzymes. I think the ultrasound was a good idea and hope your vet can get some help with the interpretation of the images. Feel free to leave an update as things progress. Praying for answers and a clear path forward.
hello
our dog is 6 years old the past 8 months his liver enzymes is elevated it is now 334 the vet put her on DeMarini and urisdol on dec 3 we have another bloodwork in February to recheck the bloodwork for that the past couple of weeks she has vomited but she is acting good happy eating pooping doing everything normal so we are now concerned because of the vomiting that it could be the liver getting worse could it be the medication also that is causing that we are so worried we love her so much 🙁
Hi Lucy,
I understand your concern for your pup. I am glad she seems to be feeling ok despite the vomiting. Hoping the medication will help to get things stabilized and praying for good news at the recheck appointment. Best wishes!
My dog has been diagnosed with Cushings and at first git very sick. Very high ALT readings. In veterinarian hospital for a couple of days on meds, testing, etc. She is on Denamarin fir that with no issues. Vet put her on Mitatane for Cushings and now she’s back in hospital with vomiting, etc All the signs of Cushings….pot bellied stomach, etc. Her ALT is ay about 900’s. High. They are trying to figure out what is making her go from being better to so sick. Ultrasound has been done, etc.
Could it be the Cushings med…I know it is like a chemo drug. Denamarin has not affected her but is also not keeping the liver low. More tests today. She is a 37 pound Beagle/Basset p, age 13.
Any help is appreciated. Loved your article.
Hi Donna,
I am so sorry your senior girl is not feeling well and dealing with such severe symptoms. I wish I had the answers you are looking for but unfortunately without examining your girl myself, it is hard to make specific conclusions. While I would not suspect the medicine to be causing these issues, I can’t completely rule out the possibility. This may be a good time to think about a consultation with a specialist. Your vet should be able to make the referral if that is something you would like to pursue. Hoping you can get the answers you need to ensure your pup is on the road to recovery. Wishing you both the best as you navigate this difficult path.
My dog was recently hospitalized too with an ALT of 3,600!!!(off the chart but we sent it out for further testing). I give her vetoryl for cushings normally. Started getting her an IV of fluid everyday, 2 nausea medicine, liver supplement, gallbladder supplement, appetite stimulant & 2 antibiotics. She was still yellowish on her belly and eyeballs. I had this weird gut feeling it was the Vetoryl (cushings med). I took her off the vetoryl, continued everything else, and clinically she was about 50% better about 4 days later and now she’s almost back to normal. ALT still super high (had to send out again), but assuming it’s dropping bc her other bloodwork was much better than it had been. I looked everywhere to see if there was a connection btwn the cushings meds and high ALT. I wouldn’t be surprised if it is in fact a rare negative reaction to it!
Hi EB,
I am so sorry your dog had these severe complications. Recently I have had several people write in with a similar experience. I think you may be right about a connection between an elevated ALT and a possible reaction to Vetoryl. This is sad and scary as it is the best treatment for Cushing’s that is currently available. Hoping new information will come to light and praying for continued healing for your pup.
How can we connect more? I would love to speak to you more about this as Imm convinced the vetoryl causes this. Thankfully my vet is amazing and brought her back to life but the ER vet basically told me I would have to put her down. awful. the whole experience was awful. Would love to figure out a way to make this more well known if this is in fact a thing..
My 2 year old frenchie had an ALT of 1.51 which the vet told me was slightly elevated. We did a blood recheck six weeks later and the ALT has risen to 1.68. With that, the vet has us using Denamerin Advantage and an ultra sound in two weeks. We have no idea what he could have ingested that would cause a problem other than a possible food change that we made. Of course we are very concerned as to what could be causing the ALT to rise.
Hi Eric,
I understand your concern for your pup. I am glad your vet is taking such a proactive stance and is moving forward with ultrasound. Hoping you get some answers and can find a clear path forward. Praying for a positive outcome and many happy years ahead for your sweet boy.
Thank you so much for this detailed article!! I always research issues and found this to be very helpful and full of great detail. I will work with my vet on my aging dogs very high liver enzymes. I feel better equipped now to be able to understand any tests or treatments.
Thank you again – this has been amazingly helpful.
Hi Kathy,
Thank you for the kind words! I am glad to hear the article was informative and will help to empower you to continue to advocate for your dog’s health and well-being. Keep up the good work and I wish you nothing but the best!
This article is so helpful! My senior Maltese had ALT 1,077 with AST 380 and ALP 3,000. I was very worried to say the least. While his vet explained things well, he understandably couldn’t go into this depth of detail. Reading this really gave me a way to plan for various scenarios and prepare myself, mentally and financially.
For now, he is on Denamarin and Urisodol with a blood panel recheck in one month. He is much improved but not out of the woods, and I suspect Cushing’s as underlying cause.
Thank you for this excellent article, it really helped me understand and plan, and know what questions to ask going forward. Much appreciated!!
Hi Lynn,
Thanks so much for your kind words about the article! I’m so thankful that it was able to help supplement what your vet told you and prepare you for whatever the future may hold. It sounds like your vet has a great plan for your pup, and I hope that he is back to his old self soon!
Our 8.5 year old CKCS was diagnosed with Cushing Disease. He has had two ACL surgeries (one on each hind leg). He has been on Galliprant and other steroids for this issue. He has been Vetoryl for Cushings for around 3 weeks. We can see a remarkable improvement in Winston’s condition. He has more energy and muscles are stronger., not panting as much, etc. Do you have any recommendations?
Hi Dottie,
I am glad to hear your pup is responding well to the Vetoryl and you are seeing an improvement in his symptoms. I am not sure I understand what sort of recommendations you are looking for. Feel free to leave a follow up comment with any questions. I’ll do my best to address them or point you in the right direction to the information you need.
A very much by chance enzyme diagnosis…
Within a week of adopting a one year old Great Pyrenees/Lab mix puppy (90 lbs and full of energy), he found his way into a compost bag. There was mold and while he didn’t ingest much while tearing the bag apart, he did have a reaction to a toxin in the mold which was discovered through bloodwork. His enzymes levels were slightly elevated. He presented with head shaking/tremors which, over the course of three hours occurred four times with a duration of approximately twenty seconds each time. The symptoms completely disappeared over the next six hours waiting my turn in veterinary ER. Had I not been home, I may never have even known about his toxic encounter except for the torn bag mess in my side yard.
I do not have the lab results in hand.
We were sent home with S-ADENOSYL-225 SAMeLQ as “liver support”.
He has had no apparent lasting issues and will have bloodwork repeated at his next exam. He is happy, healthy and rambunctious as any pup I’ve ever encountered, gets daily long walks and a healthy variety of food.
My questions : Is this a common complaint? Does this minimal treatment seem appropriate?
I truly appreciate and look forward to your email/informative columns having first finding toe grips for a dog I had several years ago (she had a slightly torn bicep).
Thank you for all you do!
Hi Victor,
It sounds like your pup experienced an acute liver injury due to a toxin that was ingested in the mold. It is common to offer supportive care in these instances and give the liver a chance to recover. The supplement you mentioned is wonderful and is exactly what I would have prescribed in this case. I think the decision to recheck lab work at the next appointment sounds perfect. This will let you know if the liver has healed or if there will be ongoing issues. If ongoing issues are suspected, then the next step in treatment can be discussed with your vet at the recheck. Hoping you receive good results and wishing your sweet boy the best for a long happy life.
my Airedale, 10, is on Galiprant for his arthritis. it has been 2 years, and he recently did blood work that shows liver enzymes up. I am giving him Hepaticlear Pro. the vet gave me. His legs still shake, and he has much trouble getting up. His skin is itchy and he has little warts all over, even one growing over his eye that needs to be removed..ugh
Hi Robin,
It can be very hard when a senior pup starts dealing with multiple issues at the same time. I am glad you are working with your vet to find ways to keep your sweet boy feeling his best. Thank you for sharing your experience with us. Best wishes to you both.