Why does my dog have enlarged heart, liver, stomach fluid, normal enzymes?

Hello and thank you for contacting Petco Pet Education Center, formerly Petcoach. Elevated liver enzymes and abnormal liver appearance on ultrasound scan does not necessary mean liver tumour or liver failure. Older dogs often have abnormal liver appearance, which is not related to any serious underlying problem. Liver enzymes level is a measure of 'damage' to liver cells but it is not directly related to prognosis. Again, older dogs often have mild elevation of liver enzymes I would think that the specialist will perform full abdominal scan and possibly take liver samples through a needle - this is commonly performed procedure in dogs with signs of liver disease. Based on the findings of the aspirate, the doctor will recommend further testing or prescribe treatment for Mars.

I assume when you say liver enzymes you mean ALT? There a few enzymes we look at and elevation in 1 value makes us consider different causes then elevation in another. ALT elevation is caused make liver cell injury and leakage of enzymes in to the bloodstream. As the liver sees all the blood of the body it can be quite a reactive organ. So the question is whether the liver enzyme is up because of something wrong with the liver/vessels to liver themselves (such as an infectious or inflammatory cause (hepatitis) or a shunt (more common in younger dogs)) or something the liver is responding too (toxicity, disease of over organs). Unfortunately all parts of sago palm are toxic to dogs with the seeds (nuts) being most toxic. And it can be quite challenging to know if this is the cause. If it is sago it depends on the degree of ingestion as to how severe the case is. Unfortunately the treatment for this is supportive as you have been doing. The values may continue to increase or hopefully may plateau off and remain mildly elevated or decrease again. Ultrasound will help to rule out other things going on in the abdomen, assess the liver for changes in texture (although a liver can appear normal on an ultrasound and not be functionally normal), and sometimes identify a portosystemic shunt. After the ultrasound then sampling either first by fine needle aspirate or with a biopsy (needed for many cases of hepatitis, some other issues) can be performed. Checking platelets and clotting times should be performed prior to liver sampling in patients whose livers are not normal to decrease the risk of bleeding from sampling. As shunts are more common in younger animals , if this is suspected, additional imaging may be recommended prior to sampling as ultrasound will not identify all shunts. There is also a disorder called microvascular dysplasia that can be found in the liver. This is best diagnosed by liver biopsy and the sample sent to a pathologist who specializes in liver pathology. I hope this has helped and not confused you more. It sounds like your vet has taken the appropriate steps thus far and has recommended the next best steps to try to rule out some other causes. Thank you for using Petco Pet Education Center, formerly Petcoach!

Hello. It is good that the blood work was normal as this indicates there is no damage or destruction going on with the liver cells. Mild inflammation could cause the liver to swell slightly, especially since the liver is the main organ for removing toxins from the bloodstream. This means the liver is doing its job. And, this might just be an artifact of positioning during the x-ray or Jackson may just have a slightly larger liver than normal. If he seems better, then the medication is doing its job. If he continues to act unwell, the next step would be to ultrasound his liver to get a better picture as to what might be going on, & perhaps additional blood work to narrow things down. But I would not be too concerned just yet, as the liver has a great capacity to repair & regenerate itself ( the only organ in our bodies that can do so ). I hope Jackson is feeling better soon. Thanks for using Petco Pet Education Center, formerly Petcoach.

My first question is whether your veterinarian tapped the abdomen to get a sample of the fluid....if so... what was it. With sudden abdominal distension, low red blood cell count I would be most concerned about a bleeding tumor. The fact that liver enzymes were elevated days following a steroid injection is hard to evaluate because the steroid injection wound cause a spike in the liver values....so were they elevated to start with or only following steroid administration. The best thing to do here is have an abdominal ultrasound and collect fluid. If the fluid is blood...there is likely a bleeding tumor. If the fluid is not blood....she may have right sided heart disease (heart worms or other cause), some type of cancerous process somewhere or other chronic metabolic disease. If you are uncertain about your veterinarian, ask for a referral for an ultrasound or seek a second opinion. I hope you find some answers . Thank you for using Petco Pet Education Center, formerly Petcoach.

Hi, thanks for using Petco Pet Education Center, formerly Petcoach! Poor Hope! Causes on increased liver enzymes/pancreatic enzymes are: liver or gall bladder infection, inflammation of the liver, liver shunt (PSS) or microdysplasia, gall bladder mucocele/sludge or obstruction, pancreatitis, cancer of liver, gall bladder or pancreas, steroid or vacuolar hepatopathy from cushings disease. I am glad you have an ultrasound scheduled! Hopefully you will find the answer and get Hope on the road to recovery!

Hi and thanks for using Petco Pet Education Center, formerly Petcoach! Sorry to hear about Kane. Fluid in a body cavity could be blood, body fluid, pus from an infection, lymphatic fluid (chyle). Probably not blood since you said the bloodwork was normal. If bleeding occurred Kane would most likely have a lower than normal red blood cell count. Possible causes include liver disease, heart failure, heart base tumor, low protein levels in the blood secondary to liver disease or protein loss into the intestinal tract or through the kidneys (kidney disease), tumor, pancreatitis, leaking of urine from the urinary system, bile leakage, intestinal perforation (hole in the intestinal tract), foreign body, among a few other causes. Your vet can perform an abdominocentesis (stick a needle into the abdomen) and collect some of the fluid and have it analyzed and cultured if needed. Once a diagnosis is made a treatment plan can be put into place. An echocardiogram of the heart may be needed to evaluate the heart for a problem or tumor. I wish you the best of luck with Kane.

Thanks for using Petco Pet Education Center, formerly Petcoach. First of all, each lab company/machine has its own “normal” ranges so I cannot exactly interpret this. But I will say, compared to the reference ranges I am used to, these are all pretty mild elevations. Unfortunately livers elevations can be mildly or moderately elevated for about a dozen reasons including: gastrointestinal upset, trauma to the liver area, toxin, infection, inflammation, cancer and more. I usually do not put much significance on them or draw any conclusions from them unless I see them trending upward with time or at a very high level. An antibiotic and liver supplement are a great place to start for these non specific signs and mild elevations in my opinion. If that it not improving things, consider an abdominal ultrasound or X-rays. Best wishes to you and Gizmo.