My dog's ALT is high. Is that normal and what should I do about it?

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!

Thanks for using Petco Pet Education Center, formerly Petcoach! That basically means that whatever process is affecting the liver such as hepatitis appears to be improving. Under general normal ranges, an ALT of 150 is just slightly increased which is not necessarily significant in dogs. It would be recommended to continue to monitor to see if that value normalizes. If it does not, it would be a good idea to work it up further with an abdominal ultrasound. Good luck and have a great day!

ALT is one of the most important liver indicators in dogs and cats. It can also be elevated in dogs and cats when there is significant damage to the muscle, but in general it is thought of as a fairly sensitive marker for some type of liver damage. There are also several other markers for liver disease, so only knowing about the elevations in ALT may be misleading. If ALT was the only marker elevated, this is usually an indication of an inflammatory or infectious disease causing harm to the hepatic system. If you would like to discuss all of the laboratory testing and diagnostic imaging performed by your veterinarian, I would be able to take a closer look at your dog's situation. Let me know if I, or one of the other experts, can help you out in any way.

ALT and GGT are both liver enzymes, so usually if they are elevated this would mean that Ginger may have a liver problem of some kind. These values can be elevated in dogs with hepatitis, gallbladder problems, or a tumor in the liver - but if the elevations are fairly mild, they can also be due to normal age-related changes in the liver, in which case there would be no reason to worry. For me personally, in an older pet that is otherwise healthy and does not have any symptoms of a problem, I often recommend repeating blood work in four weeks before doing anything else - liver values can fluctuate quite a bit, and often they are back to normal at the recheck appointment so we don't worry. If they are still elevated after four weeks, then at that point I would usually recommend abdominal x-rays and ultrasound to check for any problems. This is something that you can discuss with your vet if you're concerned, or get a second opinion if needed.

Hello. I am sorry to hear about Iako. ALT and AST can become VERY elevated so the values that you have listed are elevated, but only mildly/moderately so. The AST is mildly elevated. These enzymes need to be >2x for us to even look at them. ALP is usually elevated if the liver is irritated or 'upset'. This can also go up with exogenous steroid administration (which you likely got with the Addison's disease) so it depends on when these bloods were taken in relation to his diagnosis. Dehydration (which often occurs with an Addisonian crisis) or hypotension (also occurs) can make these values elevated. They are sensitive. I would recommend just getting the medications under control for the hypothyroidism and the Addisons, and rechecking the liver values 2 weeks after everything has settled down a bit. Good luck with Iako. The alternative is getting a liver biopsy, however I would just monitor and recheck the liver values first. I am not too concerned with these values.

Hello, thank you for using Petco Pet Education Center, formerly Petcoach. If Sancho's liver values are elevated due to the ingestion of some foreign material, be it a plant or other toxin, & he is eating with no vomiting or diarrhea, your veterinarian may be taking a wait & watch approach. Usually, we will administer emetics ( to induce vomiting ) & an intestinal absorbant such as charcoal if this was an acute issue. But often we do not see these elevations for hours to days after an insult to the liver has occurred. If Sancho is well, rechecking the values in several weeks is prudent. The values may change by this time. If not, we need to see if this is a chronic issue with the liver, or possibly even the gall bladder. Medications may be need ed at this time, including some neutraceuticals such as Sam-e and milk thistle. It is important that you stay in close contact with Sancho's veterinarian for any recommendations. Take care.

Thanks for using Petco Pet Education Center, formerly Petcoach! Yes, it is absolutely ok to go forward with anesthesia. A high ALT should be monitored and if persistent should be worked up to try to find out the cause. Sometimes a high ALT can be transient in which case it may resolve on its own. Other possible reasons include hepatitis, an infection, among other reasons. That number is not that high so monitoring would be appropriate. They could extend the panel to look for liver function tests to make sure that the liver is working completely fine just to be extra cautious. This would entail measuring bile acids. Good luck!