Why is my young Chihuahua acting odd with high ALT liver enzymes?

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!

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!

Further testing including abdominal ultrasound are appropriate at this point. If this testing was or will be done, the results of a fine needle aspirate of the liver will help direct the course of treatment. If you have further questions, please feel free to request a consult with an expert where more questions can be asked and diagnostic data can be provided.

There is really very little sense in speculating. Even a positive bile acid test will not definitively diagnose a portosystemic shunt. Only advanced imaging techniques can capture this condition. Alkaline phosphatase is an enzyme that is sometime utilized to support diagnoses of the liver and bile duct system. However, alone the number doesn't tell us much particularly in a young and from what it sounds like otherwise healthy puppy. The elevation you mentioned is also very mild, and we frequently see elevations in this enzyme in young growing animals. Just as it is found in the liver, it is also found in the bones which is why it is elevated during the time that pups are getting larger. I obviously don't know the whole situation and there is always the possibility your dog could have a shunt. However, so far you have given me no reason to suspect a serious problem. Please feel from to obtain a consult if you want to discuss the case in any greater detail.

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.

Hello, & thank you for using Petco Pet Education Center, formerly Petcoach. ALT is an enzyme that is released when liver cells are damaged. The normal values are usually less than 100. Unfortunately, the presence of the enzyme does not indicate the cause or reversibility of the damage, nor does it tell us if this is recent, but temporary damage, or on-going problems with the liver. Toxins, including plants, medications, such as steroids, viruses, & endocrine diseases can all cause increases in ALT. If Kobee is not having any problems, then I would recommend retesting in 6 weeks. If Kobee is sick, there are many more diagnostic tests that can be conducted to try & get to the cause of the problem. Often, we actually never find this out, & dogs do very, very well with moderately elevated values. We actually do not even get concerned until the values are at least 3xs normal, or there are other parameters that are abnormal. If Kobee is well, then all I might recommend is discussing with your vet about putting him on a neutroceutical called Denamarin. It can help with oxidative changes in the liver. I hope he does well. Take care.

I would be interested to see what all of these lab results were as it would certainly let me be more helpful, but the liver elevations could be chirossis, hepatitis, or even neoplasia. In the meantime I would start her on Denamarin if she is not already on it, and keep at it with fluid therapy. She may be a good candidate for an exploratory surgery. If you would like, a consult may be a great way for us to go over all of this in depth, and let me collect some more info on her so that I can be more helpful.