My senior Shih Tzu's GGT is high, ALP normal. Is it cholestasis?

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.

This may be due to a congenital disorder (liver shunt) but ideally the ALT should be interpreted considering the reference ranges given by the lab. More tests should be ideally discussed (test of liver functionality like bile acids or ammonia or bile acids stimulation tests) in order to identify specifically the problem and give you a specific answer. If you have them, please write to us again or request a consultation and upload all the results of the tests available. Please do not hesitate to contact us again on the forum or by requesting a consultation if you have any more questions or to discuss it any further.

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.

I'm sorry to hear about Chi Chi's recent issues. Vomiting and an anal gland abscess/rupture may cause some changes on the blood panel, but not typically ALP. When you have a significantly elevated ALP and normal ALT it is highly suggestive of Cushing's disease. Cushing's can be diagnosed with a few different tests, these tests involve taking blood, injecting a substance then taking blood again to see the body's ability to respond. I think it would be wise to have her checked. If she dies have Cushing's thankfully it is treatable with medication but this will be for life.

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!

Thank you for submitting your question regarding Luna. This value is a liver enzyme. It can be elevated due to liver disease or a skeletal muscle problem. Liver disease in young puppies can be congenital disorder such as a portosystemic shunt or secondary to an infection. When I have a result such as this, I will recheck blood work in a week. If the value is still elevated, then I will run a separate blood test known as a bile acids panel. This is a liver function test. The elevation could due to something as simple as her shaking during the blood draw (skeletal muscle), but you want to ensure she is not experiencing any disease. I hope this information helps!