My Maltese has high liver enzymes but acts normal. What could it be?

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 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.

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.

Thank you for using Petco Pet Education Center, formerly Petcoach! Abnormal liver enzymes typically indicate a more acute injury, and can actually return to normal as conditions become more chronic. Fluid build up can be due to low proteins in the blood, which are not being made by the liver or lost through the intestines or kidney. I hope this helps and am happy to answer any other questions you may have, or take a look at any results you have from Kimi.

Hi there! I'm so sorry to hear about Call being sick. From the blood values you've given me, I think the best case scenario for Call would be a gall bladder problem, such as a mucocoele (a soft "gallstone") or infection. The gall bladder can be fully surgically removed in these cases and the liver enzymes may be able to return to normal after recovery. Unfortunately, it may also be a sign of liver cancer, the most common being hepatocellular carcinoma. When the vet does his ultrasound, they will be able to tell you about what both the liver and gallbladder look like and hopefully it will give a clear answer as to what's going on. I hope this helps answer your question. I wish you the best of luck and I'll keep Call in my thoughts!

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.

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.