My dog's liver enzymes (ALT/GGT) are high. What should I do?

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, & 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.

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, I am sorry to hear about Ginger. Based on the recheck liver values I would be concerned that Ginger has a problem in her biliary system, such as a GB mucocele or potentially a biliary duct obstruction. I would recommend rechecking the ultrasound to look for either of these developments. One thing that is interesting is that the other values are improving. Did your vet have any concerns about the blood sample when he ran/submitted the bloodwork. If there is a large amount of hemolysis (or breakdown of red blood cells) secondary to a traumatic blood draw or mishandling of the blood tube, this can lead to a false elevation of bilirubin. Although this value seems quite high to be due solely to sample error, I wonder if it may be contributing somewhat. If Ginger has a repeat ultrasound it might also be wise to recheck her total bilirubin level. Hope this helps, good luck!

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!

This is not a particularly high ALT, I usually don't get too concerned until the liver values are twice the high end of the range. This does not seem like a toxic dose of ibuprofen or paracetamol for a dog Ginger's size if only 2.5 ml of the liquid was ingested. If he still seems restless or you have more questions about his lab results you may want to check in with his veterinarian.

Since young dogs are still growing it is always possible for liver values to be elevated. The AST and ALP can normally be elevated in younger dogs. I would not be concerned unless Bruno is acting ill. If he has any vomiting, diarrhea or anorexia I would recommend taking him to the vet for an exam