My dog has high liver enzymes and an enlarged liver. Should I worry?

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!

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.

Hello, and thanks for your question on Petco Pet Education Center, formerly Petcoach. I would classify those liver elevations as mild to moderately elevated. Liver values can be quite fluctuant - those elevations are somewhat nonspecific and simply indicate that there is higher liver cell turnover than what would typically be normal. This can be due to anything inflammatory, infectious, cancerous, or otherwise disturbing to the liver. A blood test alone cannot usually say exactly why the liver values are elevated - to have more information, a liver function test such as bile acids could be run, or the liver could be evaluated via ultrasound to make sure it still has normal architectural appearance. If these results are 8 months old, then the best next step would simply be to repeat a liver panel of bloodwork, and see if those values have remained elevated. It's very possible they may have normalized by now; if they haven't, your vet can discuss the best next step with Bear's other history and exam findings. If the values are still elevated but you choose not to pursue further diagnostic testing, there are liver protective medications that your vet may recommend to help protect the liver from oxidative damage. Hope this helps!

Hi, thanks for using Petco Pet Education Center, formerly Petcoach! Poor Hope! Causes on increased liver enzymes/pancreatic enzymes are: liver or gall bladder infection, inflammation of the liver, liver shunt (PSS) or microdysplasia, gall bladder mucocele/sludge or obstruction, pancreatitis, cancer of liver, gall bladder or pancreas, steroid or vacuolar hepatopathy from cushings disease. I am glad you have an ultrasound scheduled! Hopefully you will find the answer and get Hope on the road to recovery!

Hello and thank you for your interesting question. The first thing I would do is schedule another blood work up appointment to look at the liver enzymes in about two weeks after the first sample was taken. If the liver enzymes, specifically ALT, are still elevated, then there is some evidence that there’s been hepatocellular or liver disease or damage. I understand the veterinarian not wanting to test for Cushing’s disease, especially with the age and the lack of symptoms. But if the enzymes are still elevated, I would ask the vet if it would be worthwhile to start a liver protectant daily medication such as Denamarin. This medication given daily could potential he slow the damage to the liver cells and you may never exhibit clinical signs for the remainder of life and this medication has very little side effects. The other thing that you could possibly do if the liver enzymes are elevated used to start a liver protectant diet which is usually a prescription diet that is dispensed that your veterinary clinic. Again, these are two fairly easy, noninvasive ways to protect your pets liver from whatever is causing the cellular damage. I hope I’ve given you some information that helps. Have a great day.

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.

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.