Dog's high liver enzymes, lethargy, drinking: liver disease or pancreatitis?

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!

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, I am sorry to hear about Patches. The blood work that you’ve attached shows that Patches liver enzymes are elevated. There are a variety of causes for elevated liver enzymes including infection, inflammation, old age change, etc. Liver disease can definitely make dogs feel nauseous and have an altered appetite. If Patches is not acting like himself I would recommend having him evaluated by a veterinarian again. Having an abdominal ultrasound performed might be a helpful test as it would allow further evaluation of the liver. I hope this helps, good luck!

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 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.

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!

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.