My dog's liver enzymes were slightly high as a puppy. Do I retest?

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

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!

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!

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.

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.

These elevations are mild and not specific at this stage, especially if all the other findings at the physical examination are normal. I would recommend to follow the suggestions your local vet gave and repeat the blood tests in 2 weeks time to compare results.

She is a puppy. An elevated ALP is normal in puppies. ALP can go up because of liver problems, but also increases during bone growth. I see this elevation in about 80% of puppy bloodwork. I do not treat this as it it is not a problem and the value becomes normal when they stop growing. If there are other liver values elevated, then I am concerned, but ALP alone is not generally a problem. Per IDEXX, one of the largest veterinary pathology services in the United States, ALP values in puppies can be elevated 4 times normal (which is about where Luna is.) Denamarin, Vitamin B, and a low-carb diet will not hurt Luna, but they probably won’t change the ALP either. Best wishes to you and Luna.