My dog's liver results are high. What does this mean and what's next?

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!

Excellent question! It sounds like Bear may have some elevated liver enzymes, and if he is not showing signs of illness, your vet is likely just recommending a supplement that can help support the liver and in some cases bring the enzymes down to normal/ closer to normal . See the link below for more information on liver enzymes: https://www.vin.com/veterinarypartner/default.aspx?pid=19239&id=4952533 It may be long term, or if the liver enzymes stabilize, your vet may decide that Bear does not need the supplement anymore. This usually involves rechecking the bloodwork at intervals to see if the enzymes are increasing or decreasing

Hello, and thanks for using Petco Pet Education Center, formerly Petcoach. When you get Rocky I would have your own primary vet repeat the bloodwork to get an updated baseline, and because the units measured and normal range can differ from one lab machine to another. If decreased liver function is suspected, you should plan to run a fasted bile acids (liver function blood test). The next diagnostic step would then likely be an ultrasound with a liver biopsy, if your vet thinks that’s necessary. Of course, I would defer to the vet who’s actually examining the dog, as there may be clues in the exam to justify going a different direction with diagnostics. But this is what I’d be anticipating. Hope this helps.

There are many different causes that would include hepatitis (which can be bacterial or sterile), cancer, or an issue with his gallgladder. The next step I would recommend is an abdominal ultrasound with fine needle aspirate (FNA) to try to get some information about what is going on in the liver, and possibly a biopsy of the liver after that. The other courses of action is to try treating him to various medications to see if anything helps -- however this doesn't really make sense if he has no signs of illness. Or finally, doing nothing and checking again in 2 months to see if they are rising or staying the same. Sometimes we decide not to get to the bottom of something when there are no clinical signs.

Hello and thank you for contacting Petco Pet Education Center, formerly Petcoach. The blood results show that Finn definitely has some problems with the liver. Some of the liver enzymes and bilirubin are mildly elevated, which is never normal. What is more, ALP and GGT results could not be determined. It means that there was a machine fault when measuring these parameters, or these values were too high for the machine to read. I would suggest to run bile acid stimulation test, ultrasound scan of the liver and repeat the blood test that was run at your vets on the 7/15/20. You may consider running ACTH stimulation test to check for Cushing's disease, but it is unlikely that Finn has this problem. Based on these results, it can be decided what to do next.

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!

I would strongly recommend to have his bile acids ran to see if his liver is functioning properly. I would also recommend to have an abdominal ultrasound with possibly liver biopsies by an experience ultrasonographer or radiologist so you can find out more information about his liver. This could be due to a toxin that you are unaware of, copper storage disease, cancer, a bacterial infection or something else. I think more diagnostics need to be done to determine the cause and therefore the best treatment for him. I hope this helps!