My Bichon won't eat, has high ALT. How can I help his liver?

Poor Baby! I would make sure you have him on a liver supplement and make sure you have consulted with your vet about medications that he needs to be on for his liver issues. I am okay with him eating chicken because eating something is better than nothing at all. I would consider adding in a multi-vitamin to help supplement the other nutrients he isn't getting. If his appetite is continuing to decrease, I would talk to your vet about rechecking his bloodwork to see if he needs any fluids or change in his medications and also getting him on an appetite stimulant. I hope this helps and he starts to feel better soon!

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!

This may be due to a congenital disorder (liver shunt) but ideally the ALT should be interpreted considering the reference ranges given by the lab. More tests should be ideally discussed (test of liver functionality like bile acids or ammonia or bile acids stimulation tests) in order to identify specifically the problem and give you a specific answer. If you have them, please write to us again or request a consultation and upload all the results of the tests available. Please do not hesitate to contact us again on the forum or by requesting a consultation if you have any more questions or to discuss it any further.

My best recommendation to supplement liver function is a supplement called Denamarin. It contains several of the known ingredients we historically used to support liver health all in one supplement. Very often, I observe my patients Liver enzymes decreasing dramatically on this supplement.

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 and welcome to Petco Pet Education Center, formerly Petcoach. Hepatitis (infection and inflammation of liver) is a very serious condition and is very hard to treat. If there is an internal medicine specialist in the area I would recommend having Nala seen by them. Otherwise I would be talking with your vet about testing for infectious diseases. However, it looks like they have treated her with broad spectrum antibiotics as well as IV fluids. I would recommend continuing treatment. She may need a feeding tube placed to try to keep her protein up during this illness. Unfortunately, with how severe this is, she may or may not pull through it, but the best chance of her making it through is to be aggressive with her treatment. I would suggest continuing to monitor her liver and white cell count, and to have imaging done and possible samples of her liver to try to determine the cause of the infection. Otherwise I would be talking to your vet about the parasites and infections present in your area and get covered with certain antibiotics. The white cells have increased however not that much, and the liver enzymes are actually improving if I can read the dates right from your picture. This is very hopeful. I would continue with antibiotics (IV if you cannot get them in orally), as well as IV fluids and I would think about syringe feeding or placing a feeding tube. Best of luck with Nala, I hope she makes a good 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!