Why is my beagle puppy not eating, limping, with high liver enzymes?

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!

This sounds very peculiar especially in such a young pup. I would be worried that he has a fever, and it would be important to check. If so, I would be suspicious of polyarthritis due to sepsis, lyme disease or other tick born diseases. Common conditions I see in young pups are pancreatitis, gastrointestinal parasites, and gastroenteritis. A good physical exam would be helpful. A painful abdomen, a positive fecal exam etc would help to narrow down what is going on.

The bilirubin is a bit high, as is the ALP (alkaline phosphatase) but neither of these values is super specific in terms of what the cause or the best treatment is. We can see the ALP be elevated with stress, age, and sometimes even normal cell regeneration within the liver. The bilirubin can be slightly elevated when the blood sample is what we call "hemolyzed," which can sometimes happen when blood is spun down for a blood test to be run. Therefore, if he is still showing symptoms of illness, I would echo what Dr Ana said; it may be time to consider imaging. Either X-rays or an abdominal ultrasound maybe helpful in identifying the problem and therefore identifying the best way to treat it. Take him back to the vet if he's still having troubles, as he probably is in need of some more fluids as well. Thank you for asking Petco Pet Education Center, formerly Petcoach, I hope he's feeling better.

Hello, sorry to hear about your dog. Its likely that his liver disease needs to be further evaluated to rule out the need for antibiotics or steroids and ensure that his liver disease is not secondary to inflammation in another organ such as his pancreas. I would recommend speaking with your veterinarian about obtaining further information with an abdominal ultrasound and recheck bloodwork. It may be necessary for your dog to obtain more aggressive medical management with hospitalization. Hope this helps and best of luck.

Thanks for using Petco Pet Education Center, formerly Petcoach! Loss of appetite and vomiting can be observed with many conditions such as gastroenteritis, dietary indiscretion, kidney disease, pancreatitis, among many other possibilities. Lameness can be due to discomfort possibly due to arthritis or something else. This may be related or perhaps may be unrelated and another issue. Lyme disease is a possibility though this is not very common. I recommend that you have Jakey evaluated by your veterinarian for further assessment and treatment. They would be able to check for these possibilities and others depending on the findings on exam. Treatment would be based on findings. Good luck and have a great day! Hoping for a speedy recovery!

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!