Raised Liver Enzymes...What Next? | #49
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- Опубліковано 18 гру 2023
- Your dog has had a routine senior blood test or pre-anesthetic screen and the liver enzymes are high. Your dog has no symptoms of liver disease though. They appear completely healthy.
This is a very common situation to find yourself in. But what should your next step be?
What are liver enzymes?
• Changes in different liver enzymes mean different things• ALT and AST are used as a marker of liver damage, although AST is also found in muscle and so can also increase if the muscles are damaged.
• ALKP/ALP and GGT are markers of o problem with the normal flow of bile, a liver waste product. These are also sensitive to diseases outside the liver + non-harmful causes of elevation, as well as also being released from other tissues or in the presence of steroids.
What Causes raised liver enzymes in Dogs
• There are lots of potential causes of raised liver enzymes and screening blood tests are seldom definitive for the exact cause.
• Sometimes increased serum liver enzyme activities occur because the patient does have primary liver disease, but very often they are secondary to disease outside of the liver. And to confound results even more, tissues other than the liver also produce these enzymes.
• The liver plays a major role in the metabolism and excretion of drugs, toxins, and waste products. As a result it is susceptible to injury as a direct result of these or due to diseases in other parts of the body. Common examples include dental disease, hormone abnormalities (such as Cushings disease), intestinal disease, and pancreatic disease.
• Increased liver enzyme activities can occur from benign processes (e.g. hepatic nodular hyperplasia) which is not uncommon in older dogs.
• Diseases of the liver itself are also numerous and can include infections, cancers, immune problems, and inflammatory conditions.
What to do if your dog’s liver tests are high?
• The answer really depends on your dog!
• A mild elevation in liver enzymes can be a sign of many things like dental disease, intestinal disease, general inflammation, as well as liver disease of course. Mild elevation can also be completely normal in an older dog, and this is pretty common. The other blood results may prove a clue, as will your dog's history and physical exam.
• Options include:• Rechecking the blood levels a few weeks later to see if there is any change.
• Treating any other diseases that are known to be present (such as dental disease)
• More testing, such as a blood test called a bile acid stimulation, or imaging with ultrasound (or xrays).
• The liver is a very hard organ to know exactly what is going on and in some cases, when everything points to a problem within the liver itself, a biopsy is needed.
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I remember my veterinarian doing blood work on Arnold and he had elevated liver enzymes. Thanks for the upload Dr Alex.
I remember my veterinarian doing blood work on Arnold and he had elevated liver enzymes. She did the tests for Cushing disease but it was negative..thanks for the upload Dr Alex I appreciate you for your work in helping people with there pets.
elevated liver enzymes can certainly pose a real challenge to get to the bottom of
@@OurPetsHealth I'm dealing with this now. I've had my dog for 8 years now, she is estimated to be around 10 but could be older (probably is). took her to the vet cause she was drinking buckets of water and having accidents. They did a urinalysis (which was fine but very diluted) and bloodwork, the blood work showed elevated ALT and ALKP(the one for bile flow). they had me come back a week later to retest the blood which showed Alt increased. she's now been at the vet daily for the past three days doing a variety of tests and intravenous fluids and antibiotics. Today she seemed more like herself but she is going back tomorrow for more of the same.
A blood test over 5 months ago showed raised liver enzymes.. my dog is 14 years old.. I was given some capsules to help support the liver but my dog is showing no signs at all of any liver problems. How can I support my dog with homeopathy
That's great that there is no sign of any problem. Here are my thoughts on homeopathy - ua-cam.com/video/x3HTUMcbKEw/v-deo.html
One thing that veterinarians are keeping hush about (for some odd reason) is excess copper in commercial dog foods that are slowly killing our dog's livers. This has been known for decades but because the American Veterinary Medical Association is I bed with big dog food corporations, they just keep pet owners in the dark. The trend to natural, raw or gently cooked foods either homemade or commercial from reputable companies can also be a problem if they add a lot of bovine or lamb liver to their formulations (ungulate liver contains a lot of endogenous copper so it is not a good idea for a dog to eat these high copper foods daily if at all). Some of these fresh food companies add a lot of ungulate liver and then on top of that indiscriminately dump in a mineral premix with more copper. The result is a food with 5 to 11 fold above the AAFCO minimum for copper. No data for what is an ideal level of copper in a natural form on a daily basis so we have to guess. We do know that the European federation of feed controls has decided that a safe upper limit for dog food is 28 milligrams per kilogram dry matter. For comparison, the AAFCO minimum is 7.3 milligrams per kilogram of dry matter. So, probably shooting for around 10 to 14 milligrams per kilogram DM is a guesstimate for an optimal value. These values are themselves estimates but better to have some guidelines than none.
US companies that use human grade ingredients and no toxic byproducts AND who also publish their full nutrient, batch test average values include Evermore, Raised Right, Bixbis, and Steve's Real Food for dogs. I have only listed these four companies because they do not dump in supplemental copper to their formulas. The values for copper for the first three companies, for all their formulas including Beef and Lamb fall within a safe range of copper in my opinion BUT, The Beef and "Lamu" Steve's varieties have an average of 48 and 80 mgs/kg respectively and so in my opinion are not safe to feed-- Maybe in rotation with very low copper varieties or diluted with plain meat but no warning on the label.
My Sharpeiboxer has high ALP 1040, ALT 317 , she is eating ok, she has gained weight, she is deep breathing , she eats alot I noticed her abdomen is swollen but maybe she is fat sincce she gained like 20 pounds. My vete send her Demarian I am giving it to her, also milk thrisstle. Any ideas please?
Hey Aldo, how is your dog doing now? My dog also gained weight and turns out she’s bleeding internally
Denamarin contains the active ingredient in Milk Thistle which is Silimarin so maybe better to just give the Denamarin as prescribed. Make sure your dog is not eating a high copper food for good measure.