# So worried, very elevated ALT level



## C's Mom (Dec 7, 2009)

Susan,

I don't know a thing about the medical stuff but I do remember your post about Maggie biting at the doggie daycare. I'm hoping someone will hop in here soon and help you out but in the meantime I wanted you to know that I am keeping you and Maggie in my thoughts.


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## slowe216 (Sep 1, 2008)

Thank you!
Our vet seems perplexed but is leaning toward hepatitis


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## Pointgold (Jun 6, 2007)

Has she been on any meds like Rimadyl or other nsaids? Or, any supplements?


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## Pointgold (Jun 6, 2007)

Another meds question - has she been on any thryoid medication? 
How about having eaten something high protein/high fat? Mild pancreatits can elevate the ALT, as can a reaction to thryoxine/soloxine...


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## slowe216 (Sep 1, 2008)

No medicines.

She hasn't eaten anything unusual although I occasionally give her cheese.....
I will stop that.


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## turtle66 (Feb 19, 2010)

That's a nice summary I found:

_ALT (alanine aminotransferase) or SGPT (serum glutamic pyruvic transaminase) is a liver specific enzyme, secreted when localized liver cells die due to an infection or interruption of blood supply. Under abnormal conditions, the serum levels may go up by four to five times the normal level, and can cause non-hepatic disorders like inflammation of the gastrointestinal tract, hemolytic anemia, and heart failure. A dog undergoing treatment with anticonvulsants and glucosteroids can show this significant increase in the ATL levels. Similarly, AST (aspartate aminotransferase) or SGOT (serum glutamic oxaloacetic transaminase) is another liver enzyme which is detected in muscle tissue and red blood cells. An increase in levels of AST can also cause liver disorders more severe than ALT. Elevated liver enzymes like GGT (gamma-glutamyl transpeptidase) and SAP (serum alkaline phosphatase) can signify liver disease due to obstruction of bile ducts.

Causes of Elevated Liver Enzymes in Dogs

The following are some of the most common causes of elevated liver enzymes in dogs:
Jaundice: Jaundice, being one of the cause, usually occurs when the liver is incapable of removing bilirubin, a waste product generated from the break down of hemoglobin. It gets accumulated and causes a yellow color formation around the whites of the dog eyes or the pale areas of the gums.
Pancreatitis: Pancreatitis, or blockage in the bile duct, causes raised levels of the GGT enzyme in the liver, which gets concentrated in the kidneys and pancreas.
Cushing's Disease: Cushing's disease causes excessive generation of adrenal hormones, specifically corticosteroids. As a result, there is an increase in alkaline phosphatase in the liver which imbalances the salt levels.
Infectious Hepatitis: Infectious herpes gets transferred from one dog to another through contact or ingestion. Along with herpes, the parasites may attack the liver and increase the number of liver enzymes in order to remove the assailants.
Metabolic Diseases: Metabolic diseases like cobber accumulation, deposition of fat in the liver due to obesity, diabetes, and hypothyroidism in dogs can also lead to elevated liver enzymes in dogs.
Medications: Medicines like corticosteroids or epilepsy medicine can also raise the enzyme levels in the liver.
Other Factors: Congenital diseases like hepatic shunts, congestive heart attacks, liver cancer etc. are some other causes for elevated liver enzymes in dogs._

I am not a vet and just a human physician and I know that high elevated ALT levels are unspecific and I totally agree with you to wait another week before you do more invasive tests/ blood tests.
If there is a severe liver disease Maggie would also have jaundice!! (and other symptoms). And since she is acting normal we can almost rule out heart failure.
Hepatitis, meds like high doses of acetaminophen (=Tylenol) and all the other reasons mentioned above could cause a high ALT level.
As a human you can also have a high ALT level after 2 weeks of moderate wine consumption in Italy. I know, that doesn't help either - but it might tell you how unspecific this one test is...

Let's hope for the best and a big hug to Maggie,

Heike


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## hotel4dogs (Sep 29, 2008)

Unfortunately, I've had a lot of experience with elevated liver enzymes...
First, do NOT start her on any supplements until you determine the cause of the elevated enzyme!!! You don't want to do anything that will make it harder to diagnose the problem.
Has Maggie had a vaccination for contagious hepatitis in dogs? That's the first thing that would occur to me based on the bite.
I assume all other enzymes are normal? 
An elevated ALT in the absence of other elevated enzymes often indicates a problem somewhere in the gastrointestinal tract. Is she having any gastro symptoms?
Has her white count been checked? If it's also high, I'd highly suspect an active infection.


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## fostermom (Sep 6, 2007)

hotel4dogs said:


> Unfortunately, I've had a lot of experience with elevated liver enzymes...
> First, do NOT start her on any supplements until you determine the cause of the elevated enzyme!!! You don't want to do anything that will make it harder to diagnose the problem.
> Has Maggie had a vaccination for contagious hepatitis in dogs? That's the first thing that would occur to me based on the bite.
> I assume all other enzymes are normal?
> ...


I think the vet has told her to start the supplements. I feel that unless she consults with another vet who says to NOT start the supplements that she should not ignore her own vet's advice.


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## hotel4dogs (Sep 29, 2008)

yes, when I reread her original post I saw that the vet had suggested it. And honestly, I'd be getting a second opinion in that case. 
treating symptoms, and not causes, in a dog that young would scare me.


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## Ljilly28 (Jan 22, 2008)

Has she been exposed to any ticks?


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## slowe216 (Sep 1, 2008)

No ticks - they aren't very prevalent in CO.

She seems to be eating and eliminating normally. In the past though, she's had gastroenteritis several times.
I'm going to go check her vaccine list.

I don't want to ignore my vet but I think I'll also call my vet friend in OH and ask her opinion.


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## BeauShel (May 20, 2007)

It would not hurt to have a second opinion on what could be causing the high ALT levels. If it will put your mind at ease. I would want to find out what is causing it before giving suppliments.


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## Kevin's Goldens (May 22, 2008)

Hi, how is your pup doing? You are on the right track with the milk t. What worked well for my girl was Aloe Vera Gel. Jazz was about 30 pounds and we gave her a cap full a day. She lived to be 20. Her ALT was very high due to her epilepsy meds. we had to stp them back in 2005 and take the natural route.


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## Karen519 (Aug 21, 2006)

*Maggie*

Praying for Maggie.
Did you try googling elevated ALT in dogs?
http://www.petplace.com/dogs/understanding-blood-work-the-biochemical-profile-for-dogs-2/page1.aspx


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## turtle66 (Feb 19, 2010)

I totally agree with hotel4dogs!
Are there any new test results?

Big hugs to Maggie!
Heike


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## slowe216 (Sep 1, 2008)

Hey quick update.

I'm giving her milk thistle and this week her levels were back down to 279 (from almost 600). She is also MUCH perkier 

I will take her in this Thursday for another redraw. Thanks so much for checking.

I'm not sure what she had going on but all in all there must have been something because her energy was lower when I first started posting.


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## BeauShel (May 20, 2007)

Glad that her levels are better. Hopefully she is going to be ok.


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## turtle66 (Feb 19, 2010)

Good news - thanks for the update and another big hug to Maggie.

Heike


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## Kevin's Goldens (May 22, 2008)

Great news! Keep her on the milk thistle.


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## Debles (Sep 6, 2007)

So glad to hear her levels are down!


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## slowe216 (Sep 1, 2008)

**** it - they are going back up.

Next step is liver ultrasound. She seems okay but I had a hunch they were back up, she has just been slightly more tired (although nothing I'd worry about if I didn't know about the ALT levels).


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## hotel4dogs (Sep 29, 2008)

I'm sorry to hear that they're back up, I know it's such a worry.
Before you do the ultrasound, have them do a clotting blood test (most will insist on it anyway) which takes about a week to get the results back.
Be prepared to answer the question of whether or not you want a needle guided biopsy. You should discuss it with your vet before the ultrasound, but generally the answer is yes. Just something for you to be aware of before you go in for the ultrasound that the needle biopsy is pretty standard procedure.


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## turtle66 (Feb 19, 2010)

I am so sorry to hear that - all good thoughts to Maggie and you!

Heike

I agree totally with hotel4dogs esp on the the no liver needle biopsy without clotting test. Even though liver needle biopsy is pretty standard - bleeding is a risk...


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## AmberSunrise (Apr 1, 2009)

Also, please consider having Lepto panel done .. I had a dog come back as positive for Lepto when liver enzymes were elevated - antibiotics were prescibed. This dog was in the words of his vet 'well vaccinated' but the vaccine does not cover all the variants.


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## slowe216 (Sep 1, 2008)

Interesting about the vaccinations. I was wondering about that.

She should be having the tests done this week and I'll keep you posted.
The good news is, she is acting a okay (except she had some mild diarrhea one day).

Thanks again.


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## turtle66 (Feb 19, 2010)

How is it going? Has Maggie had any other tests?

Another big hug to Maggie and all good thoughts,

Heike


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## msc (Nov 3, 2008)

Elevated ALT 342 in our golden today.


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## cgriffin (Nov 30, 2011)

To the original OP:
My lab mix had elevated liver values, one went back down to normal with the Denamarin, his ALT is still slightly elevated. My vet said if his ALT goes up, a test for Cushing's disease would be in order. So far, I have not had to do that test.
So, did your vet say anyhing about Cushing's disease being a possibility?


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## Karen519 (Aug 21, 2006)

*MSC and CGRIFFIN*

MSC AND CGRIFFIN

Looks like slowe has not posted since 2010.
Praying Maggie is alright!


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## cgriffin (Nov 30, 2011)

Thanks, Karen!
Lol, I should have looked at the date.  :doh:


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## Penny & Maggie's Mom (Oct 4, 2007)

msc said:


> Elevated ALT 342 in our golden today.


 
I hope you'll start a new thread. Since this one is so old, I think your post may get buried. With a new thread you are more likely to get responses from people who have knowledge/ experience. I hope your golden finds this is only a temporary blip and that they come down quickly.


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