Elevated ALT at 168 but no other issues...

[Dayswalters]

I took Bonnie for her pre-spay lab work today and they found her ALT level was 168. All of her other blood work was perfect but the doctor says that she won't do the spay until her ALT level drops. This is fine with me but Im concerned for Bonnie's health. The vet says that because she is in good health and all other tests were normal, it is most likely she was exposed to a toxin such as a pesticide. She gave Bonnie medication to help her liver filter toxins and rescheduled a new round of blood work on May 16th. If her levels are still elevated at that time, we will run more tests but the vet says she thinks Bonnie will be fine. I was just wondering if anyone has input or suggestions?

[Lilah Charm]

Lilah went in for her yearly blood work early last winter and had very high liver enzyme elevation- I practicly had a melt down, we were reading up on the hepatic diet, we were already aware of the liver shunt prevelance within the breed, reading everything we could about liver shunt surgery or low liver function lifestyles, we were on a thirty day adenasol prescription (which made lilah puke and she had never been a puker before) and I was scanning her whole life, trying to see where I missed the red flag.

While considering my options I took lilah to more than one vet, I couldn't think of anything toxic she could have gotten into (though later an old photograph caused me to suspect possible geranium poisoning from a leaf falling into her water maybe). After some lengthy investigation and get conversation it seemed as though if lilah had a liver shunt it wasn't the puppy death kind but the low protein lifetime maintenance kind, we took our prescription and I kept my eyes out for any potential symptoms and we played the waiting game.

In February we went in for our bloodwork again....Lilahs liver enzymes were within normal limits!!! I hope the best for your Bonnie. I would just say to read everything you can about liver dysfunction in yorkshire terriers (there is plenty to look up on this website) and prepare yourself for whatever outcome you have, keep your eyes out for symptomatic behaviors and pay close attention so you have good information to work with your vet

[107barney]

I wouldn't jump the gun yet. See what happens on the repeat labs. If they're still elevated, consider a bile acids test.

[Dayswalters]

I have read quite a bit...which is why I am concerned. We did blood tests when she was younger and they were fine. She has never had vomiting, diarrhea, or lethargy. She has gained weight and grown normally. The only time she has been sick was from the Bordatella vaccine. I am debating having the bile acid tests run now versus waiting a month but the vet said she doesn't think we need to do that yet. She says with liver shunts there are usually multiple values that are elevated rather than just the one and that there are usually other symptoms as well. I'm hoping she's right but preparing for her to be wrong.

[Dayswalters]

Originally Posted by 107barney

I wouldn't jump the gun yet. See what happens on the repeat labs. If they're still elevated, consider a bile acids test.

Thanks...that's exactly what the vet said😊 and that I'm stressing over it too much at this point. I can't help it...she's my baby.

[ladyjane]

I have had pups with ALT in the thousands. Of course at that level there really IS something going on, but they were treated and were fine after. I would not really get too worried over one test with 168. As 107Barney said, just wait to see what the next one shows. ALT can go up and back down quickly.

[Lilah Charm]

Originally Posted by Dayswalters

I have read quite a bit...which is why I am concerned. We did blood tests when she was younger and they were fine. She has never had vomiting, diarrhea, or lethargy. She has gained weight and grown normally. The only time she has been sick was from the Bordatella vaccine. I am debating having the bile acid tests run now versus waiting a month but the vet said she doesn't think we need to do that yet. She says with liver shunts there are usually multiple values that are elevated rather than just the one and that there are usually other symptoms as well. I'm hoping she's right but preparing for her to be wrong.

Lilah was the same way- had always presented as fine, previous blood work had been normal. I had assumed (from my reading) that a bile acid test would be the next step but my vet didn't seem to think that would be very diagnostic since she was past puppyhood?... Both vets I talked to felt the best option would be a liver biopsy but of course that's a surgical issue. Lilahs were close to six hundred! I know how nervous you are but my fingers are crossed for you and little Bonnie time for the waiting game!

[ladyjane]

I can tell you that it does not really matter if there are alterations in blood work or not. They can still present with liver shunts. I have had many pups with elevated ALT and not one of them had a liver shunt! My Teddy Bear in 7 years never had any alterations in his yearly blood work but ended up with a liver shunt at the age of 8. Age approximate since he was adopted.

[Dayswalters]

I guess it's just wait and see...she is perfectly fine in everything else so hopefully it's something simple.

[ladyjane]

Originally Posted by Dayswalters

I guess it's just wait and see...she is perfectly fine in everything else so hopefully it's something simple.

My guess is that it will be....at least I hope so. But, yes, best to wait. Try not to do too much worrying about it (I know how hard that is) because usually the things we fear the most never happen.

Prayers for you and your baby. Please let us know how it goes.

[Dayswalters]

I was wondering about pet insurance now that she has had this test, would it keep her from being covered by pet insurance. I was planning to change companies in Nov. when her current contract ends because I found a company I like better. If I switch her over, and she later develops liver related concerns, would this 1 ALT test keep her from being covered?

[ladyjane]

Originally Posted by Dayswalters

I was wondering about pet insurance now that she has had this test, would it keep her from being covered by pet insurance. I was planning to change companies in Nov. when her current contract ends because I found a company I like better. If I switch her over, and she later develops liver related concerns, would this 1 ALT test keep her from being covered?

It should not be a problem. ALT can be elevated for many different reasons and is not a diagnosis/pre existing condition.
Of course, you can always call the insurance company you are thinking about using for clarification..

[dottiesyrky]

Sorry you are having stress over the ALT reading, but pray it will soon return to normal.
I don't know how long you have had insurance for her, but if anything should occur with her now it would be covered. Changing insurance could have two issues. 1. Most insurance companies increase premiums with age and 2. A new insurance could involve preexisting problems. I know when I rescued by boy and insured him straight away, I took him to a vaccination clinic for his rabies and when they examined him they noted he needed a dental. Ok, that is no big deal for a rescue. I did have the dental and all was well. However the policy said I could not be covered for any dental related thing because of that initial exam!!
So one has to be careful of such innocent vet reports when signing up for insurance or they will use any excuse to deny payment!!

[Dayswalters]

I went ahead and added Healthy Paws Insurance now. I know that I will be paying for 2 insurances for a few months but Im hoping that if it turns out that Bonnie has any issues that they will be covered because ALL of her previous vet visits were great. The only thing out of the ordinary was this one blood test which the doc said could be a result of toxins. If it turns out that they won't cover her, I can cancel with only a small penalty.

[dottiesyrky]

Good thinking It is worth the extra expense as you will have all bases covered.
I have heard Healthy Paws is very good insurance. Praying Bonnie will be fine after the next check up, but I am sure she will.