[Scoobstersmom]

Hi. I am new to your site and joined today looking for input on a medical question pertaining to my yorkie. My name is Diana and I'm owned by Scooby (14 year old porkie yorkie weighing 11.4 pounds.) We live in Arizona.

My Scooby has always had a moderately elevated ALKP of around 1500. Our vet presumed that it was elevated because Scooby has taken an antifungal medication off and on for most of his life. He took milk thistle and the number never went up or down. He had his last dose of the Fluconazole in August of 2013.

In September we noticed that his ALKP and ALT were on the rise. The ALKP had risen to 1600 and the ALT was around 300. Since then, he has had nearly monthly blood work and the numbers have continued to rise in spite of doing many things to try to bring them down. At the last check, his ALKP had risen to almost 7000 and his ALT is just under 600.

We have changed his diet a few times. First to Royal Canin Hepatic kibble, then to home cooking (Dodd's diet) and now he is on a combination of both. We have tried two long courses of antibiotics, first amoxycillin, then clamavox, and he has also had a long course of metrozonizide. He has been on denamarin since September. He is on Omega 3's. In January we stopped all the antibiotics and put him on Actigall.

Since September he has had two abdominal ultrasounds. The first was done in our regular vet's office and the findings were a slightly enlarged liver with a few mottled areas that were not suggestive of cancer. No nodules, no shunts, no bile duct blockages that could be seen and his gall bladder and adrenals appeared normal. The second one was done last week at the internal medicine doctor's office and read by a board certified radiologist. There were no changes since the first ultrasound. The radiologist suggested that the mottled areas could represent cellular regeneration or possibly neoplasia (no clue what that is), but basically nothing to cause the elevated ALKP. Last week he also had bile acid test. The results were slightly elevated but the vet said not enough to be concerned about. His pretest number was 15.6 and the post test was 35. She said we'd just watch it and test again in three months.

The IM vet has suggested a biopsy, but from everything I've read that doesn't sound like a great plan for him and would likely come back inconclusive. Even the IM vet agreed with that. So we'll likely pass on the biopsy for now. So the new plan is to go with the adjusted meds and diet change and test blood work again in a few weeks. Of course, we have been on one version or another of that plan for six months now, and we're getting no where so I don't have a lot of confidence.

In the meantime, Scooby is doing great clinically. He eats well, is active and hasn't gained or lost weight. The vet says he appears to be a completely healthy dog and she would have never guessed that the blood work would look like that.

I am frustrated because we've wasted six months, several thousand dollars in blood work, tests, and medications and we're no closer to an answer to the rising ALKP than we were six months ago. Obviously something is wrong, and I would rather know now while he's still in fairly good health and while it could still possibly be fixed, rather than just wait to see what happens next. I am hoping someone here might have had a similar situation and can give me some input on what to do next, further tests to request, ANY input would be appreciated.

Thanks for allowing me to join your site.

Diana and the Scoobster