Elevated liver enzymes
 

Hello everyone,

I'm new to this forum and have been reading wonderful stories/posts from other yorkie lovers. My Freddie is 8 1/2 years old and has always been in great health (or so I thought). We had his blood work done prior to a dental cleaning and it came back with elevated liver enzymes, so, needless to say, he couldn't be sedated. His vet put him on Sam-E for a month to see if this would lower his ALT. He has never shown any symptoms of a liver shunt (which the vet said by now I would have noticed) no meds that would have caused the elevation. She said something about Cushing's disease. I've googled as much as I can about this. Anyone with any advice/knowledge about the liver disease in yorkies? We have changed his food from Little Ceaser to homemade. I've read a lot of great recipes but I'm wondering if I should add or subtract any ingredients to his diet that won't affect his liver. Currently we boil chicken, add no-yolk noodles and some white rice. The vet was okay with this, but I'm wondering about some variety and is baby food okay.

I'm at my wits end. We love him sooooo much ( as does anyone that owns a yorkie or any pet). This news obviously explains my screen name,

Thanks for any/all advise anyone can give me.

Have you done a BAT - Serum Bile Acid Test? If not, this is what needs to be done asap. It is a simple fasting blood draw, then the Vet feeds a little food, and draws blood again after 2 hrs. The test is about $80 and you get results in a day or two. This test really shows liver function and can guide you towards Liver Shunt or MVD.

You current home made diet really isn't good. It needs to be balanced with vitamin, minerals, oil, supplements and calcium. If you want to home cook, it is best to consult with a Pet Nutritionist to create a balanced and nutritious diet appropriate for his condition.

Let us know the results of the BAT ? OR let us know the result of what the Vet feels the issue is?

We're going through this too -
 

My two year old yorkie boy was scheduled for dental work and could not be sedated for the same reason. Doctor suspects shunts. He is now on amoxycillin and SAM-E for a month to see if that helps any, at which time if it does help he can get his procedure.

If the Vets suspects a Liver Shunt or MVD - Was a BAT (Bile Acid Test) done? If not, this is really the next step in getting a clearer answer of liver issues. SAM-E is NOT going to make a Liver Shunt better :(

Additional info
 

Thanks so much for your responses. Some additional info about our Freddie......his previous vet retired this year and recommended the vet we are now using ( first visit last month). Freddie has been on DermCaps ( fish oil) for about 2 months now. Our new vet started him on Cosequin capsules last month for joints. His liver enzymes were at 223 if I remember this right.

Vet was okay with homemade food, however I agree he needs more nutrients than what I'm making. I'm researching pet nutritionist for further info on his diet. The vet did tell us she could order a special canned food for him but still wanted to see if the Sam-E was going to work. I not real sure on anymore canned food with so many recalls.

His BUN and creatinine was normal, protein was high, glucose, cbc, rbc was all withing normal range. Alt and alkaline was elevated. I can't really remember the results from all she did, she only seemed to be concerned with the ALT.

Will keep everyone informed.

Thanks again for the quick responses. Please keep sending me any info that will help.

Logan had elevated liver enzymes, too. The vet put him on a low-fat food (Hills prescription) and retested. He came out much better, so no further action has been required. I'd have your dog re-tested, too.

I have a Pet Nutritionist from Cornell University. I contact him thru emails explaining my dogs issues and needs. We work together on the ingredients and he creates and balances a diet. One diet cost $140 ~ but you know it is complete and balanced. Do you want his info?

Yes, and thanks.

While you would have most likely seen shunt symptoms by this age, some dogs goes their whole lives asymptomatic, especially with MVD.

A bile acids test should be done.

Homemade food is fine, but as Nicole said, it has to be balanced.
L/D canned is an okay food if that's what your vet was talking about as is Royal Canin LS 14 kibble.

Update
 

I spoke with Freddie's vet this morning and asked her about the BAT test. She wants to keep him on the Sam-E for the month and then retest. I was still concerned about his diet and the lack of nutrients. So she has ordered some Hill's l/d for him ( they obviously don't keep it in stock). And we'll see how he'll eat it. Like I said before, she our new vet and she doesn't know how all this is affecting my OCD !!! lol

Bought a "pill popper" or some call it a "pill gun" in order to get him to take his meds. Still no signs or symptoms of anything wrong with him.

Thanks so much TLC for the info on your nutritionist. Will hold off on contacting after the next blood work / possible ultrasound and biopsy.

I did read somewhere on the web that an infection can cause elevated enzymes. She put him on antibiotics for a week prior to the scheduled teeth cleaning because she saw some infection in and around is gums. Also, previous vet always checked him for infected anal glands and last year that was a mess to clear up. Took him in every week for them to expel the gland. He show no signs of distress, i.e., scooting his little butt across the floor,etc. But then, he never has.

Sorry for the lengthy post, just trying to get out as much info as I can with hopes of receiving as much as I can. OCD !!!!!

Thanks again everyone. I do love my babies.

What is the SAM-E supposed to do - I thought it was to help get the liver numbers down. He did have a bile acid test and it was high. Also, my vet wanted him on low protein food. He loves his Royal Canine Yorkie food but it is high in protein, so she said to switch to Science Diet for the mature dog, small bites, which has a lot less protein. He's only just two and the food is for 7 yrs + but it is just for the protein thing. Also, how does that pill popper work? I am crushing the Sam-E and putting it in liquid in a medicine syringe. Thanks for any advice!

If you are giving SAM-E in the form of Denosyl, it cannot be crushed or it is ineffective. It protects liver cells and helps prevent further cell death.

Sam-E
 

The Sam-e helps to detoxify the liver. I had a hard time getting Freddie to take it and the "hand in mouth" technique was not a option. PetSmart had the pill gun for 7.99. It's a big syringe and the end is flexible to hold the pill in case it is too large for the syringe. Works like a charm.

Only problem is my Freddie is too smart for his own good. He's used to taking by syringe,(pepto, benadryl) when he feels bad. But he definitely knows he doesn't want it when he's not feeling bad so he puts up a fuss with this Sam-E, but .....da - dah.....alpha female wins again!!! lol

Thanks to all. This site is has been great for me.

Patricia

re:spider bite
 

Thanks for the info. From everything you've described, I'm sure he has not suffered from a spider bite, and I sure am thankful. You said you lost your 10yr old to cancer. Not to bring up bad memories or anything..but was he/she a yorkie? And what type cancer? Waiting is the worst thing ever.

People say that dogs don't go to heaven ( touchy subject I'm sure ), but I sure pray for my little guys. And, personally, I don't believe they will be left here without me. Just my opinion and off topic I know.

Thanks to all

Patricia

I'd better talk to my vet. There is no way that big pill is going down my 3lb Yorkie's throat without crushing it! Thanks for the advice.

Is it Denosyl? Those pills are kinda small.
I shove them down a Yorkie throat daily.:rolleyes:

You may be able to use Vetri DMG (liquid).

Yes, it is denosyl. It is a orange-coated tablet a bit larger than a regular bayer aspirin. If I quartered it, I could probably shove the quartered pieces down his throat but I don't want to have to do that 4 times in a row. I did check with the vet and he said that as long as I am crushing the tablet and using it immediately it would not be losing its potency. I mix it in enough water to fit a small syringe and it goes right down. I just hope it helps so he can get his extra teeth removed and the rest cleaned up.

Thanks for all the help!

I hate going against what people's vets tell them but that is inaccurate.
I have the insert from Ellie's box of Denosyl right here and under "Administration of Nutritional Supplement" it says:
"Because the tablet must be kept intact to prevent destruction by stomach acid, administration range is based on the nearest whole tablet."

Stomach acid would destroy it if it is crushed.
It also shouldn't be given with food unless you have to use one small bite to get it down.

Meds
 

The exact spelling on the bottle is S-Adenosyl-100 (SAMe), and the instructions are as Ellie May says.The directions are: If giving more than one tablet,divide daily dose between AM and PM. Tablets should be given on a empty stomach at least one hour before meals. ( when I googled this med, it said one hour or longer is better). Tablets are sensitive to moisture and heat and should not be split or crumbled. Store in a temperature and humidity controlled environment.

The vet said if I had to give it with food, use very, very little. The tablets are enteric coated and I'm assuming that's to help with the tummy upset. The tabs are larger than an adult aspirin, so the pill gun really helps.

This is day 3 for Freddie. He likes this less and less. Stored that pill (which I thought was down his throat) is his mouth somewhere, like a little chipmunk, then spit it out 10 minutes later ! Needless to say, had to repeat the whole thing. Sure wish I could dissolve it or crush it to make it easier for him, but I can't.

Thanks for all your responses.

Patricia

Capone just had the same thing today. Elevated enzyme levels specifically the ALT. My Vet is running a Bile Acids test today. He seemed very pesimistic that the Bile Acid test would be ok, given the ALT was specifically high around 260. I am moving and I thought maybe the little guy was stressed.
But my vet said that is very unlikely it would cause the ALT levels to be high. He would not go into telling me anything of what could cause it other than the liver NOT functioning. I am really scared right now, and would like other opinions? I find out the Bile Acid Test at 3 today.
Does anyone have any experience about this?
:confused:

He is sending the blood to a lab, right?
Your vet is right though.
All a bile acids test can do is tell you if the liver is having a functioning problem. It won't diagnose a problem. Liver shunt and MVD is very common in Yorkies though, so that is always the first thought.

He was tested for a liver shunt as a puppy and it was negative. Can they happen at anytime? What is MVD? Thanks. -Janine

If he was bile acids tested before 20 weeks, it could be inconclusive because the organs aren't developed enough before then for a perfect reading.

They can acquire shunts later on also.

MVD or microvascular dysplasia is microscopic, inoperable shunting throughout the liver.

Re:Capone
 

How old is Capone now? My Freddie is 8 1/2 yrs. I've heard so much about the BAT test. As I said before, this is our new vet ( previous vet retired) and she comes highly recommended. Pre-dental lab work was done 4/30. Vet called late Friday 5/1 but didn't leave results. So on Monday, we took our yorkie and dachshund in for teeth cleaning. Then after we got home, vet called and told us about Freddie's ALT. In hindsight, had I known the results before Monday, I would have asked for the BAT. As of now, she wants to wait the month and go from there.

I'm wondering what the end result will be. If enzymes don't improve, and an ultrasound and biopsy is performed, what will it show? If the enzymes do improve, then will he stay on this med from now on, or will it be a diet controlled thing? I guess I'm getting ahead of things but I'm curious as to the outcome of all of this.

Patricia

If the enzymes go down, it could go either way depending on what your vet wants to do. I just don't like to see the enzymes go up that high without going deeper for a diagnosis. That is, even if they return to normal, I don't think you can be sure that there isn't something wrong. Ellie has high bile acids and her ALT was 118 once (just slightly too high). Every other time it is perfect though but there is still something going on with her liver according to her bile acids tests.

Patricia,

Capone will be 4 on May 20th. He had the liver shunt test done when he was a puppy, because he was suffering from seizures they could never explain. He grew out of them thank the Lord! I am so sorry to here about your little guy.
They are performing the BAT test today. I do not know what to do from there if they tell me the liver is not functioning properly. I don't have the money to afford an untrasound right now. Capone doesn't have any symptoms though. He eats, drinks, plays, and his urine and stool are all NORMAL looking and nothing unsual. Do you know anymore about results on BAT test and what they mean?? Thanks -Janine

Try not to freak until you get the BAT results.

A u/s isn't always necessary - Just let us the know the results of the BAT and what your Vet has to say, and we will chime in with our experiences to help guide you in the right direction ;)

Thanks!! I appreciate what a wonderful community and resource all of you are!! ( And Capone does too)

RE: BAT info
 

Janine,

Ellie May and TLC know way more than I on the tests results. It's a wait and see thing. Freddie shows absolutely no symtoms of any kind. I read that dogs are sometimes kept on maintenance meds, i.e., one every other day, just for the aide in liver function.

Hope this helps. I'm trying not to freak out. I have already learned so much from this community. I'm grateful.

Patricia