High AST/ALT?????
 

------MAR 09 ------------MAY 09-------- Dec 09 -------Jan 10
AST ---114---------------- 79 ------------240 ----------299
ALT ---421 ----------------321 -----------433---------- 544

My vet chose to start her on meds in April 09 after BAT. Started on L/D 1/19/10.

Any thoughts on what this means?

that bat is over 100 and those numbers are high for alt and ast :(

any symptom?

I would do another bat 6 mos after low protein

if having symptoms i would get a scintigraphy done

No symptoms, except a bout of Hepatic Encephalopathy 3 weekends ago, got under control with increased Lactulose. Now she's back to her normal self and actually gained a pound! My vet was going to schedule an ultrasound, and when we discussed options I asked her to call U of Tenn to see what they thought. They said not to do any more tests here, just bring her to them, they'll do whatever is needed and then surgery if indicated. I'm in the process of getting her there, these lab values are just making me nuts!:eek:

yeah i would go and do the scintigraphy unless you want to do a current bat to see where that is but the fact that she had a symptom with those numbers and first bat being over 100 I would get further testing

Well, if she had HE, then she is symptomatic.
I would do further testing.

I meant no symptoms from April 09 thru Dec o9. HE occurred Jan 2010. Since Jan, she's showing no symptoms again.

HE is a big deal and her liver enzymes look very elevated to me. I would see if surgery is an option if it were me

As I was doing other research, I came across this, from:

Gall Bladder problems in dogs

"...due to a sludge that animals can get similar to stones in people. She said that this could cause his elevated ALT and bile acids. ..."


Got an appt tomorrow with my vet.... will update....

pm luvmysissy as her dog has gallbladder issues and she knows alot about it now

it is very rare though in dogs she said to me

Thanks, doing it now!

she is not on a lot lately but she will pm you back and she did alot of research after her dog had high numbers for cpk enzyme which is affiliated with gall bladder issues - does yours have high cpk?

No. Found the answers to my questions though... what does elevated liver enzymes mean? :The diagnostic approach to asymptomatic dogs with elevated liver enzyme activities - Veterinary Medicine

All I ever wanted to know and then some...:D covers ALT,AST,ALP and GGT in depth!

I can't read anymore, I am crosseyed... but very happy!

Basicly from the article:

If microcytic RBC's are present= Liver Shunt.

If ALT, ALP & AST are increased two-threefold = Liver Shunt

If ALT, ALP & AST are normal - mildly increased = MVD

Gallbladder Mucoleles increase ALT, AST, ALP, & GGT

Increase in Bilirubin & decrease in Albumin = need for diagnostic imaging and hepatic biopsy.

Tink has increased ALT & AST (544 & 299 respectively) GGT hasn't been done, ALP/SAP is wnl, preprandial BAT=44.8 (<10) = possible Gallbladder problem, postprandial BAT=126.7 (<20) not too far from 100 or less (=MVD)

So I have lots to ask my vet... poor man.... not! :D

great observation and makes sense as dd had normal alt etc but bats were off and she is mvd

Excellent article! I sent you a PM describing howwe found Sissy's calcification in the gallbladder and her lab values. Her ALT, ASK and Total Bilirubin were all high and her CK enzyme was through the roof!!!!! My vet actually thought she had an injury because of the CK level and did two views of a full body xray which showed the bright white spots on the gallbladder. Thinking gallstones, an ultrasound was done which showed calcification of the gallbladder itself. She is on a 70mg capsule once a day of Ursodiol to dissolve the calcification. A follow-up ultrasound done a month later showed improvement. She will be on this med for 6 months and then we will follow-up again.

Once finding the calcification - this could also answer some of her previous issues which began with pancreatitis-like symptoms and ended in a diagnosis of early stage PLE. The liver duct, gallgladder ducts and pancrease ducts all work together - so many values can be off and the liver be just fine.

Oh yeah, this went well. We gassed up before taking off, the van totally smelled of gas, I was feeling ill (from the fumes) so I cancelled the appointments... told DH just to get us home ASAP... but good news... we are rescheduled for Monday! (and the van didn't blow-up!):eek:

lol well glad you are ok and got it rescheduled :) sometimes things happen for a reason loll but i am trying to still figure out my tuesday - washer smoked up and died, someone hit and run on my landcruiser and i owed the irs and state a ton - hmmm now what is the reason lollll

Okay, trying this one more time.. Vet appt 10 AM yesterday, and we made it there!
Needed to get recheck bloodwork and urinalysis, investigate a lump on her right side next to the spine below her last rib (about the size of a quarter or less), pick up more meds, and get an X-ray.

Vet felt the lump, drew blood for bloodwork, got the urine, and took 2 X-rays.

Bit of history from Dec 09: Tinkerbell had eaten an unknown amount of rancid grease from near the stove in MIL's house. Vomited for 2 days, and I made a Vet appt to rule out pancreatitis. This is when her ALT and AST came back so elevated. (AST 240 (Ref 15-66), ALT 433 (Ref 12-118)):(, but no pancreatitis. BUN and Creatinine also low. Recheck in Jan 2010 (AST 299 ALT 544) BUN and creatinine still low, and now low cholesterol, too:eek:.

Back to today: results are in: AST 50 (WNL) ALT 240:cheer: (I'll get a copy tomorrow of the rest of the results) and the Urinalysis showed many bacteria and her WBC is elevated. (UTI):(

The X rays showed 1. a small sized liver:( 2. no Gallbladder problems:cheer: 3. full intestines :yay_jump:4. two microchips:shocked7q (one where the lump is) 5. A slightly large heart :confused:

The Plan: 14 days of Clavamox for UTI, Increase Denamarin to next size up (she actually has gained weight :yeahthat:: low weight being a problem for LS dogs) And considering Ultrasound to determine if single or multiple shunts, or no shunts, or maybe repeat BAT, but get ALT to normal first.

Forgot about this thread... it contains a link to an article about liver enzyme bloodwork I've been trying to find for 2 years that someone had asked about.