Extremely elevated ALT
 

I have a 2.5 year old male Yorkie named Liam. He seems to be in good health, but I took him in to get him fixed a couple of weeks ago. They did pre-op blood work and found out he had extremely elevated ALT numbers. The normal range is around 12-118 and his number was 1043. They've since tested again 10 days later and the number was even higher. They did a bile test and that number was elevated as well so they were thinking he had a liver shunt. They did an ultrasound, x-rays, and some sort of neuroscan where they put something in his bloodstream so they can scan how it flows. That came back normal; blood is going to his liver normally, so they said there is no shunt.

The specialist put him on two antibiotics for 3 weeks and he was started on Denamarin liver vitamins. We go back in 3 weeks to retest his blood and see if the ALT number has gone down. All of his other numbers look normal. His liver was slightly smaller in the x-rays and in the ultrasound the vet said his kidneys were cloudier than she would expect for a dog his age, but nothing to worry about right now. She suggested blood work every 6 months to monitor his kidneys and liver.

The specialist suggested we do a liver biopsy next, but she seems almost at a loss for what's going on. I think she expected to find a liver shunt. His dad died at 7 years because he swelled up so bad. They never determined if it was liver issues or kidney issues. Liam isn't really showing any clinical signs of liver issues yet, thank goodness. But I'm extremely concerned because that ALT number is so extremely high. I've researched a lot online, but I'm at a loss for what to do.

Do any of you have experiences similar to this with your Yorkies? Can anyone provide any insight or guidance? Anything is helpful and appreciated! I just want to be providing Liam with the best possible care and keep him as healthy as possible.

Welcome to YT. :)

Could he have gotten into anything toxic (plants, meds, garbage, xylitol, chemicals)?

He could have MVD/PVH, but it sounds like something more.

Thanks so much for the feedback. He hasn't gotten into anything that I can think of. But it sounds like there are a number of things that might have set it off. If he did get into something, will the antibiotics most likely clear it up? I guess I just need to wait and see how this round of antibiotics goes and is if has any impact. I'm praying and have my fingers crossed that the ALT number is way down when we go back to recheck it. But if it's not, I'm at a loss for what to do. :confused:

I really have no answer for you, but wanted you to know that I will keep your little man, Liam in my prayers. I do hope you find out what has caused this...and that he will be just fine.

Thank you! I really appreciate that. I guess I will wait and see what news we get at the follow-up visit on June 13. Fingers crossed for good news!

I am hearing of more and more pups with these issues....and they often don't have a definitive diagnosis. The only real way to get one is by doing a liver biopsy and many vets don't like to do that right away. My Olivia was a mess last year and her ALT was over 2,000. She is fine now! Here is the thread about her:

http://www.yorkietalk.com/forums/sic...ick-again.html

I have a friend whose Shih Tzu had an ALT over 4,000 recently....she was not sick and was not hospitalized. They treated her with antibiotics and it is coming down.

In Olivia's case, it took three different antibiotics plus, Actigal and Ursodiol. Thankfully she is doing very well now. Her liver enzymes are all normal.

I don't know what caused it but they did suspect it was infectious. There really was nothing around here that she could have gotten in to.

Hope that Liam does as well!

Thank you SO much for that feedback! It's been a very frustrating process. I hope I have the same results with Liam as you did with Olivia. I'm so glad to hear she's doing well now!

Another YTer recently had a seriously sick yorkie. Her ALT was also very high and is normal now. She was much sicker than your baby.....

http://www.yorkietalk.com/forums/sic...-drinking.html

Prayers for your little baby Liam

Prayers & well wishes for Liam.

After two weeks of antibiotics, Liam's ALT went down significantly, more than 50%. Good news, so the vet wants to continue antibiotics for another two weeks and see if we can get it down into the normal range. I'm thankful for positive news and hope it continues!

That's terrific news!! Thank you for letting us know. :)

Progress is always good news. Happy to hear it.

Happy for the good news. Praying that Liam continues to improve!

Well, Liam's ALT was back up again at 976. The vet now wants to do a liver biopsy. Have any of you had experience with this? He's had an ultrasound and some sort of neuroscan where they injected stuff into him to see if it showed a liver shunt. Everything came back ok; no sign of a liver shunt. I'm at a loss for what to do. Several thousand dollars in and I know nothing more than I did when his first batch of blood work came back abnormal :(