My 10 month old puppy was incidentally found to have elevated liver enzymes ( ALT) when routine labs were drawn preoperatively for his neuter procedure. It was elevated at 209 (upper limit of normal is 75-100). My vet recommended rechecking again in a month, and it is now still elevated at 213. The rest of his liver enzymes are normal. Clinically, he has also been acting completely healthy! He's been growing, gaining weight, eating well, very active and energetic. He only *very occasionally* vomits after eating his own feces (when we are away and can't monitor him). Has anyone encountered this with their dog, and what ended up happening?

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This might be useful, though it's a bit of a slog: http://veterinarymedicine.dvm360.com/vetmed/Features/The-diagnostic...

I guess if it were me...well, I'd be concerned about the intermittent barfing in light of this finding. My skepticism knows no bounds, and so I would take the dog to another vet for a second opinion. If that vet came up with the same findings, I'd probably take a conservative approach to treatment but try to learn and understand as much as I could and then decide what course to follow.

Elevated liver enzymes is not a good thing.  Did your pup ever get into eating anything toxic to dogs?  Since your dog is vomiting and has elevated liver enzymes, I would say its a symptom of the liver enzymes being elevated. 

http://www.buzzle.com/articles/elevated-liver-enzymes-in-dogs.html

Please keep us updated on your pup.  I would definately want to know whats making the liver enzymes elevated. We are going through this with our 8 year old cardigan but his is from auto immune issues hes had for the last 3 years.  I hope I didn't come across too harsh. Thinking good thoughts for your pup. 

Hi, I was reading your post on elevated ALT level in your puppy and am wondering if you would share the outcome?  My corgi, 4 yrs old, had elevated (280) ALT for two blood tests now and other than that has no symptoms of illness.

The vet wants to take the next level of tests (ultrasound and bile acids test) to figure out what is going on.  I am very nervous and wondered how your pup made out.  Thank you

sending good thoughts your way... hope it isn't anything serious.

Those aren't terribly high.   Jack's came back high during blood work for a tooth extraction.  Ultrasound showed nothing.   One month on Denamarin they returned to normal.   The vet said ANYTHING can make the liver enzymes go up.  Some dogs over time have elevated levels simply do to exposure to routine meds like wormers and flea-and-tick preventatives.  It could also be a bacterial infection, fungus, virus, toxin.   The liver can regenerate so often times the liver enzymes might go up temporarily and then return to normal.

Good luck! 

My Katie, now 14 months, was diagnosed with liver disease - hepatic microvascular dysplasia- at age 5 1/2 months in the same manner - during routine pre-op blood work in prep for her spay procedure.  The first two ALTs were elevated -done 2 weeks apart.  Thank goodness I have a very sharp vet.  Katie was on a raw food diet at the time, so the vet suspected liver disease - given that Katie was otherwise happy, healthy and very active, and growing appropriately - but with some picky eating and some occasional minimal vomiting. ( Vet said a dog exposed to toxins will generally be more sick- and Katie was not sick - she was healthy)  

So the vet  ran a bile acid test.  That test basically does a protein challenge to the liver - among other things - and it came back 3 times normal.  So we knew she had a liver issue and needed to determine what kind.  The main possibilities,given her test results were a shunt - which requires surgery, or microvascular dysplasia - which is a narrowing of the blood vessels to the liver and requires a low protein diet to start and then perhaps liver supplements if that doesn't work.  There are other possibilities as the cause for the liver issues but those are the main ones.  

The vet then did another test - a protein C test - that had to be sent off to Cornell Univ for the lab work - and it came back with the diagnosis of micro vascular dysplasia rather than a shunt.  Not great to have that condition - but much better than a shunt.  At least for now its just been a diet change.  Some dogs will grow out of it - some will have no more issues after the diet change - but many will get worse down the road.   Katie will need blood work every six months to monitor of the duration.  (Thank goodness I have pet insurance.)  

The disease is a hereditary genetic condition.  It is not common in Corgi's, generally found in smaller dogs like Yorkies, but my neighbors dalmation had it years ago - so it can be in any breed.  A lot of dogs show no sign of any illness - its kind of a silent killer - and don't get diagnosed until they are older - and a lot of damage is done to the liver by then.  

The condition is severely aggravated by high protein diets- which are really hard to avoid these days.  There are prescription foods for the condition - but my vet didn't want her on it unless we had no other alternative, given her age at the time.   After lots of research I put her on Fromm's Adult Gold dry (24% protein) and Candia life stages for seniors wet food (low fat low protein) - she likes both and its working - after three months all liver testing was normal- without supplements.  So no prescription food needed - only needed to ditch the raw diet and go with a high quality lower protein food.   We were able to have her spayed at 10 months -the vet would not put her under anthesia until her liver was normal- but for now all is well.

To be on the safe side my vet explored her abdomen will doing the spay surgery - and all the organs look good and healthy.  Yeah!  Based on my crazy experience I would ask the vet if what she/he thinks about running the bile acid test and see if you can get some clarity on whats going on.  Good luck and hope all turns out well.  

Bile acids test came back slightly higher than normal.  ALT level is also slightly elevated after 1 month on denamarin.  The next step is the ultrasound but the vet is leaning towards it being a shunt.

My question now is, "what are the possible shunts situations?  Meaning, if not operable, does that mean we just have to wait for it to get worse?"  I am very scared.  Everything I read says that shunts can be intra or extra (outside), or there can be many small shunts which are not operable.  I think in my mind, the many small or internal shunts scenario is the scariest.

Please give me some advice.  Am I going zero to 100 too quick??  Thank you all!

Bile acid being slightly elevated is not bad - same with the ALT - are the ALTs down from last time?  My vet says that slight elevations can be normal so it depends on how you are defining slight.   I think I remember hearing that its when they are 3tx normal is the sign of serious problems.  I would take it one step at a time and not be so afraid right now- easier said than done when its your baby.   But it sounds like you have a good cautious vet that is checking everything - just to be safe.  Hugs and let us know how the ultrasound goes.  jan

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