increase in liver enzymes in dogs: causes and implications

increase in liver enzymes in dogs: causes and implications

Your furry friend's liver is one of the most remarkable organs – a true workhorse with a staggering 500 vital functions! This pseudo superhero filters blood, assists in metabolism, produces bile for digesting fats, and even plays a key role in blood clotting. All this happens when your beloved pet experiences elevated liver enzymes, which can be quite concerning.

But wait, what are these liver enzymes? well, they're important proteins that partake in specific chemical reactions within your pet's body. Keeping tabs on liver enzyme levels is crucial for routine health screenings as elevated levels usually hint at inflammation or damage to the liver. Some common liver enzymes to watch out for on your pet's blood work include:

• ALT (alanine aminotransferase)
• AST (aspartate aminotransferase)
• ALP (alkaline phosphate)
• GGT (gamma-glutamyl transpeptidase).

These enzymes can be grouped into two categories:

1. Those that indicate damage to the actual liver cells (ALT and AST)
2. Those that signal cholestasis or reduced bile flow (ALP and GGT)

When your veterinarian unearths elevated liver enzymes in your dog, it may spark curiosity about whether it's caused by liver disease or perhaps a non-liver ailment. We'll dive into the meaning of elevated liver enzymes, potential causes, and the steps to take next.

What Are Liver Enzymes in Dogs?

You may have noticed that your veterinarian pays close attention to liver enzymes during routine check-ups. These important proteins play a significant role in chemical reactions within your pet's body, and their values serve as an integral component of your dog's regular health screening. Elevated liver enzymes generally indicate inflammation or damage to the liver.

What Do Elevated Liver Enzymes Mean?

Routine blood work is developed to screen for potential liver diseases. Additionally, specific blood tests like liver panels, which comprise liver enzymes, might be administered if there's high concern for liver disease or a history of it. Elevated liver enzymes in dogs could indicate damage to the liver cells or issues with bile movement.

Whether or not your veterinarian is fretting about the elevated liver enzymes depends on several factors, such as:

• Degree of elevation
• Symptoms your dog might be revealing
• Whether the enzyme levels are static or increasing over time
• How many enzymes are elevated
• Other blood work and urinalysis findings
• Patient age

While any of these enzymes being decreased on the lab work isn't particularly significant.

Causes of Canine Liver Enzyme Elevations

Liver enzymes can skyrocket for several reasons, which we will break down into three broad categories:

Damage to the liver or bile flow problems

• Harmful substances – these can include xylitol, blue-green algae, Amanita mushrooms, aflatoxins, sago palms, and heavy metals
• Infectious diseases like leptospirosis, infectious canine hepatitis, or histoplasmosis
• Liver tumors, gallbladder tumors, and biliary tract tumors
• Liver inflammation (hepatitis)
• Cirrhosis
• Gallbladder inflammation (cholecystitis)
• Gallbladder distended with mucoid content (gallbladder mucocele)
• Breed-related disorders, such as copper storage hepatopathy

Non-liver diseases

• Disorders like Cushing's disease, diabetes, hypothyroidism, pancreatitis, intestinal diseases, congestive heart failure, seizures, sepsis, muscle injuries, congenital portosystemic shunts, and conditions affecting bones (e.g., osteosarcoma, osteomyelitis, or multiple myeloma)
• Certain medications, such as steroids, phenobarbital, certain chemotherapies, or carprofen

Normal factors

• It's customary for puppies to have an elevated ALP because this enzyme is also generated from growing bones, not just liver cells
• Nodular hyperplasia, common in older dogs, can lead to increased liver enzymes

Ultimately, many factors can contribute to elevated liver enzymes, with some not even being listed here. Your veterinarian may investigate further if they have plans to determine the underlying cause.

Next Steps for Dogs with Elevated Liver Enzymes

Rest assured, your veterinarian will meticulously review the whole picture when determining your pet's next steps. Routine blood work provides other values instrumental in gauging liver function or damage, including blood urea nitrogen (BUN), albumin, cholesterol, glucose, and total bilirubin. Changes in these values can be telling regarding liver function or obstructed bile flow.

If your veterinarian is not unduly worried about your pet's elevated liver enzymes, rerunning labs in 1-3 months could be recommended. However, some pets may receive medications to safeguard the liver, and labs will be run after the pet has completed the medications. Two additional laboratory tests may also be suggested: bile acids and blood ammonia.

Bile acid testing can distinguish whether the liver is functioning appropriately. Your pet's blood will be drawn after fasting for 12 hours, followed by feeding and another blood draw two hours later. Elevated bile acids after eating could signal liver dysfunction.

Ammonia levels can help assess liver function well. In normal pets, small protein molecules, known as amino acids, are broken down into ammonia in the intestines. The ammonia is then converted into urea by the liver. Elevated ammonia levels in the blood hint at liver dysfunction, indicating the liver is struggling to convert ammonia.

If your veterinarian suspects the liver enzyme elevation is concerning, they may recommend an abdominal ultrasound to visualize the liver. In some cases, liver biopsies may be recommended. Liver biopsies often require surgical intervention.

If your dog shows signs of liver disease, such as poor appetite, vomiting, diarrhea, neurologic signs, fluid buildup in the abdomen (ascites), or jaundice, your veterinarian will likely adopt a more aggressive approach to determine the cause of these symptoms. This could include imaging (abdominal ultrasound, CT scan), liver biopsies, and keeping your dog under close observation while they work out the cause of the symptoms. Crucially, if your veterinarian suspects liver disease, they will likely test your pet's ability to clot their blood prior to surgical intervention or liver biopsy.

How to Cope with Elevated Liver Enzymes in Dogs

Treatment strategies for elevated liver enzymes depend on the underlying cause. If your dog appears healthy, your veterinarian may commence a trial of antibiotics, antioxidants like Denamarin, and/or other prescription medications like Ursodiol and then recheck the liver enzymes after the medications.

Normally, Denamarin is prescribed for concerns about hepatocellular damage, while Ursodiol may be more advantageous if there are gallbladder concerns. Your pet may be given both medications or other drugs with similar active compounds.

Treatment procedures can be more intricate if other causes arise. For instance, a liver tumor is generally treated surgically. Leptospirosis usually necessitates hospitalization on intravenous fluids and treatment with antibiotics called doxycycline. Chronic hepatitis may demand immunosuppressive drugs like steroids. Pets with signs of liver failure or severe illness may require hospitalization for several days.

Do keep in mind that your dog's liver enzymes may be elevated due to Cushing's disease or pancreatitis. In those cases, treatment focuses on the underlying cause of the elevated liver enzymes, rather than the liver itself.

1. The liver in dogs, a true workhorse, carries out 500 vital functions, including filtering blood, aiding metabolism, producing bile for digestion, and playing a role in blood clotting.
2. Elevated liver enzymes in dogs can be concerning, as they often hint at inflammation or damage to the liver.
3. These important proteins, known as liver enzymes, partake in specific chemical reactions within a dog's body and are crucial for routine health screenings.
4. ALT, AST, ALP, and GGT are common liver enzymes to watch out for on a dog's blood work.
5. ALT and AST indicate damage to liver cells, while ALP and GGT signal cholestasis or reduced bile flow.
6. Routine blood work and liver panels can help screen for potential liver diseases and high concern for liver disease or a history of it.
7. Elevated liver enzymes might be caused by liver disease or a non-liver ailment, necessitating a closer investigation by a veterinarian.
8. A veterinarian's level of concern about elevated liver enzymes depends on factors like the degree of elevation, symptoms, static or increasing enzyme levels, number of elevated enzymes, other blood work and urinalysis findings, patient age, and whether any enzymes are decreased.
9. Harmful substances, infectious diseases, liver tumors, liver inflammation, cirrhosis, gallbladder inflammation, gallbladder mucocele, breed-related disorders, Cushing's disease, diabetes, pancreatitis, intestinal diseases, congestive heart failure, seizures, sepsis, bone conditions, certain medications, and muscles injuries can cause elevated liver enzymes.
10. Normal factors like puppy age and nodular hyperplasia in older dogs can also result in elevated liver enzymes.
11. Routine blood work provides other values to gauge liver function or damage, such as blood urea nitrogen, albumin, cholesterol, glucose, and total bilirubin.
12. If your veterinarian is not unduly concerned about your pet's elevated liver enzymes, rerunning labs after 1-3 months could be recommended, or medication to safeguard the liver may be suggested.
13. Bile acid testing and blood ammonia tests may also be recommended to assess liver function or bile flow.
14. An abdominal ultrasound may be recommended for further investigation if your veterinarian suspects the liver enzyme elevation is concerning.
15. Liver biopsies may be needed in some cases, which often require surgical intervention.
16. If your dog shows signs of liver disease such as poor appetite, vomiting, diarrhea, neurologic signs, fluid buildup in the abdomen, or jaundice, your veterinarian will likely adopt a more aggressive approach.
17. Treatment strategies depend on the underlying cause and can range from antibiotics, antioxidants, prescription medications, and surgical intervention for conditions like liver tumors.
18. Some dogs may require hospitalization for several days for treatment and close observation.
19. Depending on the underlying cause, treatment focuses on the liver itself or addressing the condition causing the elevated liver enzymes, such as Cushing's disease or pancreatitis.
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