Elevated ALT in a young, asymptomatic Papillon X
Species: Dog
Age: 15 months
Sex/Neuter status: Neutered
Breed: Papillon/terrier X
Body weight: 14.4 pounds
History: Adopted 6 months ago. Exhibits high anxiety to noise, separation anxiety. Working with a professional behavioral trainer for 5 months with little improvement. Was seen by a vet ~ 5 weeks ago to potentially add medication to his regime. Pet does occasionally get into trash or eat cat food. No mushrooms around. Pet does play rough with large dogs (60-90 pounds).
Clinical signs: Pet is asymptomatic, eat/drinks fine, weight stable for the last 6 months. No unusual bowel movements or concerns urinating. No vomiting or diarrhea.
Duration: ~ 5 weeks
Your general location: North bay area, California
Links to test results, X-rays, vet reports etc: Completed a senior panel to Idexx, bloodwork wnl except ALT mildly elevated (160) [full results not currently available]. Urine showed excess white blood cells, culture was negative. DVM suggested Trazadone, but wanted to wait to recheck blood. Put on Denamarin for a month and rechecked a mini panel. ALT 159. Na + 148 K+ 4.7 Cl- 116 Glucose 88 Bun 28 Creatinine 0.9 HCT 43 Hb 14.6
I currently do relief work at a high volume specialty/emergency practice. I'm awaiting a call back from my dog's GP. I am curious if anyone has input on possible etiologies. With an asymptomatic dog, is it recommended to go forward with bile acids/abdominal ultrasound, etc? Is there a chance it is just a strange, benign occurrence? Any input is appreciated, so I can continue to research.
Posted Apr 16, 2017, 6:44 PM UTC · edited
Do you have baseline blood work values taken from some earlier point in time?
Usually reference intervals are similar but can be slightly different for all clinics and labs because it's set based on a sample of the healthy population in the region that clinic or lab services. It is assumed that the majority of animals will fall close to the established average values, but that doesn't encompass every animal. The preferred way to determine normal from abnormal in an animal is to establish a baseline for blood work values because a normal value for one animal could be abnormal in another animal or group of animals.
The elevated ALT could be nothing or could be something depending on what is normal for your dog, but because of what was previously stated, determining normal can be difficult.
Just FYI: the half-life for ALT is 2-3 days. If the elevation is truly abnormal, the damage would have been done 2-3 days prior to the blood being taken. Also, while ALT is mostly associated with liver damage, skeletal muscle damage can also cause an elevation, so if you rule out damage being done to the liver, don't forget to consider that minor elevations can be attributable to muscle damage.
Thank you for your reply! The bloodwork done 5 weeks ago is the only full bloodwork done for him, and I don't currently have access to it.
No problem. You should definitely do whatever additional tests your vet recommends. Unfortunately, there's not much anyone here can tell you other than explaining what ALT is and general reasons for it to be elevated.
Good luck finding your answer!
I definitely know that we can't give diagnoses over the internet, I was just hoping for some possible rule outs that I could look into while I await further instruction.
Thank you!
The only things I can say based on your post is 1) eating garbage is a huge risk for dogs because of the incredible number of foods and household items that can end up in garbage that are hepatotoxic and 2) any sort of extreme exercise or over exertion (playing hard with big dogs) has the potential to elevate ALT because of muscle damage.
Unfortunately all we can do here is come up with contrived scenarios. ALT is much too non-specific to come up with anything certain.