# High Liver Enzymes



## Guardmouse13 (Sep 25, 2013)

Hi! I'm a new member and actually came to this board while searching for information on high liver enzymes. My maltese Andy is 9 years old and our new vet is concerned that she may have a liver shunt.

In July while visiting my mom in Arkansas I noticed she had an infected tooth so I took her to my mom's vet. We were there for a month and since Andy was also in need of a dental anyways they did a full blood panel. Her liver enzymes were elevated so I got antibiotics, which cleared up the infection. We just moved to Indianapolis from Texas and got settled with a new vet a few weeks ago. The new vet did another full blood panel for Andy and her levels were high again so they ran a bile acid test on Saturday. He said that her level was a 280, I'm honestly not sure what that means other than its high.

I asked the vet if part of it could be stress. 2012 was a really bad year for my family. My dad was diagnosed with cancer and passed 9 months later, during his treatment time I had my parents dogs as well because they all got along well and my parents traveled a lot for treatment. I was diagnosed with crohn's and had bowel surgery which put me out of commission. 2013 has been better so far, thankfully. 

Andy has always had a very sensitive stomach. She has had more frequent vomiting/diarrhea than my other dog, or any I had growing up. I had spoken about this with vets frequently and tracked her food. Couldn't find any link other than maybe anxiety. Even when she doesn't have diarrhea her stools have been looser than other dogs. When we moved to Texas is 2010 she started chewing on her back feet. It seemed to be allergies and was at least somewhat alleviated by wiping her paws down when she came inside. Last September she did have some vomiting after her annual vaccine (distemper & others, not rabies as we have done that at 3 years.) I'm not sure if that could be related. The vet there kept her for observation for the rest of the day and she was okay, had not had a reaction previously. Also, since she was a puppy when she gets really excited she kind of bends herself in half with her head right by her bottom and walks that way. Vets were never concerned but it has definitely been unique to her. She has had more frequent diarrhea since moving to Indianapolis in August and this week she has vomited every time after eating dog food so I've given her some eggs and she's been able to keep that down. Going along with the vomiting she's been very sluggish and clingy but was a little more chipper after eating and keeping the eggs down.

She has had blood work at least twice, maybe three times, previously for spaying and dental work. No vet has ever talked to me before about elevated levels or concerns. She's currently scheduled for an ultrasound on October 7 but from what I've read those aren't always super accurate for diagnosing. I've looked some into the liver diets, including the Dr. Dodds diet on this board and plan on trying that out to see if it helps her. Any other advice is greatly appreciated. I'm lost on what to do to make her feel better. Thanks in advance.


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## jmm (Nov 23, 2004)

At this age I would be more suspicious of an acquired liver disease...such as secondary to Cushing's or infection or an inflammatory condition. An ultrasound would be a good next step.


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## wkomorow (Aug 26, 2011)

An ultrasound is a good choice as long as it is read by someone who really knows what they are doing, and only a doppler ultrasound can actually map blood flow thtough and around the liver. It will give you a sense of the size and shape of the internal organs, which can be helpful. Where are you having it done? There are a lot of liver disorders and distinguishing among them can be very difficult.

Good luck and remember many dogs with liver disorders can be managed and controlled for a very long time.


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## CrystalAndZoe (Jul 11, 2006)

Welcome to SM!

First off I think you need to get a video of your darling Andy doing the 'yoga walk'. I bet it's adorable seeing her do that!

Have you ever had a Bile Acid Test performed on her before or is this the first one? The majority of all Maltese are asymptomatic MVD and can have high BA's with perfectly normal liver values (ALT and AST). And there is nothing that needs to be done for these Malts. They live perfectly normal lives. The reason I'm asking is if you already know her BA's are high, this could help in diagnosing. And another question...did the ALT and AST come back into the normal range after her course of antibiotics and dental and are now high again?

There are all sorts of reasons why a dog could have elevated liver values and BA's. Any kind of infection really. Even digestive issues such as IBS or IBD can elevate liver values somewhat. And would explain her sensitive tummy issues. And I know firsthand what a number stress can do on any dog. And again the tummy issues that go along with that. So I do think stress can play a part in their overall health, but stress on its own would not raise liver values. What type of ultrasound are they doing? If it's the regular ultrasound, that would not be the best way to see a shunt, but my understanding is the doppler ultrasound is a great tool to find a shunt. If it is a traditional ultrasound, hopefully they will be able to take a look at some other organs, like her kidneys, to see if they look normal. I don't know enough about the doppler ultrasound so I don't know if they can see other organs with this as well. But like JMM, I'm more suspicious of an acquired liver disease. My oldest had Lepto when she was 2 and she was starting to vomit and not have the energy she normally had, more lethargic. The vets of course automatically always think of a shunt with a Maltese and elevated liver values. When they did the ultrasound on Zoe, they were able to see that her kidneys were dilated. So that helped to determine she had Lepto even though the original titer came back negative. We just caught it early enough. When we retested a couple of months after, there was a marker for Lepto. 



Good luck and let us know what you find out. It's always so scary and overwhelming when our baby is not well and we don't know why.


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## Grace'sMom (Feb 22, 2012)

Welcome 

So sorry Andy isn't feeling well 

First, my Gus does the weird bent wiggle walk thing when he is SUPER happy! Always makes us laugh 


I'd be concerned about liver disease as well... if she has been healthy up to this point... it could be MVD, but could be something like liver disease.

Do you have a copy of the test with all the numbers?

Any past tests?

That might help us help you more


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