# high liver enzymes



## mnk1220 (Feb 5, 2009)

Hello i just wanted to get some input on high liver enzymes.. I brought my dog in for a teeth cleaning and was told his liver enzymes have gone up... I just want to know everyones opinion on this... Scedules for a urine xray and cbc tomorrow...


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## CrystalAndZoe (Jul 11, 2006)

Hi! I'm so sorry your first time posting here on SM is one with some worry. Which enzymes and how high? The ALT's? The AST's? And you said they were up from last time. So were they high before? And how old is your baby?


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## mnk1220 (Feb 5, 2009)

ALT i dont know the numbers. the vet said they were slightley higher then the last time... Hudson just turned 5 on the 1st.


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## jmm (Nov 23, 2004)

1. Liver enzymes can be elevated when there is infection. This includes dental infection. A dental cleaning and antibiotics can resolve this. 

2. Chronically elevated liver enzymes in a healthy Maltese are often due to MVD, which is an asymptomatic liver problem. The next test would be a bile acid assay (pre- and post- prandial samples). A urine sample (to look for urate crystals) and the x-ray (to give a baseline of liver size) are good steps. 

3. Following this, if the bile acids are elevated, a Protein C test can be sent to Cornell to help differentiate between MVD and a liver shunt. MVD dogs with no symptoms live long and healthy lives. 

Look at the thread for bile acids tests above and the Protein C here http://diaglab.vet.cornell.edu/coag/test/proteinC.asp


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## mnk1220 (Feb 5, 2009)

Thank you!


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## mnk1220 (Feb 5, 2009)

okay so the xray showed enlaRGED liver... waiting to hear from the vet when the results from the blood work and urine are in.. they put him on a supplement called Denamarin


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## luvmyfurbaby (Feb 11, 2007)

QUOTE (mnk1220 @ Feb 5 2009, 10:25 PM) index.php?act=findpost&pid=720334


> okay so the xray showed enlaRGED liver... waiting to hear from the vet when the results from the blood work and urine are in.. they put him on a supplement called Denamarin[/B]


You may want to ask your vet if you can give him this 
http://www.homevet.com/osc/product_info.php?products_id=74 or
http://www.homevet.com/osc/product_reviews...mp;reviews_id=7

and this

<a href="http://www.homevet.com/osc/product_info.php?cPath=2&products_id=9" target="_blank">http
://www.homevet.com/osc/product_info.ph...;products_id=9
</a>
those are the two staple items that a liver compromised dogs should take. Basically Milk Thistle, SamE, Marin

You can print it out and take it to your vet.


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## mnk1220 (Feb 5, 2009)

thank you


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## Ladysmom (Oct 19, 2004)

QUOTE (LuvMyFurbaby @ Feb 5 2009, 10:49 PM) index.php?act=findpost&pid=720342


> QUOTE (mnk1220 @ Feb 5 2009, 10:25 PM) index.php?act=findpost&pid=720334





> okay so the xray showed enlaRGED liver... waiting to hear from the vet when the results from the blood work and urine are in.. they put him on a supplement called Denamarin[/B]


You may want to ask your vet if you can give him this 
http://www.homevet.com/osc/product_info.php?products_id=74 or
http://www.homevet.com/osc/product_reviews...mp;reviews_id=7

and this

<a href="http://www.homevet.com/osc/product_info.php?cPath=2&products_id=9" target="_blank">http
://www.homevet.com/osc/product_info.ph...;products_id=9
</a>
those are the two staple items that a liver compromised dogs should take. Basically Milk Thistle, SamE, Marin

You can print it out and take it to your vet.
[/B][/QUOTE]

Denamarin is the same thing, Marin (milk thistle/silybin) and Denosyl (SamE). It's just a combination of the two and you need a prescription.

http://www.nutramaxlabs.com/products/anima...marin/index.asp


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## mnk1220 (Feb 5, 2009)

update: blood work came back he does not hqave cushings.. his liver is slightley enlarged. going to wait 3 weeks take him back for bloodwork and see if there are any changes...


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## Ladysmom (Oct 19, 2004)

Has he had a bile acids test yet?


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## dwerten (Oct 6, 2007)

What food are you feeding and are there any symptoms? I would get your baby on a low protein diet as well as that helps with liver disease - my dd is mvd with no symptoms just showed up on 3 bile acids


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## dwerten (Oct 6, 2007)

i would have the protein c test done on next blood draw as i have read that is the best test determine mvd or liver shunt as pre and post biles are good but protein c is the better test. The bile acids can be affected by gall bladder contraction at blood draw so why we had to do it twice and then i did it a third time when she was on low protein and it went from 73 to 54 down to 26 so that is why low protein diet is very important when liver tests high - also make sure no protein treats on top of the food eating -- liver is high in vitamin A which is also not good for liver disease dogs -- fish is a good diet as well as natural balance vegetarian diet as they are low in protein and fish is a protein that is easily digestible. Juiced zucchini is great for liver dogs as it cleanses the liver as well.


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## jmm (Nov 23, 2004)

QUOTE (dwerten @ Feb 7 2009, 11:46 AM) index.php?act=findpost&pid=721239


> i would have the protein c test done on next blood draw as i have read that is the best test determine mvd or liver shunt as pre and post biles are good but protein c is the better test. The bile acids can be affected by gall bladder contraction at blood draw so why we had to do it twice and then i did it a third time when she was on low protein and it went from 73 to 54 down to 26 so that is why low protein diet is very important when liver tests high - also make sure no protein treats on top of the food eating -- liver is high in vitamin A which is also not good for liver disease dogs -- fish is a good diet as well as natural balance vegetarian diet as they are low in protein and fish is a protein that is easily digestible. Juiced zucchini is great for liver dogs as it cleanses the liver as well.[/B]


Bile acids are a test of liver perfusion. A low fat, normal protein meal should be fed. 

A protein C test differentiates between shunt/mvd, but it does not tell you if a dog has normal perfusion if it is in the normal range. Protein C is a clotting factor. 

A protein C test in itself is not a total picture.


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## dwerten (Oct 6, 2007)

so if a dog is below 100 post bile then no need to do protein C? I never did protein C on Dee Dee. I have always read a highly digestible protein or low protein diet for mvd and liver shunt dogs is this not true? I have dd on low protein soy diet and her post biles went from 54 down to 26 just with diet change alone and post bile was done by jean dodds the last time - just curious if she needs to stay low protein as always thought - fish, soy, vegetarian diets were best for liver compromised dogs?


QUOTE (JMM @ Feb 7 2009, 12:57 PM) index.php?act=findpost&pid=721249


> QUOTE (dwerten @ Feb 7 2009, 11:46 AM) index.php?act=findpost&pid=721239





> i would have the protein c test done on next blood draw as i have read that is the best test determine mvd or liver shunt as pre and post biles are good but protein c is the better test. The bile acids can be affected by gall bladder contraction at blood draw so why we had to do it twice and then i did it a third time when she was on low protein and it went from 73 to 54 down to 26 so that is why low protein diet is very important when liver tests high - also make sure no protein treats on top of the food eating -- liver is high in vitamin A which is also not good for liver disease dogs -- fish is a good diet as well as natural balance vegetarian diet as they are low in protein and fish is a protein that is easily digestible. Juiced zucchini is great for liver dogs as it cleanses the liver as well.[/B]


Bile acids are a test of liver perfusion. A low fat, normal protein meal should be fed. 

A protein C test differentiates between shunt/mvd, but it does not tell you if a dog has normal perfusion if it is in the normal range. Protein C is a clotting factor. 

A protein C test in itself is not a total picture.
[/B][/QUOTE]


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## dwerten (Oct 6, 2007)

also i do not do any supplementation with her and she has never had symptoms of liver disease except her skin issues could be derived partly from that as the body can detox through skin if liver is not functioning 100% 


QUOTE (dwerten @ Feb 7 2009, 01:11 PM) index.php?act=findpost&pid=721256


> so if a dog is below 100 post bile then no need to do protein C? I never did protein C on Dee Dee. I have always read a highly digestible protein or low protein diet for mvd and liver shunt dogs is this not true? I have dd on low protein soy diet and her post biles went from 54 down to 26 just with diet change alone and post bile was done by jean dodds the last time - just curious if she needs to stay low protein as always thought - fish, soy, vegetarian diets were best for liver compromised dogs?
> 
> 
> QUOTE (JMM @ Feb 7 2009, 12:57 PM) index.php?act=findpost&pid=721249





> QUOTE (dwerten @ Feb 7 2009, 11:46 AM) index.php?act=findpost&pid=721239





> i would have the protein c test done on next blood draw as i have read that is the best test determine mvd or liver shunt as pre and post biles are good but protein c is the better test. The bile acids can be affected by gall bladder contraction at blood draw so why we had to do it twice and then i did it a third time when she was on low protein and it went from 73 to 54 down to 26 so that is why low protein diet is very important when liver tests high - also make sure no protein treats on top of the food eating -- liver is high in vitamin A which is also not good for liver disease dogs -- fish is a good diet as well as natural balance vegetarian diet as they are low in protein and fish is a protein that is easily digestible. Juiced zucchini is great for liver dogs as it cleanses the liver as well.[/B]


Bile acids are a test of liver perfusion. A low fat, normal protein meal should be fed. 

A protein C test differentiates between shunt/mvd, but it does not tell you if a dog has normal perfusion if it is in the normal range. Protein C is a clotting factor. 

A protein C test in itself is not a total picture.
[/B][/QUOTE]
[/B][/QUOTE]


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## jmm (Nov 23, 2004)

Deb, please read what I said. For the bile acid test, a low fat, normal protein meal should be fed. 

Protein C is looking for a shunt. Protein C is a test to follow up on a bile acid assay or if you simply want to know there is no shunt, but don't want to know if there may still be MVD. 

Bile acids are not a good monitoring test. Every time you test you will get different values and if you alter the food from a low fat, normal protein meal. Remember, you are testing perfusion with this test. A monitoring test would be liver enzymes. 

QUOTE (dwerten @ Feb 7 2009, 12:11 PM) index.php?act=findpost&pid=721256


> so if a dog is below 100 post bile then no need to do protein C? I never did protein C on Dee Dee. I have always read a highly digestible protein or low protein diet for mvd and liver shunt dogs is this not true? I have dd on low protein soy diet and her post biles went from 54 down to 26 just with diet change alone and post bile was done by jean dodds the last time - just curious if she needs to stay low protein as always thought - fish, soy, vegetarian diets were best for liver compromised dogs?
> 
> 
> QUOTE (JMM @ Feb 7 2009, 12:57 PM) index.php?act=findpost&pid=721249





> Bile acids are a test of liver perfusion. A low fat, normal protein meal should be fed.
> 
> A protein C test differentiates between shunt/mvd, but it does not tell you if a dog has normal perfusion if it is in the normal range. Protein C is a clotting factor.
> 
> A protein C test in itself is not a total picture.[/B]


[/B][/QUOTE]


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## mnk1220 (Feb 5, 2009)

Hudson is on a special diet that the vet put him on do to stones.. he had stones removed about a year ago.. Urinary SO canned food that i mix witht he urinary so dryedfood. The vet said that the food has nothing to do with his high liver enzymes and enlarged liver.. His liver enzymes were high when i had his 1st cleaning done on his teeth.. About 2 years later (feb 2009) i had his teeth cleaned again and the levels have gone up a little more.. HE has to take a supplement (Denamarine) I am soo confused on all of this and just trying to learn everything i can to help my dog. My vet said if the levels have gone up on the next blood work i mite want to think about a liver biopsy/ultrasound. He also mentioned that this could jsut be him meaning he just mite have a slightely enlarged liver then other dogs. I thank you all for your advice and support!


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## jmm (Nov 23, 2004)

Keep in mind that an ultrasound is non invasive and does not require any medications. Its not so bad at all other than a shaved belly.


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## mnk1220 (Feb 5, 2009)

your rite.. but the vet also said a ultrasound could come back inconclusive,, i will hope for lower lvel in 3 weeks


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## luvmyfurbaby (Feb 11, 2007)

QUOTE (LadysMom @ Feb 7 2009, 10:47 AM) index.php?act=findpost&pid=721190


> QUOTE (LuvMyFurbaby @ Feb 5 2009, 10:49 PM) index.php?act=findpost&pid=720342





> QUOTE (mnk1220 @ Feb 5 2009, 10:25 PM) index.php?act=findpost&pid=720334





> okay so the xray showed enlaRGED liver... waiting to hear from the vet when the results from the blood work and urine are in.. they put him on a supplement called Denamarin[/B]


You may want to ask your vet if you can give him this 
http://www.homevet.com/osc/product_info.php?products_id=74 or
http://www.homevet.com/osc/product_reviews...mp;reviews_id=7

and this

<a href="http://www.homevet.com/osc/product_info.php?cPath=2&products_id=9" target="_blank">http
://www.homevet.com/osc/product_info.ph...;products_id=9
</a>
those are the two staple items that a liver compromised dogs should take. Basically Milk Thistle, SamE, Marin

You can print it out and take it to your vet.
[/B][/QUOTE]

Denamarin is the same thing, Marin (milk thistle/silybin) and Denosyl (SamE). It's just a combination of the two and you need a prescription.

http://www.nutramaxlabs.com/products/anima...marin/index.asp
[/B][/QUOTE]

The vet on that site will go ahead and dispense them for you. They are what is recommended on various LS/MVD forums.

QUOTE (mnk1220 @ Feb 7 2009, 10:43 PM) index.php?act=findpost&pid=721649


> your rite.. but the vet also said a ultrasound could come back inconclusive,, i will hope for lower lvel in 3 weeks[/B]


An Ultrasound found my Yorkie's liver shunt right away but you need to go to a radiologist that specializes in this.


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## dwerten (Oct 6, 2007)

The vet wanted dd to have a liver scan with post biles less than 100 and i chose not to as she had no symptoms of liver shunt and i lowered her protein and her bile acids went down. I do feel in some cases treat the dog not the bloodwork and if your dog has been acting normal and no issues i would do the pre and post bile just to see what is going on like i did but I read everything on liver shunt and mvd and joined a group for this and read everything and read if mvd lower the protein to less than 22% for a dog not having symptoms and a dog having symptoms below 18% protein. Eventually i want to do the dr dodds liver cleansing diet which many use and it is a fish diet that works well for liver compromised dogs. I can honestly say i had the pre and post done on a higher protein diet and after feeding a lower protein diet and my dogs post biles dropped in half. I will not put my dog through any testing unless absolutely necessary like liver biopsy etc and why i researched everything before just running out and doing the liver scan as i was not having them put radio active dye in my dog without it being necessary as she showed no signs of head pressing, seizures, spaced out after eating etc. I have read that they have to be really good to read an ultrasound and catch it but the biggest indicator is on the pre and post if the post are over 100 then it is a possibility it is a shunt. If below most likely mvd. I do not supplement dd and she is almost 5 years old and on temarilp which affects the liver and she gets bloodwork every 6 mos and is fine. 



QUOTE (mnk1220 @ Feb 7 2009, 10:32 PM) index.php?act=findpost&pid=721598


> Hudson is on a special diet that the vet put him on do to stones.. he had stones removed about a year ago.. Urinary SO canned food that i mix witht he urinary so dryedfood. The vet said that the food has nothing to do with his high liver enzymes and enlarged liver.. His liver enzymes were high when i had his 1st cleaning done on his teeth.. About 2 years later (feb 2009) i had his teeth cleaned again and the levels have gone up a little more.. HE has to take a supplement (Denamarine) I am soo confused on all of this and just trying to learn everything i can to help my dog. My vet said if the levels have gone up on the next blood work i mite want to think about a liver biopsy/ultrasound. He also mentioned that this could jsut be him meaning he just mite have a slightely enlarged liver then other dogs. I thank you all for your advice and support![/B]


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## dwerten (Oct 6, 2007)

huh i have never read that on the liver shunt group always low protein - low fat for pancreatitis but low protein for mvd -interesting. How does fat affect the liver? Right that is what i thought protein C test can determine if there is a shunt more so than an ultrasound as very hard to detect in an ultrasound. The other test for liver shunt is the Scintigraphy- the facility below is where dee dee was referred but with no symptoms i was not going to put her through this. There are only a few facilities that offer this testing though as they use radioactive dye. 

http://www.avmi.net/NewFiles/Scintigraphy/Portal.html

I have read a ton on this as my dee dee is mvd. I read the terry shumsky site joined to liver shunt mvd groups on yahoo as i wanted to know everything about this when she was diagnosed. I do know that the test can be altered by a gall bladder contraction but once a dog tests over 26 post bile and below 100 usually mvd.


QUOTE (JMM @ Feb 7 2009, 04:59 PM) index.php?act=findpost&pid=721398


> Deb, please read what I said. For the bile acid test, a low fat, normal protein meal should be fed.
> 
> Protein C is looking for a shunt. Protein C is a test to follow up on a bile acid assay or if you simply want to know there is no shunt, but don't want to know if there may still be MVD.
> 
> ...





> so if a dog is below 100 post bile then no need to do protein C? I never did protein C on Dee Dee. I have always read a highly digestible protein or low protein diet for mvd and liver shunt dogs is this not true? I have dd on low protein soy diet and her post biles went from 54 down to 26 just with diet change alone and post bile was done by jean dodds the last time - just curious if she needs to stay low protein as always thought - fish, soy, vegetarian diets were best for liver compromised dogs?
> 
> 
> QUOTE (JMM @ Feb 7 2009, 12:57 PM) index.php?act=findpost&pid=721249





> Bile acids are a test of liver perfusion. A low fat, normal protein meal should be fed.
> 
> A protein C test differentiates between shunt/mvd, but it does not tell you if a dog has normal perfusion if it is in the normal range. Protein C is a clotting factor.
> 
> A protein C test in itself is not a total picture.[/B]


[/B][/QUOTE]
[/B][/QUOTE]


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## dwerten (Oct 6, 2007)

http://www.peteducation.com/article.cfm?c=2+2083&aid=514

http://www.peteducation.com/article.cfm?c=2+2103&aid=882


some more info on liver above


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## dwerten (Oct 6, 2007)

http://www.peteducation.com/article.cfm?c=2+2103&aid=315

more info


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## dwerten (Oct 6, 2007)

http://www.yorkieangelpatrol.com/mvd.htm


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## dwerten (Oct 6, 2007)

I do supplement dee dee with probiotics everyday 30 min before food which helps as well for her digestive tract and helps with keeping bacteria infections down with an allergy dog as well


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## jmm (Nov 23, 2004)

Deb, it is great you want to share information, but please read what I have written for the third time. 

For the bile acid test, a low fat, normal protein meal should be fed. FOR THE TEST. Feeding high fat or altering other things for your retests will in itself alter the results. 

This has NOTHING TO DO WITH FEEDING TO TREAT LIVER DISEASE.


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## dwerten (Oct 6, 2007)

We fed dee dee's normal diet she was eating for the test. We were not told to feed anything different and i never heard that before. She ate her normal food for the first test and the second test then we fed her for 6 months a low protein diet and she was tested again and her bile acids were done again and they dropped due to the low protein diet. I guess i am not understanding what you are saying as I was suggesting a low protein diet if the dog has mvd. 


QUOTE (JMM @ Feb 8 2009, 01:52 AM) index.php?act=findpost&pid=721727


> Deb, it is great you want to share information, but please read what I have written for the third time.
> 
> For the bile acid test, a low fat, normal protein meal should be fed. FOR THE TEST. Feeding high fat or altering other things for your retests will in itself alter the results.
> 
> This has NOTHING TO DO WITH FEEDING TO TREAT LIVER DISEASE.[/B]


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## dwerten (Oct 6, 2007)

ok in reading this again i see what you are referring to but i was never told this by my vet nor by dr dodds when they both did the bile acids and never read this before on any of the liver shunt mvd groups i am on so this is new to me. We just fed what she was eating then switched to a low protein diet and re-did it. It was not clear to me what you were saying below as i thought you were saying a low fat normal protein meal should be fed not for the test 


QUOTE (JMM @ Feb 7 2009, 01:57 PM) index.php?act=findpost&pid=721249


> QUOTE (dwerten @ Feb 7 2009, 11:46 AM) index.php?act=findpost&pid=721239





> i would have the protein c test done on next blood draw as i have read that is the best test determine mvd or liver shunt as pre and post biles are good but protein c is the better test. The bile acids can be affected by gall bladder contraction at blood draw so why we had to do it twice and then i did it a third time when she was on low protein and it went from 73 to 54 down to 26 so that is why low protein diet is very important when liver tests high - also make sure no protein treats on top of the food eating -- liver is high in vitamin A which is also not good for liver disease dogs -- fish is a good diet as well as natural balance vegetarian diet as they are low in protein and fish is a protein that is easily digestible. Juiced zucchini is great for liver dogs as it cleanses the liver as well.[/B]


Bile acids are a test of liver perfusion. A low fat, normal protein meal should be fed. 

A protein C test differentiates between shunt/mvd, but it does not tell you if a dog has normal perfusion if it is in the normal range. Protein C is a clotting factor. 

A protein C test in itself is not a total picture.
[/B][/QUOTE]


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