# Elevated ALT, BUN, and Creatine



## mistilarae (Mar 18, 2007)

My one year old Maltese was just at his vet and had some lab work done. They have been monitering his ALT for the last few month since it's been elevated.
Well now his Creatine has come back elevated also and our vet is telling us his kidneys are not functing proberly. 
His labs on 11/20/06 were:
Bun 30
Alt 290
Creatine 1.2
Labs 3/17/07:
Bun 40
ALT 403
Creatine 2.7

I have just heard about the food recall and so far Sully doesn't eat any of those brands. He was on Wellness. Yesterday his vet switched him to Prescription Diet with no protien.
Sully acts fine. He does not act sick. No vomiting, diarrhea, or any indication that he is ill.
I would appreciate any imput that anyone has on this.
Thank you.
Mistie


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## Ladysmom (Oct 19, 2004)

This is great to download and keep a copy on hand to help figure out bloodwork.

http://www.bichonfriseusa.com/caninebloodwork.htm

Hopefully Jaimie will see this and can explain more, but has your vet tested his liver function? Unfortunately Maltese are prone to liver disease and if your breeder wasn't carefully screening her dogs for it before breeding, it can be passed on. Did you have a bile acids test done before bringing him home?

Since his elevated levels go back to November, I'm sure it has nothing to do with his food.


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## Cathy (Mar 19, 2006)

> This is great to download and keep a copy on hand to help figure out bloodwork.
> 
> http://www.bichonfriseusa.com/caninebloodwork.htm
> 
> ...


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## CloudClan (Jan 31, 2007)

> My one year old Maltese was just at his vet and had some lab work done. They have been monitering his ALT for the last few month since it's been elevated.
> Well now his Creatine has come back elevated also and our vet is telling us his kidneys are not functing proberly.
> His labs on 11/20/06 were:
> Bun 30
> ...


Mistie,

I am so sorry to hear that you are dealing with this with your little Sully. Has your vet talked to you about the possible causes of his kidney problem (i.e. could it be stones?). 

He is so young. Do you know the health history of his parents, grandparents?

There are some folks on this board who know a lot about these type of things. Jackie (JamiMalts) knows a lot, so hopefully she will see this thread. 



> This is great to download and keep a copy on hand to help figure out bloodwork.
> 
> http://www.bichonfriseusa.com/caninebloodwork.htm
> 
> ...


Marj,

Thanks so much for that link. The boys have had so much bloodwork over the years and I have looked up some of the individual issues, but I have never seen a list of the bloodwork like that in one place. I hope I don't need it anytime soon, but I have bookmarked it.


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## Cathy (Mar 19, 2006)

> My one year old Maltese was just at his vet and had some lab work done. They have been monitering his ALT for the last few month since it's been elevated.
> Well now his Creatine has come back elevated also and our vet is telling us his kidneys are not functing proberly.
> His labs on 11/20/06 were:
> Bun 30
> ...


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## Ladysmom (Oct 19, 2004)

I always request a copy of all bloodwork and go back and compare to earlier results sometimes. I have a pet first aid kit that is actually one of those three drawer carts ( a lot of health issues, that Miss Lady has!) and I keep a copy in a plastic sleeve in one drawer.

Jackie's website has some great links to information about liver disease and other genetic disorders Maltese are prone to. She unfortunately had to deal with a lot of liver disease firsthand in her Maltese. I haven't seen her online in a while though.

http://www.jamimaltese.com/maltesehealth.htm

Mistilarae, have you spoken to Sully's breeder about these test results? That might shed some light on his probelms.


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## Scoobydoo (May 26, 2005)

> My one year old Maltese was just at his vet and had some lab work done. They have been monitering his ALT for the last few month since it's been elevated.
> Well now his Creatine has come back elevated also and our vet is telling us his kidneys are not functing proberly.
> His labs on 11/20/06 were:
> Bun 30
> ...


Oh gee I am so sorry to hear this, your pup is so young to have this problem, I sure hope you can treat Sully successfully and get him well.


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## dr.jaimie (Mar 23, 2004)

have they done any xrays or ultrasound? performed a urinalysis? those would be my next step. things that effect both liver and kidneys are lepto and toxins...some meds....

does this dog go outside? what does the cbc look like? i would be concerned with azotemia (high BUN and creatinine) in this age of a dog or any age...but i wouldnt wait and see what the numbers do now..i would run more tests.


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## jmm (Nov 23, 2004)

Have any other diagnostics been performed? 

A pre- and post-prandial bile acid assay would give you a better picture of liver function. 

With the increasing kidney values, has a urinalysis been checked and the urine also cultured? 

Leptospirosis, tick borne disease, and other infectious diseases are considerations (as already mentioned). 

Have any radiographs been taken? What the subjective liver size small? Were there bladder or kidney stones seen on them? (blockage of the ureters or urethra from stones can increase the kidney values and dogs with liver disease can be prone to form ammonium urate stones - these may only show up on ultrasound)

It may be more convenient to begin the work up with an internist since, more than likely, an ultrasound would end up offering more information.


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## mistilarae (Mar 18, 2007)

> Have any other diagnostics been performed?
> 
> A pre- and post-prandial bile acid assay would give you a better picture of liver function.
> 
> ...


Thank you so much for your reply. I appreciate any help or suggestions I can get.
The vet wanted to get a Urinalysis but Sully had just went potty. (This all took place on a Sat.) So I am taking him in tomorrow to get a urine sample and whatever else they suggest. One possible cause they did mention to me was Polysystemic shunt disease. But again he appears healthy. No symptoms.
I have also heard that it can be normal for Maltese to have a elevated ALT.
Mistie



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## dr.jaimie (Mar 23, 2004)

just eating can raise a BUN but the creatinine would take a lot more...dehydration can cause it but there r no other signs in the blood work of that...so i dont think the fact that it wasnt fasting would change much


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## Ladysmom (Oct 19, 2004)

Here is some information from Bhe Jei Maltese about liver shunts:

http://www.bhejei.com/health-pss.htm


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## mistilarae (Mar 18, 2007)

> Here is some information from Bhe Jei Maltese about liver shunts:
> 
> http://www.bhejei.com/health-pss.htm[/B]



Thank you so much for the great link to liver shunts. It was a great article to read. I sure hope thats not whats wrong with sully.
Mistie


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## jmm (Nov 23, 2004)

It is common for Maltese to have elevated ALTs and bile acids, but it is NOT NORMAL. Maltese are prone to hepatic microvascular dysplasia and/or portosystemic shunts. Dogs can have either or both and be asymptomatic.


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## mistilarae (Mar 18, 2007)

> It is common for Maltese to have elevated ALTs and bile acids, but it is NOT NORMAL. Maltese are prone to hepatic microvascular dysplasia and/or portosystemic shunts. Dogs can have either or both and be asymptomatic.[/B]


Sully is having Bile live Acids checked tomorrow. If those come back positve then they will send him to Michigan State University to have a ultasound done.
His urinalysis came back ok today. It was:
PH 6.0
specific gravity 1.031
protien neg
glucose neg
ketones neg
bilirubin 1+
blood neg
wbc 0-3
rbc 0-3
granular cast 1-3
calcium oxalate cystals mod.
Everything elese negative.

Thanks again for everyones input and concern.
Mistie


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## CathyB (Mar 10, 2007)

> Here is some information from Bhe Jei Maltese about liver shunts:
> 
> http://www.bhejei.com/health-pss.htm[/B]










What a interesting site Thank You


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