# Elevated ALT...



## PooBean

Hello.

I'm PooBean. We've adopted a standard poodle last May. I still pinch myself 
to see if I really have this beautiful boy by my side!

Well, since we got him, we took him to the vet a couple of times for varying
reasons...but during summer, we were told that his ALT level was high...(was
almost at 300) But it was his initial test and so they kind of wanted to see 
how it will be in few months... 

Last December, he had his ALT checked again and it was still around the same
value...so they got him on the supplement to see if that would help. 
(prescription supplement, something starts with M...can't remember...)
After few weeks of this temp treatment, he had blood work again and the vet
told us that his ALT actually went up!! This time, it is 544...:argh:

They are suggesting we need to do the vile-acid test and then ultrasound...
I am wondering...is this condition something that standards are prone to have?
Something to do with food or age??

Since he is my first standard poodle, I don't know what to expect...or do...
Oh he is 7 years old and weighs about 55 pounds...otherwise, very healthy...
(ALT value was the only abnormality they found...am not completely sure what
kind of blood work they did but...)

Any info/pointers would be greatly appreciated.
Thank you in advance.

poobean


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## N2Mischief

The bile acid tests are to check to see if his liver is working properly. Very high bile acids are indicative of possible shunt. Many vets would want you to have an ultrasound done after high bile acids were found to rule out the shunt....but the ultrasound is very inaccurate and is often times a waste of money. Scintigraphy or CT scan are a much better way to go. 

But you haven't even come to that bridge yet. You have a dog with high ALT which can be caused by a number of things....recent vaccines, exposure to chemicals, flea products, even Angel Eyes for tear stains can raise ALT. I am thinking they probably had you try Milk thistle. 

Liver function is obviously very important, so I would definitely get the Bile Acids tested and go from there.


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## PooBean

@N2Mischief,
Thank you for your input.

I am sorry...it wasn't vile...it was bile...
Also, the supplement was Denamarin...

I had been reading different stuff online...my dog is actually on
heartguard and I read that it contains chemicals that could be hard
on dog's liver...is it true?? Do you use heartguard??

As soon as my boy's tummy problem goes away, I am going to
make apo to go ahead and do the bile acid test... And like you
said, take it from there...

Thank you very much...


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## N2Mischief

Yes Denamarin has milk thistle as one of the ingredients. Your heartguard may be part of the problem. My dogs don't take heartworm meds because in California they are less prevalent. 

Liver problems can cause gastro problems so maybe they are related. My Misha would vomit a couple of times a week and often gagged up white foam. Her ALT only slightly high and her bile acids slightly high too. With Misha it was as simple as changing her diet and her ALT is normal, haven't retested bile acids. 

I hope things turn out simple for you as well!


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## elem8886

Hi PooBean, I hope your boy is doing well otherwise. When you had the tests in the summer had he been showing any physical symptoms? 


In October my spoo Tika had elevated levels of white blood cells (possible sign of infection), ALP and ALT (759 when it's max normal is 113). She wasn't showing any sort of symptoms, it was just routine blood work before her dental appointment. Standard poodles are prone to liver problems (specifically Chronic Active Hepatitis, or CAH) so the vet did a bile acid test and an ultrasound. Everything seemed normal on those tests and the vet started her on antibiotics and Zentonil Advanced (similar to Denmarin - both contain SAM-E and milk thistle extract) to see if we could get her enzymes down to normal ranges. 

We did another round of blood work a month later and only her ALT was elevated but it had improved to 203. I was away for a couple weeks and did another blood test when I got back and her ALT had gone up to around 500 without the Zentonil Advanced. The vet did a liver function test that came back normal. She has been on a smaller dose of Zentonil Advanced since then and I am going to have her blood work done again next week to see how she is doing. 

I personally feel that the cause of all this liver trouble was the Leptospirosis vaccine the vet talked me into a week or two before the dental cleaning. I hope that eventually Tika can maintain her enzymes at a normal range without any medication soon but we'll need to decrease her dosage over time and keep doing blood tests to make sure.

Since I have no conclusive reason for her liver troubles I stopped using Revolution on her and switched her food to white fish / poultry based protein and lower levels of copper (dietary recommendations for some types of liver problems). I figure none of those changes are going to hurt and maybe they will help.

Once your boy has the bile-acid test hopefully your vet will be closer to determining what is causing the elevated ALT and what you can do about it. I know it's terrible waiting to find out what's wrong with your dog but I hope things turn out well for him.


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## PooBean

*...Update...*

Hello.

Firstly, thank you elem8886 for your reply. Nope, he is pretty active and eats
normal...the only 'abnormality' was his ALT...we still have hard time believing
something is wrong with his health... 
I hope your Tika is doing well...

As for my pup...we did the for-mentioned bile-acid test and nothing was out of
'normal' range. 
So we went to do the ultra-sound yesterday hoping that it would reveal
something... At the same time, they did another round of blood test to see
his ALT again. This time it was 878!! (previous one was done in Feb
at 544...) 
The diagnosis for him was the Chronic Active Hepatitis...
So the vet suggested this battle plan...he will be on Metronidazole 250mg,
Amoxicillin 250mg, Ursodiol 300mg, Denamarin 425mg and Vitamin E for the 
next two weeks and have a follow-up blood test...
I really really hope this will improve his ALT level...(otherwise, they are 
suggesting having biopsy done as the next step...) I kind of wonder if there
is any 'holistic' approach available??

I am searching this forum for more information about ACH...along with other
sites...I have no idea how serious/what to expect... Any info/suggested web
to read-up is greatly appreciated! 
Thank you in advance!


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## Lunaluv

PooBean said:


> Hello.
> 
> I'm PooBean. We've adopted a standard poodle last May. I still pinch myself
> to see if I really have this beautiful boy by my side!
> 
> Well, since we got him, we took him to the vet a couple of times for varying
> reasons...but during summer, we were told that his ALT level was high...(was
> almost at 300) But it was his initial test and so they kind of wanted to see
> how it will be in few months...
> 
> Last December, he had his ALT checked again and it was still around the same
> value...so they got him on the supplement to see if that would help.
> (prescription supplement, something starts with M...can't remember...)
> After few weeks of this temp treatment, he had blood work again and the vet
> told us that his ALT actually went up!! This time, it is 544...:argh:
> 
> They are suggesting we need to do the vile-acid test and then ultrasound...
> I am wondering...is this condition something that standards are prone to have?
> Something to do with food or age??
> 
> Since he is my first standard poodle, I don't know what to expect...or do...
> Oh he is 7 years old and weighs about 55 pounds...otherwise, very healthy...
> (ALT value was the only abnormality they found...am not completely sure what
> kind of blood work they did but...)
> 
> Any info/pointers would be greatly appreciated.
> Thank you in advance.
> 
> poobean


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## Lunaluv

Did the metrazole and other supplements treatment work? Our toy poodle has a similar issue and i want to avoid the biopsy


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## PeggyTheParti

Lunaluv said:


> Did the metrazole and other supplements treatment work? Our toy poodle has a similar issue and i want to avoid the biopsy


Welcome @Lunaluv. If you don’t get a reply from the original poster here, feel free to start a new thread. Others may be able to share some experiences with you.


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## johanne

Hi We have a 3 1/2 year old red standard poodle with high ALT as well. His are in the 630-700. He is on Royal Canine Hepatic food and Honest Kitchen dehydrated food with low copper (they have only 3 options that is low in copper) and I add cooked brown rice, mixed frozen berries to it. We get the grain friendly Turkey or Fish gran free from Honest Kitchen. He is followed by a Holistic Vet and he is on Chinese herbs, and milk thistle. He is healthy besides that. We are not sure what the cause is but he did get 2 ultra sounds, inconclusive both.


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