Liver enzymes ALT level of 1500

Epi4Dogs Foundation Inc.’s mission is the advancement of science and education relating to EPI (Exocrine Pancreatic Insufficiency), yielding useful insights and positive outcomes in better managing EPI in dogs and cats. Our goals are to support and/or collaborate with veterinary EPI research and researchers, and to promote EPI awareness by educating the general public, pet owners, pet organizations, rescue and shelter organizations, veterinary schools and veterinarians.
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nessmuk@ntcnet.com
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Location: Upstate NY
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State: New York
Pet name: Whiskey
My name: Elizabeth

Liver enzymes ALT level of 1500

Post by nessmuk@ntcnet.com » 20 Oct 2021, 23:47

I have a 7 year old GSD, Whiskey. He was diagnosed with EPI as a young dog and has been on enzymes for many years. I recently had blood chemistry that the ALT level of 1100 then a month after taking denamarin it went up to 1500. Has anyone else had problems with liver enzymes being this high? Is liver issues a common problem with EPI dogs? He acts normal and our original concern was he was loosing weight. Background: I had a routine GI panel in June 2021 and levels all came back normal. In August I had a urinalysis done. All levels were normal. I then had a blood chemistry in September which came back with extremely high ALT liver enzyme level of 1100. The vets office had to dilute it many times to get a reading which confused my vet as they usually don't have problems with getting high reading without diluting. She commented that it seemed that the machine just didn't like his blood. This comment seemed to concern me as I wondered why this was happening. Has anyone else heard of a problem like this? She prescribed denamarin and he has been on it since then. She recommended an ultrasound as the next step to identify what was happening. The ultrasound in September came back clear of any issues. Then on October 15 after the 1500 reading she prescribed metronidazole for a month. She suggested I go back after a month and recheck his blood. His poop has always been soft but recently gotten very yellow in color. I have increased his enzymes to see if that would help. I also slowly changed his food to 1/2 Hills Diet Liver care and 1/2 Canidae Salmon/sweet potato. I have started giving him slippery elm powder. His poop was a little browner yesterday but today it is back to more yellowish. Even though he acts pretty normal I don't want to wait until his symptoms get worse in case I can get an early jump on fixing whatever is wrong. I would appreciate anyone's help or input. Thank you.

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jilbert57
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Re: Liver enzymes ALT level of 1500

Post by jilbert57 » 21 Oct 2021, 10:09

Hi Elizabeth,
Here is a link from our Concurrent Conditions file. I will do some asking.

https://epi4dogs.com/liver-conditions/

Jill
My name is Jill and we live on the Hood Canal in Washington State. We currently have one pup. TJ is a 5 year old Jack Russell.

Mickey and his pancreatitis brought me to Epi4dogs.com site in 2012 to help manage it.
He lived from 6/99 - 8/2014

Mickey, Jack Russell. Chronic Pancreatitis. Dianes enzymes, 1/8t 3x/day with meals.

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nessmuk@ntcnet.com
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Location: Upstate NY
Country: United States
State: New York
Pet name: Whiskey
My name: Elizabeth

Re: Liver enzymes ALT level of 1500

Post by nessmuk@ntcnet.com » 21 Oct 2021, 12:18

Thank you for the reply. I did see that article and it was above my understanding but I am printing it out and will give it to my vet. She will be able to understand it. I do have a consultation appointment with Cornell University Vet Hospital (which I am 3 hours away from) in mid December. I am trying to make sure I am not waiting and doing any harm to my precious dog. I want to at least do no more harm if possible until we get to the appointment. It is just hard to wait and be patient to see if these other options work when the numbers went up and are so high. I don't see much on the internet that says that the ALT levels are as high as his. Thanks again for your help.

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jilbert57
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Re: Liver enzymes ALT level of 1500

Post by jilbert57 » 21 Oct 2021, 16:24

My name is Jill and we live on the Hood Canal in Washington State. We currently have one pup. TJ is a 5 year old Jack Russell.

Mickey and his pancreatitis brought me to Epi4dogs.com site in 2012 to help manage it.
He lived from 6/99 - 8/2014

Mickey, Jack Russell. Chronic Pancreatitis. Dianes enzymes, 1/8t 3x/day with meals.

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nessmuk@ntcnet.com
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Posts: 23
Location: Upstate NY
Country: United States
State: New York
Pet name: Whiskey
My name: Elizabeth

Re: Liver enzymes ALT level of 1500

Post by nessmuk@ntcnet.com » 21 Oct 2021, 16:58

Thank you that article, it was very helpful. I will question my vet about the pre and post bile acids blood test. I guess we all get very anxious when it comes to our dogs, they are so important to us! I will continue on with what I am doing and hope his levels improve. I am grateful for your website and the epi community. It is scary feeling alone in trying to figure out what is best for our dogs. Vets can't know everything about all diseases and I know they are doing the best they can. Having real live people sharing their experiences and challenges is helpful to make us not feel alone. It is so hard to figure out what foods are good for them, what kinds of supplements will help, so many options and decisions to make on our own. Thanks again for your assistance and any more input is welcomed.

Tuckaboo Pam
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Re: Liver enzymes ALT level of 1500

Post by Tuckaboo Pam » 21 Oct 2021, 19:24

I am very sorry you are having to go through this, and I hope things work out for you and Whiskey.---Pam
Tucker is a shepherd/lab mix; he has tested positive on the ScheBo test for EPI, as well as the fasting TLI. Results--- TLI 1.3, Folate 9.7, Cobalamin 666, Lipase 38. Currently taking Diane's Enzymes 4 teaspoons/day, Wonderlab B12 one capsule per day, and Tylan 1/16 teaspoon twice/day (to hold SID at bay). Sport Dog Elite, herding dogs 3 1/2 cups/day. No more poop eating, has gone from 60 to 80 pounds, and he is a happy member of the family, though a bit of a stinker, if you ask the other dogs. Tucker is my boyfriend, and my husband is OK with that.

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Olesia711
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Re: Liver enzymes ALT level of 1500

Post by Olesia711 » 22 Oct 2021, 12:39

Hi ELizabeth.... very often in EPI dogs, the ALT liver enzymes are elevated and sometimes by a lot due to SID...... and then further down in your posts i read where the poos are getting more crappy looking (yellowish).... and that certainly reaffirms that this is most likely do to uncontrolled SID.. Of course it can always be something else, so it is best to have your vet check everything out, better safe than sorry..... but uncontrolled SID would be my first suspect in an EPI dog.

Next... although i know your vet was probably trying to address a gastrointestinal issues / SID with the Metronidazole antibiotic... but please contact your vet and ask if they can swap out the Metro for Tylan (Tylosin Tartrate ).. Metro is now a 'no-no" for any CHRONIC gastrointestinal issue via current research (and SID is a chronic condition), especially like SID in EPI dogs, per Dr. Joerg Steiner (head of the TAMU gastro lab), Dr. Jan Suchodolski (premier TAMU gastro researcher). The deal is that EPI dogs not only do not have enough bacteria in their gut flora, but that they also don't have enough variety. Metro KILLS all bacteria and the bad part is that in our EPI dogs some of the bacterial strains that are killed will never come back no matter how many probiotics you feed the dog trying to replenish the gut flora to get SID under better control.

Tylan on the other hand is a macrolide antibiotic, which suppresses the reproduction of bacteria..... so you have a better chance of not doing permanent damage with Tylan vs. Metro.

Typically what is now recommended is to first start with a prebiotic (like Slippery Elm, but there are other products too) and if that helps, but not enough, then implement a pre+probiotic (like Visbiome or Proviable)... BUT..... sometimes you are beyond this and simply need an antibiotic, which it sounds like that is where you are at.. hence the need for an antibiotic- -just use the right one. So please talk to your vet and try to swap out the metro for tylan. Also tylan usually work wayyyyyyyy better than metro.

Once you start the tylan (45 days regimen/twice a day) about half way thru... talk to your vet about introducing a pre+probiotic ..... you can actually give this at the same time as the tylan (you cannot do this with metro!)... BUT.... we also strongly recommend starting with less than half the dose of the pre+probiotic and work your way up to a full dose over the course of a week or two.. SOme dogs get loose stools when started on a probiotic... that is why we recommend starting slow............

hope this helps and PLEASE share with your vet everything that we suggests to you.
Olesia, was owned by Izzy, a 35lb Spanish Water Dog (SWD), Diagnosed at 1.5 years old - TLI results 1.. Izzy passed away on February 13, 2020 at 15 years old. She lived with EPI for 13+1/2 years. It was because of Izzy that Epi4Dogs was started... she was the inspiration. May her legacy of helping others with EPI continue for as long as needed.........

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nessmuk@ntcnet.com
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Posts: 23
Location: Upstate NY
Country: United States
State: New York
Pet name: Whiskey
My name: Elizabeth

Re: Liver enzymes ALT level of 1500

Post by nessmuk@ntcnet.com » 22 Oct 2021, 14:34

Thank you so much for your website and your prompt response to my inquiry. I have sent it on to my vet and hope she gives me the suggested items and learns more from this whole experience, She didn't seem to have much experience with EPI dogs. I knew you would have a much wider information base due to the many people and dogs you have helped. Our dogs are our precious gems and I have been blessed with many of them over the years and currently have 6 dogs for which my life revolves around. Most of them are healthy and happy but as they age new issues come and at least Whiskey's issue has your wonderful support to help me through his aging years. I am encouraged to hear how long your dog lived and hope Whiskey can come through this stronger for it.
Take good care and thanks again!

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Olesia711
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Location: North Carolina
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My name: olesia

Re: Liver enzymes ALT level of 1500

Post by Olesia711 » 22 Oct 2021, 14:58

Elizabeth, you are more than welcome!

If your vet is interested in reading the actual research on Metronidazole, we have it on this page: https://epi4dogs.com/sid-sibo-microbiome-research/
At least with Tylan, short term (45 days) you have a MUCH better shot at rebuilding the gut flora :)

If your vet is interested in the the not enough bacteria and not enough bacterial variety in the gut of an EPI dog.... here is an abstract from Dr. Suchodolski/TAMU: https://epi4dogs.com/microbiomemicrobiota-research/

And if your vet is really interested in the latest findings in gut flora of an EPI dog, you an share with her this research Drs. David A. Williams and Patrick Barko ... a correlation with certain Metabolites in EPI+SEPI dogs! https://epi4dogs.com/epi-research/

Over the years, Epi4Dogs Fdn has collaborated on multiple EPI research projects with Texas A&M (TAMU), the University of Illinois, Clemson University and veterinarian schools outside of the USA in our desire and effort to uncover what triggers EPI and how can we better manage it. SO we do our best to keep this website updated with the most current information, findings and research on EPI. Each section has a research tab. :)

And last but not least... it really doesn't matter if you have a vet that is not well versed in EPI.... some of the best EPI vets have turned out to be those that were not overly familiar with EPI but were so interested in their EPI patient that they were excited to work WITH the client, did research on their own and were willing to "try" a variety of adjustments when needed ....
Olesia, was owned by Izzy, a 35lb Spanish Water Dog (SWD), Diagnosed at 1.5 years old - TLI results 1.. Izzy passed away on February 13, 2020 at 15 years old. She lived with EPI for 13+1/2 years. It was because of Izzy that Epi4Dogs was started... she was the inspiration. May her legacy of helping others with EPI continue for as long as needed.........

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nessmuk@ntcnet.com
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Posts: 23
Location: Upstate NY
Country: United States
State: New York
Pet name: Whiskey
My name: Elizabeth

Re: Liver enzymes ALT level of 1500

Post by nessmuk@ntcnet.com » 22 Oct 2021, 15:57

Great info, thanks, I have also sent it on to my vet. Unfortunately it is Friday and my vet isnt the best at getting back to me so she may not read any of this until next week. In the mean time I ask you for some guidance. Would you suggest I stop the antibiotic so as to not do any more damage until I get the other one?. Also I do have the slippery elm bark power for dogs from Wonderlabs. Should I give him some of that in the mean time? If so how much? He is 70 lbs. I have been giving him the Demanarin 2 pills per day 1 hour before meal, should I continue? I have been feeding him CANIDAE Grain-Free PURE Limited Ingredient Salmon & Sweet Potato Recipe Dry Dog Food but when we got his high liver enzyme levels I was afraid that it was too much fish since that I read fish wasnt good for liver issues but I hated to switch anything due to possible messing up his system too much. So I am now feeding him 1 cup of that plus 1 cup of dry Hill's Prescription Diet l/d Liver Care Chicken Flavor Dry Dog Food 2X a day.,. He has always been a finicky eater so I top dress it with a couple tablespoons of scrambled eggs (from my own hens) with some canned tripe. I use to give him PetKind Tripett New Zealand Green Lamb Tripe Grain-Free Canned Dog Food but recently this brand of tripe became unavailable so I switched to Ziwi Peak Tripe & Lamb Recipe Canned Dog Food. I then added some Hill's Prescription Diet l/d Liver Care Original Canned Dog Food on top too after the high liver enzyme reading. I read on the internet that you should avoid feeding fish and organ meat to dogs with liver problems so I split the difference between what was good for the liver and what might be better for his EPI condition. Ugh, so confusing and scary! I try to feed him only the best and I just hope I don't complicate his issues due to my over zealous desire to help him. I use to give him 1 tsp Diane Enzymes per 2 cups dry plus 1/4 cup soft food but recently increased that to now 2 tsp/2 dry plus 1/4soft food. I was concerned over his soft poop being yellow and thought maybe having more enzymes might help. To be honest I have 6 dogs and have very large fenced in woodland homestead and it is very hard to see his poop as he poops off into the woods. It has never been great or even good but I thought that it was his normal. It wasn't until I noticed he was loosing a little weight that I got the blood work done. His GI bloodwork this summer was good so I didn't think I had to worry. Once I noticed the soft yellow poop that seemed odd and different for him. Also another interesting fact, his poop use to really stink and now it doesn't smell at all, weird? Well thanks again for listening and helping me help my sweet boy.

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