Dear Dr. John,
My Welsh Terrier is ten months old. She went in for her spay after going into heat a short while ago. The original bloodwork and surgery were both delayed until now. I received a call from the vet informing me that one thing in her pre-surgery bloodwork was abnormal and, as such, they wanted to delay the anesthesia and surgery pending further diagnosis. They told me that a liver enzyme called ALT was around 1000. They ran it twice to be sure and one time was slightly over and the second just under that figure. They did not go into the possible causes yet but what could they be? Will my puppy be okay? She is otherwise acting completely normally and has never had any health issues whatsoever. — W.R.
Dear W.R.,
If your puppy is otherwise normal in all other aspects, I would relax for now. Liver problems in dogs lead to their being jaundiced, decreased appetites, and even vomiting and diarrhea and your puppy has not displayed such. By the time you receive my response, hopefully a proper diagnosis will have been made and any needed procedures or treatment initiated or concluded. ALT is alanine aminotransferase, and it is the only liver specific enzyme. This case is a great example of why pre-surgical bloodwork, even in a young seemingly healthy puppy, is a worthwhile endeavor.
Normal ALT in a puppy should be somewhere between 20-125. Values as high as the ones your puppy have are either machine error or indicative of a specific liver issue and could suggest liver cellular damage. The confusing thing is the puppy does not seem ill. I’m hoping for machine error but the fact that they might have drawn two blood samples and got the same results is somewhat concerning. Things that can cause elevated ALT include hepatitis, heart failure, intestinal inflammation, severe dental problems, endocrine disorders, a genetic disorder, copper storage issue, Leptospirosis, or toxin ingestion such as getting into Tylenol. I suspect they will measure bile acids. This will lead to a more specific understanding of the liver function or suggest need for an ultrasound and/or liver biopsy. Good luck!
Dr. John de Jong owns and operates the Boston Mobile Veterinary Clinic .He can be reached at 781-899-9994.
