9/26 - Update on Oliver and question about high ALT/AST

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FluffBunny

Member Since 2014
Oliver has been OTJ since 6/15 and he has been doing really well. He is completely off the prednisolone now and all was well until last week when he barfed twice. He also has lost a little weight - about 1/4 lb. I took him in for a checkup Tuesday. When his blood test results came back, everything was normal except his liver enzymes. ALT and AST were both very high. The upper range of normal for this lab is 100 and Oliver's values were over 200 for one and over 300 for the other. My vet tells me that this indicates liver damage - or possibly a problem with his pancreas or IBD. (He was on the pred. for possible IBD, but his liver values were not elevated when he was diagnosed. His ultrasound at the time did show a shadow on his pancreas which may have been inflammation.)

My question is - has anyone else had issues with high liver enzymes with eerything else normal? There is so much kitty knowledge here, I thought I'd ask. Oliver is going in for an ultrasound next week, but, in the meantime, I would appreciate any information or insight any of you might have.

Thanks,
Linda
 
Re: 9/26 - Update on Oliver and question

My Leo (civvie) has some form of IBD/intestinal irritation, and the only real symptom besides thickened intestines on ultrasound has been elevated liver values and weight loss. He's now on injected Dexium (a steroid) since he's utterly impossible to pill, and so far doing well - liver values back to normal and has gained about 3/4 lb over the last two months. So far his bgs are normal, knock wood.
 
Re: 9/26 - Update on Oliver and question

Hi Linda,

Marje's Gracie also has elevated ALT levels with no other apparent problems. I know she's tried some different things for it so hopefully she'll be able to pop in with some suggestions for you. (Maybe update your subject line to say something about high ALT/AST levels to try to catch the attention of those who have experience with it???)

I really wish I could help you with it, but I have no experience there. I am, however, really glad to hear that Oliver is doing well otherwise.

Shelly
 
Thanks to those who have responded. Oliver's T-4 is normal. I really hope he doesn't have to go back on a steroid for his IBD since that is what caused his diabetes.
 
Sorry to hear Oliver hasn't felt well :YMHUG: :YMHUG: Is there any other medication he takes besides pred that could be causing inflammation? My Tiger had elevated ALT and AST values on her 4/8/2014 Labs, and also on 4/14/2014 she had elevated AST only. Both times she was in to see the vet due to vomiting and inappetance; on 4/14 she had to be hospitalized and put on an IV for 4 days. During that time she was given an anti-nausea med, appetite stimulant. I always wondered if that didn't cause the liver enzymes to be messed up. Once she came home, the levels returned to normal. At that time, her thyroid T4 was 0.6(hypothyroid)

For what it's worth, I myself had elevated ALT and AST after gallbladder surgery-as my GI system was all messed up :roll: My GI Doc wasn't too worried - she made me drink a lot of water and I had to keep going in to get more BW done for a week or two, then for whatever reason, it went down and I haven't had a problem since.
 
Max has had high ALT at times when he had a pancreatitis episode. It got close to 200 but never over that. His test in April it was well under 100 for the first time in 4 years and he wasn't showing signs of pancreatitis at that time so we didn't test for it.
 
The appetite stimulant is a possibility, I guess. I have given him cyprohepradine recently to stimulate his appetite.
 
I often thought that when Max was on cyproheptadine and ondansetron with the pancreatitis it might have caused the elevation of the ALT. I would think that if they are processed through the liver it might do that. Interesting that you thought so as well Ruth. I never read up on that or asked my vet though.
 
I don't know much about the liver, but I saved this link that someone posted a while back. Maybe it would be helpful to you.

http://zimmer-foundation.org/sch/ajf.html
AST, ALT, ALP, CK, and cholesterol are a group of tests that help evaluate liver function. AST, ALT, and ALP are hepatocellular enzymes that are released into the blood when there is direct cellular damage to liver cells. AST and ALP are fairly nonspecific, because they can also be released from muscle or other tissue damage. ALT is fairly liver specific. CK helps differentiate, because it is only released from muscle damage (interestingly, CK can be high in human patients after a heart attack). If the only enzymes in this group that are elevated are AST and CK, then it is generally concluded that the liver is probably okay and the cause is muscle damage. However, if the pattern of elevated values includes AST, ALT, and ALP, but CK is normal, it would suggest that liver damage is more likely. If the only value that is elevated is ALP, that is considered very non-specific and not very informative. Finally, if cholesterol is abnormal, it may be due to liver dysfunction.

Marje does have a lot of experience with this, but she's been sick this week. I'm guessing she might be online today.
 
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