Regular Wellness Exam: Cookie's ALT Was Elevated

Regular wellness exams are one of the most important things you can do for your dog. Many problems can be caught long before they cause clinical signs. Things you missed can be discovered.

A regular health evaluation can address early dental disease, weight issues, orthopedic issues and catch systemic disease or organ damage early.

JD's results didn't show any abnormalities. Everything is looking good, including his mobility. Outside all the time, walking, running, playing with Cookie and his hips are not causing him any problems.

I don't look sick to you, mama, do I?

Cookie's blood work came back with elevated ALT.

Nothing crazy, just right about double the upper normal value. Her level was 218 U/L; the normal range is 10- 118 U/L). Everything else looked fine. So the question is what does it mean and is that something to worry about?

It is certainly a reason to re-check the values again within a few weeks.

Here what her vet said. "Typically any value below 250U/L is deemed clinically insignificant, as long as other values are normal and if Cookie is clinically normal. 

ALT can be increased with a self correcting, transitory liver insult, gastrointestinal irritation (vomiting/ diarrhea etc), mild muscle injury. 

Because Cookie is clinically normal, it is most likely a minor insult to her liver (ingesting a mild irritant, minor allergic reaction etc.) or a mild muscle injury. To ensure this is a transitory issue, a recheck bloodwork is recommended in 6-8 weeks or sooner if clinical signs appear (anorexia, vomiting, diarrhea, limping etc)."

Cookie's vet in Fergus also feels it is nothing to be alarmed about.

"The ALT is not alarming.. had a dog go over 2000 yesterday just because I touched the liver in surgery, looking for abnormalities on the different surfaces.

A plan to follow up down the road is prudent and cautious.... at that level would not do anything more."

It is true that Jasmine's liver values were off the charts after her drug-induced hyperthermia and the liver healed just fine. Because of its many jobs, many things reflect in liver values.

One thing about this is that the one test provides a narrow frame in time.

It doesn't tell us whether the value was actually on its way down, on its way up or whether it's been lingering at this level for some time. That's why we need to take at least one other look.

What is ALT?

ALT is short for alanine aminotransferase, which is an enzyme found primarily in liver but also in other tissues (kidneys, heart, muscles and pancreas). When a cell is damaged, ALT spills into the blood stream.

In most situations, ALT is considered a liver-specific enzyme.

Which means it usually reflects damage of liver cells.

Conditions that can cause this are liver or bile duct disease but also trauma, toxins, pancreatitis, Cushing's disease, corticosteroid medication, diabetes and more ... even missing a few meals can increase the ALT.

All we know for certain is that we need to check them out again.

Cookie seems perfectly fine. Her stool was kind of funky the day before the blood test, so perhaps she ate or drank something that caused some trouble.

If she started looking sick we'd go in right away. As it is right now, we will wait and retest and I'll try not to worry in the meantime.

Related articles:
What's In The Blood? Blood Testing And Interpretation
Practicing What I Preach: Jasmine's Semi Annual Wellness Exam

Incontinence? Cookie's Mysterious Leaks
From The End Of A Lead Line To Casa Jasmine: Meet Cookie, Our New Adoptee
And So It Begins Again(?) Our First Health-Related Heart Attack With Cookie 
I Didn't Know I Could Fly: Why Cookie Wears A Harness Instead Of A Collar
C.E.T. Oral Hygiene Chews For Dogs CAN Be A Choking Hazzard 
Our First Health-Related Heart Attack With Cookie: The Knee Or The Foot? 
Creative Solutions And An Incidental Product Review
Too Young For Pot: Cookie's Snack With A Side Of Hydrogen Peroxide  
Taming Of The Wild Beast: Cookie's Transition To Civilization  
Staying On Top Of The Ears: Cookie Is Not Impressed  
Putting The Easy Back Into Walking
Cookie's Ears Are Still Not Happy 
The Threat Of The Bulge Is Always Lurking 
Today Is Cookie's Three-Months Adoptoversary  
Cookie Meets The Electric Horse Fence And Her First Chiropractic Adjustment  
Why Examine Your Dog's Vomit? 
Why Is That Leg Still Not Happy? Cookie's Leg Keeps Getting Sore 
Cookie Too Is Insured With Trupanion
Does Being Insured Mean Being Covered? Our First Claim With Trupanion
Is Cookie's Leg Finally Getting Better?
Is Cookie Going To Be Another Medical Challenge Or Are We Looking To Closely? 
The Project That Is Cookie: Pancreatitis Up Close And Personal  
Pancreatitis: Cookie’s Blood Work   
Another Belly Upset: Pancreatitis Again Or Not?  
Happy Birthday, Cookie 
Who's Training Whom? Stick And Treat 
Don't Just Stand There, Do Something? Cookie's Mysterious Bumps 
Cookie's Mysterious Bumps Update
One Vomit, No Vomit 
Happy One-Year Adoptoversary, Cookie!
Cookie's Leaks Are Back: Garden Variety Incontinence Or Not?
Cookie's Leaks Update 
Don't Panic, Don't Panic: Know What Your Job Is 
The Continuing Saga Of Cookie's Leeks: Trying Chiropractic Approach 
Cookie's Minor Eye Irritation

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What were the first signs you noticed? How did you dog get diagnosed? What treatment did/didn't work for you? What was your experience with your vet(s)? How did you cope with the challenges?

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  1. Such a cute picture! I am glad JD is doing so well. That is great news! And I bet Miss Cookie is just fine as well. Like you said, maybe she just ate something she shouldn't have.

    1. She sure looks fine. We will recheck in couple of weeks and hopefully everything will be normal then.

  2. My dog, Brandy, lives with elevated ALT from the time she was 5 until the day she passed - and we had no symptoms or reason why. We protected her liver with a nutraceutical. Hugs and best of everything to you.

    1. Thank you. Did you ever figure out what kept the ALT up? Cookie's had been normal in the past; thinking it could have been something she ate/drank. We'll see what the next test shows. Meanwhile I stocked up on milk thistle.


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