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Canine Autoimmune Hemolytic Anemia (AIHA & IMHA) - ? about consistantly high ALT
| Should I be worried? Wylie, my senior 11+ AIHA in remission has had consistantly high ALT since her relapse in November. At that time it was 250, her test before that was 138. Here is her progression. I know the initial spike was due to the pred. Her first diagnosis, April 08 her ALT dropped signifantly to 138 soon after stopping the pred. The vet say it could be many things especially since it went down after being on doxy, (she was only on it for 2 weeks then jumped back up) She had spleen removed May 2008,vet noticed some mottling/scar tissue on teh liver at that time. Here are her numbers, oh, her HCT has been great 42-47 range for months, her last ALK was 11/1 and 57. We will run this in a few weeks when she has her recheck. ALT 8/20 450 7/11 277 6/7 503 (started 2 weeks of doxy) 5/13 553 3/16 587 (last prednizone pill) 1/10 680 12/6 990 11/1 250 (relapse, started on pred) 6/25 138 Thanks Laurie |
| Laurie CA |
| Laurie- It's linked with liver performance and high ALT's show that the liver could potentially be failing. With numerous meds being used, they would obviously have some link to the higher numbers, esp doses of prednisone. I would be more inclined to say it's just the liver's way of responding to the overall treatment length of AIHA and how that has affected it long term - it is definitely something to keep your eye on when you do blood panels, but it is clearly half as low as what it was from dec-mar so maybe it will start to level out over the next few months. Wishing Wylie well. |
| Josh California |
| Laurie, From: http://broadwayveterinaryhospital.evetsites.net/site/view/83223_LaboratoryAssessmentDescriptions.pml "The ALT, or Alanine Transferase, is quite elevated. This is an enzyme that is primarily found in liver cells. Any liver problem will result in a high ALT. Common liver diseases that could cause such an elevation include cholangiohepatitis (an auto-immune disease), severe trauma to the liver, lack of oxygen or blood flow to the liver, cirrhosis, acute biliary obstruction (such as a gall bladder stone), cancer, infection, or pancreatitis. There are many drugs that can affect the liver as well, including glucocorticoids, Acetaminophen (Tylenol®), non-steroidal anti-inflammatory medications (like Rimadyl® or Metacam®), antifungal medications, Methimazole, diazepam, anti-seizure drugs, Tetracycline and many chemotherapy drugs. Copper Storage disease should be considered in Dobermans, Westies, and Bedlington terriers and hyperthyroidism should be considered in older cats. If the ALT is the only liver enzyme elevated, this value should be monitored, since it may be the first sign of emerging liver disease. Also, an elevated ALT does not mean the liver is not functioning normally. Additional tests would need to be done to evaluate this." So need to evaluate the whole liver panel as a group. What did your vet say? patrice |
| Patrice NYS |
| Patrice, thanks for that link, Its confusing, since the vet seems very concerned at her ALT level of 450 and Jake my other dog whose is 12 years old, his ALK is 1300, ALY is normal and he is not too concerned. (we did the cushings test and it was negative) and he acts great. Would you suspect infection since the ALT went down after the doxy? She looks great otherwise except she has slowed down on how long it takes her to eat. Thats why I brought her in, I thought maybe she had a tooth problem. She still loves to eat, but takes like 3 times as long to finish. She did throw up once last week, but I havent seen her do it again. No sign of jaundice, so whats a complete liver panel involve? I need to have her full cbc run again and kicking myself for not doing it yesterday. The other number that has been bouncing around in the high range is the PLT 3/16 798 4/6 607 6/17 815 When I last talked to my vet abouth this in June, he was stumped and wasn't so worried, and Patrice you had mentioned before other vets use an even higher normal range for this. Thanks Laurie |
| Laurie CA |
| note above: pancreatitis can cause a higher alt too. reluctance to eat and vomiting can indicate pancreatitis. ask your vet if they think this might be a possibility. If so use this test: IDEXX Spec cPL Test (canine pancreas-specific lipase). best test. patrice |
| Patrice NYS |
| Holly's ALK has been around the 400 mark. Each time we decrease the prednisone 1 mg, it goes down about 25-50 points but last reading on Monday was 391 and only 1 mg of prednisone a week. Her Lipase reading is also always high, last reading on that was 1087. I am always very confused about the Lipase reading and know I have asked before. The vet doesn't ever seem concerned about the Lipase nor does Dr Dodds. Holly was doing great, but the last few days she has been throwing up about once a day, so of course now concerned again and not sure what is going on??? Most times it is just like a yellow liquid. Could it be maybe an infection of some kind?? She NEVER loses her appetite at all! Linda |
| Linda Sapphire |
| I am waiting for the vet to open, Wylies tummy has been GURGLING all night, you can hear it from 10 feet away. She had an episode similar to this about 5 years ago. Her tummy started gurgling, then she started throwing up a few days later undigested food hours later. I think I ended up in the ER 3 times since it was at night, they finallly tested for pancreatitis and treated as such since the test took 3 days to get back, and kept her since she was so sick,because this had gone on a week. Something called her duodnum in the intestine was swollen so they think the food wasnt getting past and she was negative for pancreatitis and she slowly got better. Laurie |
| Laurie CA |
| Laurie, Lots of good info on these webpages. http://www.dogaware.com/wdjpancreatitis.html http://www.dogaware.com/specific.html#ibd patrice |
| Patrice NYS |
This thread was discussed between 21/08/2009 and 22/08/2009
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