Elevated ALT (liver enzyme and elevated bile acids. What should I do?

maggieh said:

The first thing is to determine if this is a shunt or MVD. A liver shunt can often be surgically repaired, and MVD can be managed through diet and supplements. Honestly, I'm surprised you said your vet is going ahead with the spay without further action. Denamarin or similar supplements can help reduce the liver values; adding Milk Thistle daily is also a good way to control ALT.

If there is a specialty vet near you, seek out an internist for further testing and to determine if it is a liver shunt. I personally know of a very sick one year old maltese/poodle mix years ago who we did not think would survive because the liver shunt had been untreated for months. After successful surgery, this little guy, Samson, lived another 12 or 13 years.

Good luck to you!

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maggieh said:

The first thing is to determine if this is a shunt or MVD. A liver shunt can often be surgically repaired, and MVD can be managed through diet and supplements. Honestly, I'm surprised you said your vet is going ahead with the spay without further action. Denamarin or similar supplements can help reduce the liver values; adding Milk Thistle daily is also a good way to control ALT.

If there is a specialty vet near you, seek out an internist for further testing and to determine if it is a liver shunt. I personally know of a very sick one year old maltese/poodle mix years ago who we did not think would survive because the liver shunt had been untreated for months. After successful surgery, this little guy, Samson, lived another 12 or 13 years.

Good luck to you!

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wkomorow said:

i am sorry that your husband passed.

Typically dogs with shunts have bile acid levels over 100, it is more likely MVD. There is a relatively inexpensive blood test called a protein c assay. It is been a whil but they should be under $100. Both MVD and liver shunts can been treated medically and with diet. My Lucky had a shunt. He lived to 9, but died from an unrelated cancer. There are specialists, most general vets don't have the experience with liver issues in small dogs I would recommend you look at a lower protein diet, with protein supplements from dairy which is easier fot the liver to process. Not sure what part of the country you are in but Cornell has some excellent vets that specialize in liver issues. In adition to denamarin or marin and sam-e for liver support, prescription lactulose is given. The greatest danger is from ammonia build up in the blood, which is why lower protein and dairy are recommended, they reduce ammonia build up.

Also remember blood tests are just snapshots and the readiings could be an anomaly. if it were me and she is asymptomatic, I would ask for a protein c test, it would further confirm MVD over a shunt, which is a bile acid of 80 would suggest. But I would talk to your vet or a nutrionist about a liver friendly diet either way.

Don't be overly worried about a single blood test. Good luck.

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Love my Millie said:

Dear Walter,
Thank you so much for your wisdom and guidance. Sounds like you really understand this condition. Millie is scheduled tomorrow for the protein C test. I hope after all these test the doctor will be able to clearly diagnose if it is a shunt or MVD without a liver biopsy. What do you think about allowing a liver biopsy? I have an appointment next Friday with a specialist. The information you provided is invaluable. I will keep you updated on our progress. I live in California so Cornell is not an option. I wish it was. Your baby is adorable. Thank you again for reaching out. I am so grateful.

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Coster said:

Thankyou Stacey!! I have a dog too with liver disease I just bought the bark and whiskers! Thankyou for sharing!! Cody is having high levels right now too! Hope this helps! Thanks again!

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Coster said:

Hi Stacey! Just want to Thankyou for sharing what worked for your baby! I bought bark&whiskers and Cody been on it for 7 days only and his some of his liver values are coming down! Thankyou again!!!

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