# Questions about Elevated Liver Enzymes



## newtonj (Jan 8, 2010)

Hello, my cat is 12 years old. Two months ago my vet said that his blood showed elevated levels of the liver enzyme ALT. He appears to be in very good health- eating normally, not losing/gaining weight, acting playful, etc.- the only thing wrong is that he's got a lot of build up on his teeth. He had his teeth cleaned 4 years ago and prior to that showed elevated liver enzyme levels. The problem is that we didn't have his blood tested after the cleaning so there's no way of knowing if the enzymes are high b/c of the dental bacteria or if there is something else going on. 

What I'm trying to get a handle on is what to do....vet wants me to bring him in for a cleaning, then test blood in a month, then if still elevated we'll address the problem. On one hand I think dental cleaning would be great so the decay doesn't get worse plus we can know about the liver enzymes. On the other hand I'm skittish about the anesthesia given his age plus I'm thinking that if it is possible that he's had elevated liver enzymes for the last 4 years and nothing seems to be wrong then maybe that's just a normal level for him. I just don't want to see the enzymes stay elevated after the cleaning and start doing lots of biopsies, ultrasounds, etc. etc. that might do more harm than good if this really isn't a problem.

Long story short I guess my questions are how big of a concern is elevated ALT? What could it possibly be a symptom of? Is it a big enough concern to justify the cleaning? Should I be worried about the anesthesia?

As a side note, kitty did have feline diabetes about a year and a half ago. Through change in diet and insulin shots he kicked it. Just mentioning it in case it's related.


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## nanook (Jun 12, 2005)

If your kitty needs a dental cleaning, you should have it done. Just make sure they use the very safest anesthesia, he gets fluids and is monitored throughout the procedure. Having bad teeth and gums can lead to all sorts of serious health issues, so it's gotta be done. The older he gets, the more risky, so better to do it now.
As for the elevated liver enzymes. How elevated are they? If it's a minor elevation, I wouldn't be too concerned. It could be caused by a million things (even stress from being at the vet). Or it could be normal for _him_. I'd just monitor it. IE: run blood every 6 months, which is a good idea at his age anyway.


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## Mom of 4 (Jul 29, 2006)

Liver disease can be silent for years. But is also possible for a person, cat or dog to have a higher number be the norm for them.

When you say elevated, what numbers are you talking about?

One of my dogs had nausea and vomiting for a week last June. She was treated with Flagyl for a week and got better. But 3 weeks later, at her annual checkup, her ALT was sky high. 8O Before I panicked, I remembered that some of the lab values rise quickly and drop quickly, while other are slower to rise and fall. Here values were normal in 2008. My vet is very conservative and we agreed to recheck her in a month since she appeared healthy at the time of the visit. And the repeated labs in August were normal. We have decided Flagyl didn't agree with her and she won't get it again.


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## doodlebug (May 13, 2006)

Definitely get the dental done now...yes a 12 year old is at higher risk, but the problem is only going to get worse. Better to take care of it now than to have to do it 3 or 4 years from now. Dental issues can cause a host of problems including heart issues. So you don't want to put it off until it becomes critical and he's already weakened. 

This was a reply made by a vet to another issue someone was having with a cat, but it it seems to apply to you as well. The mention of toxins could apply to the dental issue or it could just be idiopathic.

_The elevation in the alanine transferase (ALT) occurs when there is damage to liver cells. This can happen for a number of reasons. Medication reactions, toxins, cancer and hepatic lipidosis are probably among the most common causes in cats but there are also lots of times when the ALT rises for no apparent reason and then is normal on testing after a week to a month or so. In the absence of any recognizable disease it is probably best to do exactly what your vet advised, recheck the levels after a reasonable interval and then decide what to do if the ALT remains elevated._

http://www.vetinfo.com/cblood.html

If it were me, I'd have the dental done, then follow up on the ALT levels an appropriate time later. If they're still elevated, but he appears healthy then you could choose to just continue to monitor it at regular intervals.


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## newtonj (Jan 8, 2010)

Thank you so much for the responses. You've made me feel way more comfortable with getting the dental cleaning done. I'm definitely going to go ahead with it independent of the ALT situation. While I'm at the vet I'll find out what the ALT level actually was so I can get a better sense of what elevated means. Will post back here with an update after that. Thanks again!!


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## hoofmaiden (Sep 28, 2009)

Ask the vet to fax you a copy of ALL the bloodwork results your kitty has ever had. You need to be able to compare previous results to current ones, as well as his results to the lab normals. PM me w/ your email addy if you'd like a copy of my Excel spreadsheet where I keep track of my animals' labwork results.


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