Liver Panel Results

[Guest BlackandBrindle]

Where can I find the 'normal' for liver panels?

 

I just got a copy of Sadie's liver panel that we did on February 18. My vet is out of town anyway so I can't ask him what it means.

 

The only things that flagged are

 

AST(SGOT) 67 reference range 5-55 U/L

GGT 15 reference range 0-14 U/L

 

Bile Acids 16.1 reference range Less than 7.0 umol/L

 

I'm going to test her liver function again when we test for her titer in about a month/few weeks.

 

She's on a raw diet if that makes any difference?

 

I just noticed it said,

 

"Specimen required ultracentrifugation due to gross lipemia. Unable to report serum indexes o this sample."

[Batmom]

The reference ranges on the sheet are the normals for that lab .

 

Was this a fasting blood test, or had she had a big meal in the last few hours before the test?

 

Some meds can affect these things, too. I wouldn't worry over it until you've talked with your vet.

[Guest BlackandBrindle]

Well the reason I ask is because I don't know that I'm trusting the vet's opinion (not just about this, but in general).

 

This was probably done midmorning to midday and she'd had her regular breakfast (probably about a pound of so of food).

[Batmom]

Might PM houndznigz (I think that's her GT name) -- she might know more about this sort of thing. Practically everybody will know more than I do, alas, but she might know a lot more. Or Dr. Feeman.

[greyhndz]

Oooo my ears were burning!

 

Interesting that you asked about LFTs, because I spent a good portion of the day researching this. My iggy, who has renal disease and immune mediated polyarthritis, developed an elevated ALT (another liver enzyme; the typical liver function tests include ALT, ASP, ALP (alkaline phosphotase), bilirubin, albumin, and GGT. An elevated AST by itself (and your pup's AST is only slightly elevated) isn't specific to the liver - it can also reflect skeletal muscle breakdown, such as occurs with injury or hard exercise.

 

Researching the veterinary literature today, the recommendation for evaluating elevated liver function tests is measuring both the ALT and a fasting bile acids; an elevated ALT together with a fasting bile acid of > 25 correlates with liver disease. This can also be confirmed by adding on a postprandial (2 hrs after meal) bile acids. I can't recall offhand the increase in the PPBA that's considered diagnostic of liver disease.

 

Suzanne Stack explains the meaning of the various liver function tests here

 

I come from the school of medicine (I'm a PA) which advocates looking at the patient, not the numbers. If your pup has been healthy, without any symptoms of illness such as jaundice or lack of appetite, I, personally, would repeat the labs in a couple of months to see if they've normalized. If they're still elevated, the vet may want to pursue this further by repeating the bile acids both fasting and after a meal, and if abnormal, possibly obtaining an ultrasound, with or without a liver biopsy. Some medications can also cause elevated LFTs and your vet should talk with you to find out if this is the case. There are also infections (such as lepto) which can affect the liver.

 

My iggy's internal medicine vet told my regular vet that her ALT is elevated because of progression of her chronic renal disease - this is called a "reactive hepatitis". She's also been on steroids for over a year, which can increase enzymes. Treatment for this is Sam-E, liver support, and control of her chronic renal disease. Lexi has been acting like a sick dog this past week, but as of one week ago, her ALT was normal.

 

Bottom line: if your pup has been acting sick, if her bilirubin is elevated resulting in jaundice, etc. the labs should be rechecked and additional workup done if indicated. If this was just an incidental finding and she's been healthy, I'd probably just repeat the labs to see where they're headed.

 

I hope this helps without being too technical!

 

ETA: Batmom, you are a WEALTH of knowledge of anything greyhound, including health issues!

Edited April 16, 2009 by houndznigz

[Guest BlackandBrindle]

Thanks!

 

We tested because she's on fluconazole to treat valley fever and it can cause liver damage. She was a bit off so I made him check her liver values.

 

She's been on Denamarin for almost two months to help protect the liver. We'll retest again in a month when we test her VF titers.

[greyhndz]

Thanks!

 

We tested because she's on fluconazole to treat valley fever and it can cause liver damage. She was a bit off so I made him check her liver values.

 

BINGO! I'll lay odds that's the culprit. We use this in humans as well for various types of fungal infections, and routinely check LFTs before treatment and every 4-6 weeks while on fluconazole. The reassuring news is that the LFTs usually return to normal after the med is stopped.

She's been on Denamarin for almost two months to help protect the liver. We'll retest again in a month when we test her VF titers.