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Alt High, & Bouncing Around, Ideas Please?


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So after the Xilotol incident, we checked Henry's liver values again, even though poison control thought he'd be just fine because he ingested under the threshold for liver damage. So here's what we have.

 

3 years ago (pre-neuter): around 200 (current vet missed originally since it wasn't done at her office, she found it once we started trying to figure this out).

pre-dental in February: 75 (lowest on record)--no prior medications given.

w/in 4 hours of xilotal ingestion: 204

after fluid/glucose suport and 4 days of Denamarine: 175

after 2 weeks of Denamarine + 2 weeks off, 418

after 2 more weeks on Denamarine and Clavamox (just in case there was an infection): 368

 

We had also recently added fish oil to his diet, but Leo takes that too, and we just ran Leo's blood, including ALT, which was all normal. We're still pulling him off it for now, just in case. He takes no other medications or supplements.

 

Every other darn blood value is normal, including liver values. He is a healthy weight, has a healthy appetite (on the same food as Leo). His weight is normal and stable. He acts 100% normal for a greyhound. He loves his life and has a no signs of illness or pain that us or the vet can detect. He's basically bomb-proof temperment wise and that hasn't changed at all.

 

Current plan: All the Denamarine dosing has been 2x day, 425mg/dose (1 hour before eating), we're staying at that for now (that's double the normal dose). Vet said to wait 30-60 days to retest, so we're waiting 30 days.

 

Things we haven't done: ultrasound the liver for a tumor--can't do that here (seems highly unlikely according to the vet giving his past history of 3 years of this and comlete absence of signs).

Tested for cushings, again she seems convinced he couldn't have done that.

Done a complete thyroid panel again--completely asymptomatic and when done pre-neuter was normal.

 

Ideas? What are we missing? Anyone seen this before? Is it possible he just runs eratic and using Denamarine (or long-term if it works the vitamins purchased separately) to supress it would help?

Beth, Petey (8 September 2018- ), and Faith (22 March 2019). Godspeed Patrick (28 April 1999 - 5 August 2012), Murphy (23 June 2004 - 27 July 2013), Leo (1 May 2009 - 27 January 2020), and Henry (10 August 2010 - 7 August 2020), you were loved more than you can know.

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Assuming the high end of normal for your lab is @ 100, that's the only elevated result, and the dog is acting well, I wouldn't worry about it. If it were 10 times the high end of normal, different story.

Star aka Starz Ovation (Ronco x Oneco Maggie*, litter #48538), Coco aka Low Key (Kiowa Mon Manny x Party Hardy, litter # 59881), and mom in Illinois
We miss Reko Batman (Trouper Zeke x Marque Louisiana), 11/15/95-6/29/06, Rocco the thistledown whippet, 04/29/93-10/14/08, Reko Zema (Mo Kick x Reko Princess), 8/16/98-4/18/10, the most beautiful girl in the whole USA, my good egg Joseph aka Won by a Nose (Oneco Cufflink x Buy Back), 09/22/2003-03/01/2013, and our gentle sweet Gidget (Digitizer, Dodgem by Design x Sobe Mulberry), 1/29/2006-11/22/2014, gone much too soon. Never forgetting CJC's Buckshot, 1/2/07-10/25/10.

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Right, but the normal range I believe was 18-180ish (should have asked for copies, can't until Monday). So over three years, he's had only 1 normal value. I should add, except for the pre-neuter bloodwork, all of these have been in house tests, one done at the evet, the 2nd to last one done 2 different ways at our vet, the last one done at the vet one way.


Adding, I've seen how far he is outside the normal range in terms of the bar lines, and he is running 2-3 times the max of what this equipment/process considers normal.

Beth, Petey (8 September 2018- ), and Faith (22 March 2019). Godspeed Patrick (28 April 1999 - 5 August 2012), Murphy (23 June 2004 - 27 July 2013), Leo (1 May 2009 - 27 January 2020), and Henry (10 August 2010 - 7 August 2020), you were loved more than you can know.

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Greyhounds can run a little high on ALT. Mild elevation with no other indicators, you usually don't worry about.

Star aka Starz Ovation (Ronco x Oneco Maggie*, litter #48538), Coco aka Low Key (Kiowa Mon Manny x Party Hardy, litter # 59881), and mom in Illinois
We miss Reko Batman (Trouper Zeke x Marque Louisiana), 11/15/95-6/29/06, Rocco the thistledown whippet, 04/29/93-10/14/08, Reko Zema (Mo Kick x Reko Princess), 8/16/98-4/18/10, the most beautiful girl in the whole USA, my good egg Joseph aka Won by a Nose (Oneco Cufflink x Buy Back), 09/22/2003-03/01/2013, and our gentle sweet Gidget (Digitizer, Dodgem by Design x Sobe Mulberry), 1/29/2006-11/22/2014, gone much too soon. Never forgetting CJC's Buckshot, 1/2/07-10/25/10.

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Assuming the high end of normal for your lab is @ 100, that's the only elevated result, and the dog is acting well, I wouldn't worry about it. If it were 10 times the high end of normal, different story.

Now I see what you mean, since it's the only elevated value. We asked and asked about that, if he could just run high, she didn't seem to know. I'm not super-confident in our vet, but our friends and I who are picky about our vet care have collectively tried just about practice in town and have all ended up here, we're short on options. Does Coutro do consults for things like this, or only cancer issues?

Beth, Petey (8 September 2018- ), and Faith (22 March 2019). Godspeed Patrick (28 April 1999 - 5 August 2012), Murphy (23 June 2004 - 27 July 2013), Leo (1 May 2009 - 27 January 2020), and Henry (10 August 2010 - 7 August 2020), you were loved more than you can know.

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Dr C would consult, I'm sure :) . I don't think you're at that point but that's me, not you, and I can sure understand that sometimes peace of mind is worth it.

Star aka Starz Ovation (Ronco x Oneco Maggie*, litter #48538), Coco aka Low Key (Kiowa Mon Manny x Party Hardy, litter # 59881), and mom in Illinois
We miss Reko Batman (Trouper Zeke x Marque Louisiana), 11/15/95-6/29/06, Rocco the thistledown whippet, 04/29/93-10/14/08, Reko Zema (Mo Kick x Reko Princess), 8/16/98-4/18/10, the most beautiful girl in the whole USA, my good egg Joseph aka Won by a Nose (Oneco Cufflink x Buy Back), 09/22/2003-03/01/2013, and our gentle sweet Gidget (Digitizer, Dodgem by Design x Sobe Mulberry), 1/29/2006-11/22/2014, gone much too soon. Never forgetting CJC's Buckshot, 1/2/07-10/25/10.

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Dr C would consult, I'm sure :) . I don't think you're at that point but that's me, not you, and I can sure understand that sometimes peace of mind is worth it.

Not including the evet visit (which was necessary since his blood sugar did drop and they fixed it), we've probably thrown $500+ at this alone already. I checked, his consults seem to range from $60-150. The peace of mind alone would be worth it. I emailed to ask if he did and what lab he thinks is best to use. Thanks for the advice, you guys are helping me calm down some.

Beth, Petey (8 September 2018- ), and Faith (22 March 2019). Godspeed Patrick (28 April 1999 - 5 August 2012), Murphy (23 June 2004 - 27 July 2013), Leo (1 May 2009 - 27 January 2020), and Henry (10 August 2010 - 7 August 2020), you were loved more than you can know.

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