Vomiting and elevated liver enzymes.

Dr. Marie replied:

This is a tough question to answer. I'll give you my thoughts on what you have written and sent to me.

It's hard to say what breed your girl is but she certainly is beautiful. :)



The lab results you have sent me are not actually a CBC. A CBC looks at the dog's red and white blood cells. What you have sent me are actually liver values.





I am guessing that these tests were run in a human laboratory. The reason for my guess is that the cholesterol test talks about whether or not there is coronary artery disease and this is something that we don't see in dogs. The cholesterol level of 308 is actually in the normal range for a dog.

The liver enzymes show the following:

Total bilirubin of 0.6 mg/dl - This is actually a little higher than the normal for dogs of 0.3 mg/dl. The other "bilirubins" are just other ways to measure this liver pigment.

GGT 11 U/L which is higher than the normal of 6 U/L seen in dogs.

ALT of 80 which is normal for dogs.

ALKP of 597 which is higher than the normal of 141 for dogs.

What I see from this are some mildly elevated liver enzymes, but it doesn't tell me exactly what the problem is. The problem may not be even related to the liver.

There are many possibilities for what could be causing Marley's vomiting. The elevated liver enzymes could be a sign of pancreatitis. If she has pancreatitis then continuing the anti-vomiting medication for a while may help. If she is still eating then it is not likely that she needs in hospital care.

Another possibility is if she has eaten something that is now stuck in her stomach. A blood test would not tell us about this. Xrays may be helpful.

It could be that she has some type of infectious disease such as leptospirosis. However, she would probably be acting sicker. In fact, if she really did have liver disease and that was what was causing her to vomit then you would expect her to be off of her food and lethargic.

My next step would be to do some xrays to go looking for some type of foreign object in her stomach.

I wish I could offer you more. Cases like this are tough!

Dr. Marie


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Dr. Marie replied:

Ah, ok. So let's look at these results. Again, the reference ranges are for humans so we'll see what is abnormal for dogs:



BUN and CREA are kidney enzymes and they are perfectly normal values for dogs.

The ALT and ALKP are liver enzymes and are perfectly normal as well.

Next, the CBC:



The HCT is something called hematocrit which tells us about the red cell level. Normal for dogs is up to 55% so 60% can mean that Marley is a little dehydrated.

The next thing to look at is the White Blood Cell level (WBC). 8.8 is perfectly normal for dogs. Neutrophils are a big component of the White cell level. However, for dogs we don't usually look at the percentage, but rather the absolute number so it's hard for me to interpret this. The rest of the results look normal to me. It's hard to say why your vet felt there was an infection there. However, I never want to contradict a vet as they have all of the information in front of them and I only have a little.

So, I would say that these results tell us very little other than mild dehydration which is likely caused by the vomiting. I hope the xray determines something!

Dr. Marie.