High ALP in a pug.

Dr. Marie replied:

Hi there Krissy and thanks for your question. It sounds like you are doing an amazing job with Phoebe!

I have seen a number of dogs who have a high alkaline phosphatase (ALP). Often we don't know why. But there are a few possible reasons and sometimes it can be hard to figure them out, but I'll give you an idea of what kind of things you could be looking for.

First of all, the ALP level is high enough that it warrants investigation. Sometimes if I see a number that is 300-400 I will just write it off as a variation of normal, but I don't believe this is the case.

The most common reason for a dog to have a high ALP is Cushing's disease. However, she is a little young for this, but it is still possible. Cushing's is caused by the adrenal glands producing too much cortisol. Dogs with cushing's tend to have an increase in thirst and appetite and often will have a pot-bellied appearance. And yes, dogs with Cushing's can be more prone to skin infections.

There are two ways to test for Cushing's. The most accurate is something called a low dose dexamethasone suppression test. It is a test where she stays in the hospital for a full day and has a few blood tests done. In my practice it costs around $200 or maybe a little less. There is also a quick urine test that is much less expensive but it is not as accurate.

Some dogs can have high ALP because of a problem with the bile duct. This could be mild pancreatitis (which would certainly be helped by the changes you have made in her diet). If so, then the next blood test should show a decrease in the level. It could also be caused by a gall bladder problem (although this is not terribly common in dogs), diabetes (although this would be evident in the initial bloodwork), or an infection in the liver (but we should be seeing elevation in other values, plus she should be not feeling well).

One other thought - Is Phoebe on any prednisone or other steroid? Steroids can increase the ALP dramatically.

I am not worried about her platelet level.

Hope that helps. Let me know if you have more questions and thanks for using my website!

Dr. Marie.


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Dr. Marie replied:

You're very welcome! I will answer what I can, although some of these questions may need to be answered by your own vet.

Question 1:I would follow your vet's advice on when to retest the ALP level. I understand your reasoning that an extra month gives us more time to lose weight. However, on the off chance that there is a medical issue going on, (in which the ALP) may be increased, I don't know that I would want to wait 2 months before finding this out.

Question 2: Carrots are extremely unlikely to cause pancreatitis. Pancreatitis is usually caused by a fatty food such as bacon grease or butter, and lots of it. Also, dogs with pancreatitis tend to be really really sick and she doesn't sound sick.

Question 3: Generally any vegetable (other than onions or garlic) are good to add as treats. The ones that you have mentioned are all great. I am fine with baby carrots.

Question 4: It really does not sound like she has Cushing's as these dogs usually have very obvious signs of increased thirst, urination and appetite which she does not have. If this were my case and the ALP was not decreasing I would likely do the urine test for Cushing's just to rule it out for sure, but it is extremely unlikely.

I should add that I often do see dogs who have a high ALP with no known reason for it. What I generally do is recheck the value in a month or so and then recheck it 1-3x per year. As long as it is not continuing to increase dramatically and the dog is feeling well, then I simply keep an eye on things.

Hope that helps!

Dr. Marie.

Dr. Marie replied:

Again, you're very welcome, and thank you for the kind words about my website!

As far as I know, just having extra weight should not directly cause an elevated ALP. In theory, if there was some extra fat around the liver or bile duct it could indirectly cause an elevation in ALP. However, this is not one of the "textbook" causes for an increase in ALP.

It's never a bad idea to lose weight though!

Thank you for recommending me!

Dr. Marie.

Dr. Marie replied:

Thanks so much for the bonus! It is greatly appreciated!

Dr. Marie replied:

Hi again Krissy...antibiotics will not raise the ALP. Prednisone (which is a steroid that we use sometimes to help with itchiness) can raise the level, but not antibiotics.

Hope that helps!
Dr. Marie.