Species: Dog Breed: medium hair mongrel Age: 11-15 years
my cat was diagnosed with high alt liver enzyme and hi white blood cell count in mid-june--she had been not wanting to eat.an ultrasound was done and no cancer was found,no small intestine inflammation and possible a little pancreas inflammation.because of the white blood cell count she was put on antibiotic( clavamox) for one week.she is an epileptic cat and gets phenobarbitol (2x/day) but was told the elevated enzyme was not due to that(testing for pheno barb was also done).she was also put on 100mg zentonil advanced (1x/day).a week after antibiotic was finished she had more blood work done--the alt had gone from 195 to 95 and the white blood cell count had gone down but not in the normal range(but near to).continued with the zentonil--her appetite had returned and she was now on better food.two weeks after this blood test took her in for another blood test---only her enzyme levels were checked.however,the alt had gone back up to 135.now told to wait a month to "see what happens" and take her in again for more blood work.she has gained 9 ounces in the two weeks between the two blood tests.i am wondering what could be going on and what the chances are that things will return to normal in the next month.
Dr. Marie replied:
Hi and thanks for your question.
It sounds like your vet has been very thorough.
There are a number of reasons for an increase in ALT in a cat and often it is hard to determine why.
I think your vet's approach to the slightly increased ALT is good. An ALT level of 135 is really only slightly above the normal level. Personally, I don't get terribly worried until I see an ALT of greater than 300. (However, a slight ALT combined with the symptoms of not eating well would make me want to do additional tests on the liver.)
as Fluffy is improving and gaining weight I think it is a good plan to wait and see how things go and then retest the ALT after a month.
Do you know if your vet has done pre and post prandial bile acids? These blood tests can often tell us if there is a problem with liver function. If these tests are normal then usually this tells us that we don't need to be too worried about the liver.
Some cats will have an increase in ALT because of mild pancreatitis or inflammatory bowel disease, or even possibly hyperthryoidism. Most likely your vet has checked for these as well.
It sounds like you and your vet are on the right track.
Disclaimer: Although Dr. Marie is a qualified veterinarian, the information found on this site is not meant to replace the advice of your own veterinarian. AskAVetQuestion.com and Dr. Marie do not accept any responsibility for any loss, damage, injury, death, or disease which may arise from reliance on information contained on this site. Do not use information found on this site for diagnosing or treating your pet. Anything you read here is for information only.
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Dr. Marie is a veterinarian who practices in a busy animal hospital in Ottawa, Ontario. She created Ask A Vet Question as a resource for good, accurate veterinary advice online. Dr. Marie treats dogs, cats, hamsters, guinea pigs, and rats. She has been a vet since 1999.
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