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Doc Sara
Doc Sara, Veterinarian
Category: Dog Veterinary
Satisfied Customers: 952
Experience:  I am a dog and cat veterinarian with a lifetime of experience in our family veterinary hospital.
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My name is ***** *****. I just had a Yorkie who died from an

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Customer: Hello. My name is ***** *****. I just had a Yorkie who died from an unknown cause at 10 years of age. She did have elevated liver enzymes and vomiting and diarhea. I have another Yorkie, 9 years old, not related to the first. This morning she became ill, vomiting and diarhea. I took her to vet, has an ALT of 911 and Alkp of 227. She has not been sick since this morning. What could be the cause? The vet prescribed antibiotics, saying it could be a liver shunt or hepatitis.
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Customer: No, that's about all we know right now.
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Submitted: 10 months ago.
Category: Dog Veterinary
Expert:  Doc Sara replied 10 months ago.

Hi there, I'm Dr. Sara. I'm a licensed veterinarian who works exclusively with dogs and cats. i'm so sorry to hear about your Yorkie who died - how long ago did you lose her? If it was very recently, that's when I'd be concerned that this might be an infectious issue that had been contagious.

Truly, the most frequent cause of vomiting and diarrhea is either a passing "stomach bug" or dietary indiscretion. Often, finding the elevated liver enzymes is unrelated - they may have been elevated before she became ill but we didn't know because we hadn't looked. In that case, the vomiting and diarrhea will likely resolve with the supportive care that your veterinarian has prescribed. Elevated ALP and ALT are very nonspecific, meaning that they can be caused by a wide array of issues ranging from benign reactive hepatopathy to "bad" things like cancer. At her age, I'd expect that if she had a shunt you would have seen signs long ago.

Generally my plan for elevated ALP/ALT would be to treat the pet symptomatically first (as frequently the vomiting and diarrhea are caused by unrelated issues), start the dog on a liver supplement like Dasuquin to support liver function, and recheck the enzymes in about a month (obviously sooner if the pet isn't improving with symptomatic care). It can be very difficult to locate the cause of elevated liver enzymes without doing some in depth diagnostics - potentially even a liver biopsy - so if the pet is asymptomatic and feeling fine, I don't always pursue them. The next steps in work up would likely be X-rays of the abdomen, an abdominal ultrasound, and possibly aspiration or biopsy of the liver. Again, I'd be pursuing these things if the dog continues to show any sign of illness.

I hope that this gives you some info to think about and discuss with your vet. Please let me know if I can answer any other questions for you.

~Dr. Sara

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