Hello, I'm Dr. Deb and will do my best to help you today.
I can understand your concern about Abby's elevated ALP value especially since it increased so dramatically in one year.
But, I typically encourage my owners to look at the whole picture (and dog) and not just one blood value. If she's asymptomatic with absolutely no change in thirst, urination, appetite or weight, then I don't know if I'd necessarily suggest additional testing, especially given her age nor would I necessarily be terribly troubled.
Unfortuantely, there are a number of different reasons why this one value might be high. It certainly can be elevated when liver disease is present, but usually other liver values are high as well....not just the Alk Phos.
1. Cushing’s Disease which is a somewhat complicated disease to explain but essentially the adrenal glands are producing a large amount of cortisol. Many patients will also have protein in their urine although not all of them do.
But, typically there are other symptoms present such as increased thirst, urination and hunger because of the cortisol levels in their blood.
Additional testing would need to be done to diagnose this condition but in all honesty, very few of my clients elect to treat their dogs for any number of reasons....cost of the drug, costs associated with follow up testing, for example, as well as the fact that most patients will live the same length of time (about two years after diagnosis) whether they're treated or not.
2. Any sort of inflammation in the body can cause an elevation in Alkaline Phosphatase:
a) Inflammatory bowel disease.
b) Dental disease
3. Aging related changes.
4. Hypothyroid disease
5. Heart disease
6. Something called Vacuolar Hepatopathy which is a biopsy term but just means that the liver cells are storing more glycogen. This is sometimes seen secondary to Cushing’s Disease but is also often Idiopathic…meaning we don’t know what causes it.
7. Nodular hyperplasia (basically aging changes)
9. Normal for certain breeds such as Scotties...but not JRT's
10. Drugs such as Phenobarbitol or steroids. Or chronic steroid ointments
If this were my patient and otherwise healthy, I probably wouldn't worry too much about this elevated value.
As to the bleeding from her rectum, I'd want to do a rectal and evaluate her anal glands and palpate for any polyps or small masses which might be responsible for the blood you saw.
I hope this helps to reassure you. Deb