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Dr. Andy
Dr. Andy, Medical Director
Category: Dog
Satisfied Customers: 30041
Experience:  UC Davis Graduate, Interests: Dermatology, Internal Medicine, Pain Management
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My dog has an enlarged liver and his bloodwork shows an enzyme

Resolved Question:

My dog has an enlarged liver and his bloodwork shows an enzyme of the liver that is high off the charts. What does my my dog have?
Submitted: 8 years ago.
Category: Dog
Expert:  Dr. Andy replied 8 years ago.
I am sorry to hear about the liver.
Do you know any of the values of the different liver enzymes?
Customer: replied 8 years ago.

I just called the vet and she gave me all the info. that was abnormal on his sheet. The following:

ALT 168

ALKP greater than 2000

Cholesterol 499

CDC red blood count 5.23

HCT 34.3%

NCH 30.98

Platelettes 657

Expert:  Dr. Andy replied 8 years ago.
Wow....that's a pretty high alkaline phosphatase.
Slam Dunk....
Someone needs to do a Low-dose Dexamethasone suppression test, as well as, a abdominal ultrasound.

I am very suspicious for a condition called Cushing's Disease.
I definitely would not jump to cancer yet.
If your vet didn't even mention Cushing's, than you should consider a second opinion with another doctor. Really!

Here is so more information about Cushing's.
Good Luck

By the way, this breed is predisposed to Cushing's.

Customer: replied 8 years ago.
Yeah he did mention cushings but just is not certain of anything specific yet and there was an xray done, which is how we found that the liver was enlarged. Thank you though and I will ask about the dexamethasone suppression test but what will that confirm? Also what does an ultra sound show that an xray would not that may be important?
Expert:  Dr. Andy replied 8 years ago.
The low-dose dex test is the most sensitive for confirming Cushing's disese. The ultrasound would show us the adrenal glands. We need to know if they are enlarged, both enlarged, etc...85% of Cushing's is due to a pituitary gland nodule that is hyperactive, 15% is due to an adrenal tumor. That's why we need the ultrasound. Adrenals are tricky on ultrasound, so make sure a specialist does it. If the low-dose test is negative, then the ultrasound is helpful to actually look at the architecture of the liver to check for masses, not just if the liver is big or not.
The link will go into more detail.
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