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Lisa, Certified Vet Tech
Category: Dog
Satisfied Customers: 16502
Experience:  AAS Vet Tech. Bully breed rehab & Behavior modification
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My nearly 10 yr. old Old English Sheepdog Hannah was found

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My nearly 10 yr. old Old English Sheepdog Hannah was found about 3 yrs. ago through ultrasound to have a quarter sized lision on her spleen. Though asymptomatic, her vet said that if it was cancer, it would move fast so he recommended a spleenectomy. He set a surgery date but I opted for a more conservative approach with frequent ultrasounds and a second opinion. After another two ultrasounds over three months and no change in the lision, the vet was confident that the lision was benign. I have since continued 3-4 time a year ultrasounds and twice a year blood chems. A year and a half ago, one of these ultrasounds found another quarter sized lision on her liver though she continues to be asymptomatic. After three more ultrasounds and no change in the lision, the vet felt confident that it is also benign. However, the concurrent blood chem. showed a mild elevation of 218 in the liver enzyme ALT. He recommends a second blood chem in three weeks. He states that if the enzyme were quadrupled in elevation, he'd suggest a aspiration biopsy and notes that it could be many things including an infection in need of a antibiotic or even supplements. He doesn't seem paniced but I am. What's your view of the current status and vet recommendation? Should I be moving in any manner more proactively? I lost a previous and beloved OES at 10 suddenly and unexpectedly from liver cancer. Her docs were not at all prescient. Thanks for your opinion.
Hello! My name is XXXXX XXXXX it will be my pleasure to help you with your dog today.

Your vet is actually doing exactly what our vet would do.

The steroids that she was on could absolutely, positively have caused that slight elevation in her ALT. The metronidazole can also cause a slight elevation, so your vet is definitely doing exactly what we would have done.

Now that she's off the steroids and metronidazole, it will take at least 7 days to completely clear the system, then another week for the liver to repair itself and then the retest. I strongly suspect that the elevated ALT will drop.

I can understand how worried you are about Hannah, especially in light of the death of your previous OES, but the absolutely best thing you can do is to try not to think about it...try to be positive.

I hope this helps.
Customer: replied 3 years ago.

Hi Lisa,


The vet said that the steroid might was more likely to affect the ALP or AST enzyme than the but the ALT. Likewise, he said the Metronidozole would not have affected the ALT. How does that square with your knowledge?



Hi again Ken...

In my experience, I've learned to never say never.

The liver is essentially part of the filtering system of the body. Everything that goes it, has to make it through the although Metronidazole may not have as big of an impact as the steroids, I have seen some dogs who have an elevated ALT from just about anything.
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