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Dr. B.
Dr. B., Board Certified Veterinarian
Category: Veterinary
Satisfied Customers: 20928
Experience:  General practice veterinary surgeon with extensive experience in a wide range of species.
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I have a 5 yr old lab who has had elevated ALT's for over 1

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i have a 5 yr old lab who has had elevated ALT's for over 1 yr now. She had a liver ultrasound which was neg 1yr ago just showed a plump adrenal gland. Vet talked me into a $365 Cushing test which I knew would come back negative ( dog has no symptoms) and it did. She has been on Denamarin and it does not seem to bring the levels down. Was told to put dog on raw diet this would be better??? Am very confused just what to help my dog. Any ideas?

Hello & welcome, I am Dr. B, a licensed veterinarian and I would like to help you today.

Now I share your concern here about your lass. The ALT liver enzyme is one that is released in the body when the liver cells have been damaged or have died. And to see her have continued high levels despite treatment raises worries of ongoing liver damage and to a lesser extent pancreatitis (a rare cause of this). So, while its good that no severe tumors or changes were seen on that previous ultrasound, if she were my patient I'd want that rechecked to see if there are any changes a year on since her blood suggest damage has been ongoing all that time. So, we may actually be able to see change at this stage. Of course, as they check that we could also make sure this liver has normal blood flow (another concern to why this liver is struggling). And with that, a fine needle aspirate or biopsy would be ideal. That way the tissue can be analysed and checked to see what is impacting the liver. Or at the very least, you could have her vet check a bile acid stimulation test to check the liver's functionality despite the ALT concern. And once we know, we'd be in a better position to potentially treat this for her.

Otherwise, in regards ***** ***** diet, the main focus for these cases is feeding easy to digest protein in a moderate level. The reason is because we are trying to reduce her liver's workload. So, raw meat can be used but usually we'd want to be using something else with it so we don't overdo the protein. In fact, as an adult dog, she only needs 1 gram of protein per pound of her weight daily. So, we can use rice/pasta/potato to bulk up the diet or even add in veggies (ie carrots, broccoli, cauliflower, cabbage but in moderate since it can make them gassy). Of course, with any of this, make sure she is on a low copper vitamin supplement to meet her trace vitamin/mineral needs. And it goes without saying that if you feed homemade raw diets you need to handle that meat with care since we don't want to risk her or you developing a bacterial infection (ie salmonella, campylobacter, etc) from her diet.

Kind regards,

Dr. B.

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