Tarzan - Liver enzyme reading high. Lynn or anyone.Advice please

[Beanie]

Thamks swampmaxmum and Lynn

[swampmaxmum]

if you google Ursodeoxycholic acid (Ursodial, Actigal. ®. ) - had to copy and paste that one! - there's quite a lot online about usage in America. My vet wanted/wants Swampy off it but we checked with Davies specialists and I checked via emailing an academic who'd written a paper on it and they said they can't see too much bother using it long term if it's helping. I hope they are right obviously.
Zentonil/Hepatosyl are food supplements so think they can be taken indefinitely. I read that they are best taken on an empty tum. Btw if your vet doesn't get upset, I found them much cheaper on vetuk than via the vet's.

[CurlyCatz]

i guessed last night that it must be human preparation as i couldnt find either of them in the veterinary data sheets.

Its great when these very useful human drugs filter through and can be used on animals as they do so much good in many cases where otherwise there arent any options.

[swampmaxmum]

Destolit's a goodie  - not yet animal tested (human medicine) but is increasingly being used long term. I think AFAIK that Hepatosyl is pretty much the, er, SAMe thing (sorry!) as Zentonil, just diff manufacturers? That's another goodie.
all the best with Tarzan.

[CurlyCatz]

Thanks for mentioning those drugs pete, Ive not heard of either of them (i dont think) so i'll have to go and look them up now and hopefully log the info in the few grey cells that are left 

fingers and toes crossed they do their job and his levels soon to be back within normal ref range 

[Beanie]

Hi guys,

Thanks to you all for your responses and, in aprticular, Lynn.

Tarzan was on Destolit but now has to have 1 daily dose of Hepatosyl. I believe, but stand to be corrected, that this is some form of blood oxidysing drug.

He's a real little soldier.

[swampmaxmum]

Hi, even though my cat Swampy's making a very gradual recovery from liver disease (cholangiohepatitis is the vet's best guess as no biopsy was done) I'm still a bit vague about ALT, other than that when it's too high the liver and bile ducts are likely to be inflamed and swollen.
My vet put the Swamp on Destolit and Zentonil, which have helped. There haven't been any clinical trials on Destolit but if you have a look at the American vet pages, over there they are using it with good results (Ursodial over there). It's also used in Australia where they have a high standard of vet medicine and increasingly here too. Maybe that's what he's on already? Poor Tarzan; he must be feeling very sick.
I found theHills l/d food helped a lot although they have now changed it to pork liver which he may refuse to eat.
Is Tarzan overweight? That can cause fatty liver disease although my vet said that cholangiohepatitis is more common in England than hepatic lipidosis (fatty liver disease) - but don't let him not eat for more than a day as with liver disease that is dangerous.
I really feel for you and Tarzan but hang in there as the liver can regenerate. Is his weight stable?

Btw 150 is high but when Swampy was hospitalised (just to give you a point of reference) his ALT was 1500.

[Desley (booktigger)]

Good luck with him Pete, I have had a cat with raised liver enzymes, but it did take 10 months to develop into something more serious, her only symptoms really were sickness and diarrhea (she woudlnt eat the prescription food unless she was really feeling poorly). I hope the meds work, and as Swamp says, the liver can regenerate.

[CurlyCatz]

Hiya Pete.

I will copy and paste some info for you, I think it probably explains it better then i could (well probably alot quicker than me anyway  )
What i will say though is that Tarzans readings may be high but they can go much higher and i am sure cats can live with slightly high readings for a fair length of time (depending on the cause of course)
Also my soots had high ALT for probably closer to 2 years .. He was fiv/felv positive so slightly different circumstances but that gives you an idea.  Also many cats have high readings can go back to "normal" reference ranges.
Tell me what drugs is it he gets to reduce the levels ? (purely for my own curiosity)

ALT (Alanine aminotransferase)

ALT is almost liver specific in dogs and cats. It is found in the cytoplasm of hepatocytes and is released into the blood during changes in cell membrane permeability or necrosis. Its superficial location means that a relatively mild insult ,e.g. hypoxia, may lead to increased serum levels. Half life is about 60 hours in the dog and shorter in the cat.. In chronic hepatic disease with loss of functional mass levels may be deceptively low. In acute disease a rapid decline in levels may be a favourable sign. Recent work has demonstrated that ALT levels may also increase due to increased synthesis and release by healthy hepatocytes.

ELEVATED LEVELS

Primary Hepatopathies
Acute liver disease
Chronic active hepatitis (dog) - Fibrosis/cirrhosis
Poisoning/Toxicity hepatitis
Cholangiohepatitis (cat)
Lymphocytic cholangitis (cat)
Acute pancreatitis
Obstructive jaundice (slightly raised)
Pregnancy (slightly raised)
Glucocorticoid use
Hypoxia
Acute pancreatitis
Hepatic neoplasia
Secondary hepatopathiesCopper storage disease
Hyperthyroidism (cat)
Hyperadrenocorticism
Diabetes mellitus
Glucocorticoid therapy
Hypothyroidism (dog)
Post hepatic obstructive jaundice

Hope that info is ok, sort of explains it quite well i think but please dont go over alarmed with the list of possible causes, i pondered on wether to scrub that bit out but i'm sure you'd rather see the extract in full.  I'm sure it will be more to do with post op reasons rather than any other.

[Beanie]

HI all,

Can I turn to you for your expertise - particularly Lynn or anyone elsewith veterinary knowldege?

Tarzan had hyperthyroidism and, as a result, had his thyroid glands removed. At first his calcium levels dropped and 2 liver enzyme blood tests showed that the levels were high. A course of medication got them back within normal limits.

Gradually he came off the tablets and after 2 weeks needed another blood test to see if he had returned to normal. The 3 tests are known as ALKP, ALT and TBIL.

The upshot is that the ALT liver enzyme level has increased again into the 'High' category. The normal range is between 12 and 130 U/L. Tarzan has gone up again to 155 U/L.

The other readings are in the 'Normal' range. The vet has been prescribed medication again to bring it down again. It will need to be used for at least 3 months.

My question is, what exactly does ALT measure in the liver and does it point to a specific liver disease? If so, what is the prognosis? I will ask my vet (NB I didn't see him as my wife took the wee fellow in and he is extremely busy today.)

Tarzan is a rescue and we think he is 12 plus. He's my superstar and can be viewed in the gallery.

Any knowledge greatly appreciated.