Elevated Liver Enzymes
An 8-year-old MN Ragdoll cat was presented for examination due to ADR. Blood chemistry found hypokalemia, elevated liver enzymes, hyponatremia, and a CPK of 11981. Urinalysis showed a specifi gravity of 1.039, pH 7.5, 3+ protein, RBC 11-20, and WBC 2-3.
The patient was presented for vomiting 3-4 days prior. Was recently gagging, not urinating often despite normal drinking. The patient had a decreased appetite or was not eating at all and having innappropriate defecation in the house. Blood chemistry showed liver enzyme elevation and low BUN. Bile Acids test results were high at 464.6 umol/L. An abdominal ultrasound was recommended to rule out PSS, liver disease. possible infection- Lepto? (patient from Ontario, Canada), toxin, glomerulopathy, protein starvation, chronic non-obstructive FB, Addison, glomerulopathy, other.
A 13-year-old MN Border Collie was presented for anorexia. Blood chemistry revealed moderate to severe BUN, creatinine and phosphorus with minor ALT, CPK and globulin elevations. Urinalysis revealed isosthenuria was present with a urine PH of 6.0 and some epithelial cells. Clinical dehydration and depression was present. Survey abdominal radiographs and CBC were unreremarkable.
A 4-year-old MN Maltese was presented for an annual exam, but the dog had been noted to be losing weight. Physical exam was unremarkable. Blood chemistry revealed hyperphosphatemia, and elevated ALT, and AST enzyme activities . CBC found leukocytosis consisting of a neutrophilia, lymphocytosis, and monocytosis. The patient was nonresponsive to antibiotic therapy over a 3 week period. The patient was doing well on re-evaluation; he had a good appetite, but was still losing weight. Recheck blood chemistry still showed persistently elevated liver enzyme activities, hypocholesterolemia, low urea and creatinine concentrations. The neutrophilia and monocytosis were still present on the CBC, however thrombocytopenia was also present. Serum bile acids were severely elevated, both pre and post-prandial. A coagulation panel was within normal limits.