Advice on high ALT level

[aston011]

Hi all

I am new to this forum. My dog is a terrier mix and is approx. 7 or 8 years old and is diagnosed last August 2012 with cushings disease in the adrenal gland. His medication is Veterol 30mg once a day and he is monitored every three months and all is well so far and he is happy and has energy.
On our last visit to the vet last week the vet said that his blood work results were good and she was happy with them but his ALT was high but she was not worried and we will retest again in August this year.
Here are the lab results and I would like to hear your thoughts on the ALT results please. Thanks in advance.

Biochemistry
Total protein 57.0 g/L (54.0-77.0)
albumin 28 g/l (26.0-40.0)
globulin 29 g/l (20.0-47.0)
sodium 141.8 mmol/L (139-154)
potassium 5.26 mmol/L (3.5-6.0)
Na: K ratio 27 (25.0-35.0)
chloride 112.1 mmol/L (99-125)
total calcium 2.49 mmol/L (2.0-3.0)
phosphate 1.10 mmol/L (0.8-1.6)
urea 6.9 mmol/L (2.0-9.0)
creatinine 81 umol/L (40.0-106.0)
alk phos 25 U/L (0.0-25.0)
ALT 32 U/L High (0.0-25.0)
GLDH 4 U/L (0.0-10.0)
total bilirubin 0 umol/L (0-90)
Bile acids 4 umol?L (-)
glucose No OXF received
CK 85 U/L (0.0-190.0)
cholesterol 6.60 mmol/L (3.8-7.0)
triglycerides 1.44 mmol/L (0.45-1.9)
amylase 737 U/L (0.0-1800.0)
lipase 44 U/L (0.0-150.0)
Sample comment : serum quality good
HAEMATOLOGY
No EDTA received
ENDOCRINOLOGY
bASAL CORTISOL 55.5 nmol/L (less than 125)
cortisol post ACTH 118 nmol/L (less than 600)
CLINICAL COMMENT: hyperadrenocorticism appears well controlled


The numbers in brackets are guideline figures I think.
Thanks

Brid and scruffy

[mytil]

Hi and welcome to our site.

I have just a second, but the ALT is only slightly elevated as well as the alk phos of which is right on this side of being slightly elevated. Both of these are associated with the liver and functions.

The ACTH test seems to be okay (55.5 nmol = 2.01 ug/dl and (118 nmol = 4.27 ug/dl). I converted the nmol to ug/dl by dividing by 27.59.

I know others will chime in shortly.

Also how are your dog's current symptoms? Showing any typical Cushing's signs? When you get the chance, post the results of the tests performed to diagnose Cushing's

Terry

[Budsters Mom]

Hello and welcome from me too. :)
I am sorry for the reason that brought you here, but so glad you found us. You have come to the right place! There are many K9Cushing's angels standing by to help and stay with you every step of the way. They love details, test results, any information you can get your hands on. The more the better. We will do all we can to help. Others will be popping in to welcome you also. So again welcome to you and Your sweet little fur baby.

Hugs,
Kathy

[lulusmom]

Hi Brid and welcome to you and Scruffy.

Scruffy's bloodwork looks awesome and his stim test results look great. It looks like you have the cushing's well under control so good job! With regard to the ALT, can you double check the reference range? I'm not sure what lab was used but I've never seen reference ranges for ALT and ALKP that low. Most of the labwork done for my dogs has been done by Antech and their reference range for ALT is 12 - 118 IU/L. In any event, it looks to be a minimal elevation and with such a short half life, it could be completely normal by now. Any number of things can cause a mild and transient elevation in ALT and with everything else being within the normal range, I can understand why your vet isn't that concerned about it. If there was something serious going on, I believe you'd see a lot more abnormalities.

I just want to clarify that Scruffy does have an adrenal tumor. Is that correct? Most dogs have pituitary dependent cushing's so I'm just double checking. Was an abdominal ultrasound done by your vet before s/he confirmed the diagnosis? Was the possibility of surgery discussed with you?

Glynda

[Simba's Mom]

Hello and welcome to you and Scruffy, this is an awesome place to find info on cushings and get some encouragement along the way...settle in and read some threads, its amazing how much you can learn....take care!

[goldengirl88]

Hello:
Just wanted to welcome you to the site, and tell you that these are wonderful people that know all about Cushings etc. They will guide you and support you through everything, though it seems you are doing well controlling your babies cortisol. Wishing you both well. Blessings
Patti

[molly muffin]

Hello and welcome from me too. The test actually looks pretty good and the ALT isn't that much elevated and is often elevated in dogs with cushings as the cortisol affects the liver too.
Sounds like you are doing good. I too want to know if an ultrasound was done to confirm an adrenal tumor. :)

Sharlene and Molly Muffin

[aston011]

Hello everyone,

Greetings from a rainy day in the west of Ireland :D
Many thanks from both scruffy and I for all of your replies. It was great to hear that you all think his blood work results are good...this is comforting to us!
Yes an ultra sound was done before he was diagnosed for cushings but ultra sound was clear but since he was diagnosed with cushings the vet suggested that perhaps the growth is small and hard to view as adrenal glands are small. I think he was diagnosed with adrenal cushings through a series of blood work but I am not 100% sure of that, but yes he was confirmed with adrenal cushings. My vet is reluctant to operate as she suggested the tumour may be attached to the main artery to heart and if this is nicked during surgery and he may bleed out.
I double checked the range for ALT and ALKP and the range posted before of 0-25.0 is correct.
Scruffy is in great form since being diagnosed and he will be in better form today knowing his ALT is nothing to worry about!

Is it ok sedate him via a drip to do some dental work?

Thanks to you all and I will try and get the original results of his diagnosis for adrenal cushings.

aston011

[labblab]

Sorry I don't have time to write a lengthier reply right now, but wanted you to know that your membership approval has now been finalized so your posts will now be publicly visible just as soon as you write them. :)

Marianne