Ultrasound?

[ifregosi]

Hi everyone

I am new to this forum but am blessed to find it. Nice to be speaking to people that have the same issues as I do.

My dog Milo, is 13 turning 14 this year. He was diagnosed with cushings approx 2 years ago.

In August 2013, they ran blood tests and the liver functions came back as :

ALP: 642
ALT: 411.

The vets did an ultrasound on his liver and it was fine.

He went back in yesterday to have this full bloods redone.

The new levels that are of concern are:

ALP: 878
ALT: 201.

As you can see the ALP levels have risen while the ALT levels have decreased.

His Post ACTH levels are at 78 and he is on Trilostane 0.5ml of liquid once a day. So this is ok and is stable - thank God!

The vets are wanting to do another ultrasound. Do you think that it would be worth it?

I am concerned about the increased levels of ALP but is this only cushings related.:confused:

Any advice is greatly appreciated.

[mytil]

Hi and welcome to our site. I had manually approved your membership (see the email that was just sent). Am very glad to hear things have gone well all these years with the treatment of your Milo.

When you get the chance let us know the letters following the number you have listed (ug/dl or nmol for example).

The lowering ALT can be several things - one that the liver is recovering and moving back to normal levels or on the other extreme a falling number of functional liver cells.

The increase in the ALP may also be associated with decreased liver functions.

When was the last ACTH test performed?

The changes in the ALT and ALP could be associated with the senior age of your Milo but given that he has Cushing's your vet may be thinking about decreased liver functions and wants to take a good look at his liver with the ultrasound and it may be worth it. Will this be a high resolution ultrasound?

Keep us posted
Terry

[ifregosi]

Hi Terry

The levels are U/L


He had his ACTH level was done yesterday and it's at 78.

[ifregosi]

I think it will be a high profile ultrasound

His cortisol level is at 69 nmol/L

I really appreciate your advice

I wish I could attach the blood tests for you guys to see

[molly muffin]

Welcome to the forum.

The ALT coming down is good, because that is a liver specific test. The ALKP though can be affected by other things, not just liver, so my guess if the reason they want to do an ultrasound to compare is to see if anything else is going on, sludge for example in the gall bladder, etc and to see what the liver looks like.

I like the ultrasounds as they do give you a good idea of what is going on and changes can be caught early using them. That is my personal opinion of course.

The cortisol is a good level, 69nmol would be 2.5 ug. I wouldn't want him to go any lower than that though.

[Wrighton]

My dog's life was saved by the discovery of a mucoscele during an ultrasound when her two numbers, ALT and ALKP, were up. They were not profoundly raised. She, indeed, had sludge in her gallbladder. While I am sure, Icy's condition was not typical, the subsequent removal of her gallbladder saved her life. For just sludge, ursidiol helps many dogs when doctor prescribes.

I apologize for whom this was a repeat, but I am still so grateful an ultrasound was done.

Gail and Icy 15 weeks post gallbladder and stringer every day

[Harley PoMMom]

I wish I could attach the blood tests for you guys to see

You can type in the abnormal values that are listed on the blood panel along with the reference ranges and the units of measurement...e.g.ALT 150 U/L (5-50).

Regarding the high ALP, 80% or 90% of dogs have a steroid induced isoenzyme of ALP so if one of those dogs has Cushing's, you are gonna see anywhere from a mild to severe increase in ALP. These increases are not because the excess steroids are killing liver cells, it's because the steroids are causing an abnormal accumulation of fat in the liver and it is having to work a bit harder.

Hugs, Lori