# Fable's Health Scare - ALT Elevated



## FablesMom (Jul 13, 2008)

I'm new to the Board and did post an intro in the general discussion forum and told a bit of our story. Now that it looks like we've neared the end, I thought I would post here in case any one else comes against this problem.

Fable has been a wonderful puppy! extremely smart (I think that's in the breed .. they're perfect dontcha know eace We took him in to get neutered at 6 months and was asked if we wanted his blood work done before the operation to test his liver. We said, of course. So, they phoned and said his ALT was elevated ... 318 to be exact. Needless to say, we didn't get the operation done. He was put on Hepato Support for a month and then we went in for another test. His ALT had gone up to 680. We were scared.

So, last week, we had the bile acid test done. I just got the results today! His before was 6.6 (normal range 0 - 16) and his after was 24.7 (normal 0 - 22). So we've ruled out liver shunt, thank god! Our vet said that we should just go on living at this point. To not feed him a high protein diet and to make sure to mention that his liver isn't perfect if he ever needs an operation so that they can change the meds around for him.

All in all it was an incredibly scary experience! I know that we now face a future of watching his diet ... and getting scared if he gets even a little bit sick .. but he's with us and doesn't need any treatment.

The saving grace .. he has absolutely no sypmtoms and all his other levels were perfectly normal 

Anyways, if someone ever has questions or wants to know more, feel free to PM me 

In the meantime, I'm going to go and enjoy my little man :juggle:

Carissa :whoo:


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## Dawna (Aug 3, 2006)

That is GREAT Carissa!!!!!!!!! 
I'm beginning to think there almost need to be different testing parameters for our breed, if not several of the toy breeds. I have heard and read about this same experience very, very many times. Hmmmm, now I'll have to start researching that to see what the professionals are saying. 
Dawna


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## FablesMom (Jul 13, 2008)

Thank you so much Dawna  I'm so happy right now I'm crying *lol*


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## Cheryl (Mar 17, 2007)

Thank you for posting Carissa. As you know this is a scary experience and I am sure it will help ease some fears at some point.


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## mellowbo (Aug 12, 2007)

Carissa, there have been posts about puppies having their liver enzymes affected by puppy shots or the first rabies shot. 
Carole


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## Me&2Girls (May 11, 2007)

Carissa, that's such exciting news. We've got some very experienced liver issue owners who can help you with the lower protein diet to help you guy stay healthy.


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## marjrc (Jan 13, 2007)

Carissa, we've been going through a journey of our own with Ricky's elevated ALT since last Nov. It was a sky-high 1200 and 1800 on the weekend we brought him into the ER back then. It's a LONG story and as you know, there is a thread about it in this section of the forum ... 

It is a good thing Fable's bile acid results are good. The high ALT can be due to something toxic she got into, or some type of virus so best to monitor that in a couple of months, I think. Ricky was asymptomatic the entire 7 months, but that ALT took a long time to go down. It finally is now, so I understand about that happy crying. :biggrin1:

There is a great yahoo group, Canine Liver health at:http://pets.groups.yahoo.com/group/canineliver-d/ They offer great advice, diets tried and tested, support and anything you might need.


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## FablesMom (Jul 13, 2008)

Thanks Carole! I didn't know that! and I thought I was doing the right thing by getting him all his shots


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## FablesMom (Jul 13, 2008)

marjrc said:


> Carissa, we've been going through a journey of our own with Ricky's elevated ALT since last Nov. It was a sky-high 1200 and 1800 on the weekend we brought him into the ER back then. It's a LONG story and as you know, there is a thread about it in this section of the forum ...
> 
> It is a good thing Fable's bile acid results are good. The high ALT can be due to something toxic she got into, or some type of virus so best to monitor that in a couple of months, I think. Ricky was asymptomatic the entire 7 months, but that ALT took a long time to go down. It finally is now, so I understand about that happy crying. :biggrin1:
> 
> There is a great yahoo group, Canine Liver health at:http://pets.groups.yahoo.com/group/canineliver-d/ They offer great advice, diets tried and tested, support and anything you might need.


I'm so glad that Ricky is okay 

Well, I know that the vet said "don't worry" and "don't need to test again". But, we'll be testing again in a couple of months, with a different vet. A vet recommended by our breeder 

Thanks for the link to the group! That will help me a ton


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## Judy A (Jan 13, 2007)

good news, Carissa....I can't imagine the scare!


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## mellowbo (Aug 12, 2007)

Carissa, the shots seem to be just one of those things that we don't know about. I think most dogs do just fine with them and you were doing the right thing by giving them to your puppy. It just seems like some dogs have poor reactions and sometimes it shows up in the liver blood tests. You don't need to worry about it. Like others have said, there's plenty of good info. on this forum and on the yahoo liver support group. I'm glad your baby is healthy!
Carole


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## FablesMom (Jul 13, 2008)

Update on Fable:
Fable went in to a new vet last month and was fixed. The new vet was great and we really have a lot of confindence in her. She wanted to re-test his ALT and it came back at 500  much higher than last July. Then she did the Bile Acid test again and his results have doubled. SO, now we're on to a liver biopsy and a bleeding test. I just can't believe that we're going through all of this. He's the happiest, most outgoing dog that I've ever know. You can't even tell that he's sick in the least! Maybe that's a good thing? Means that we've caught it early enough? I don't know ... I do know that my stomach is flipping and I feel like crying. I really don't want to loose our little guy. I guess, for now, all we can do is go through all the testing and try to figure out what is wrong, there's nothing else that we can really do at this point.
Oh and another thing that has happenned ... Fable needed to be shaved down due to matting .. he was wearing clothes (I didn't think that that would be a problem ... apparently it is with Havs). Anyways, now that he's all shaved down we can see that his front left leg is bowed. He doesn't seem to have any problems with running and jumping and playing though, I guess it's just something else that we'll have to keep our eyes on.


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## karlabythec (Nov 9, 2008)

Awwww...I'm so sorry. I hope everything turns out okay. {{{{}}}}


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## Judy A (Jan 13, 2007)

Carissa...keeping Fable in my prayers and hope that all turns out OK. I can't imagine having to go through illnesses like this with one of our babies. They have stolen our hearts....


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## ivyagogo (Sep 11, 2007)

I hope everything turns out okay. Fable is absolutely adorable and I love the name. Welcome to the board!


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## Sheri (Oct 11, 2008)

Fable's Mom,
I'm so sorry to read about this! There are several people on here who have had similar experiences. I'm sure there will be lots of practical support, besides the emotional support others of us can give. Keep us posted!


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## Missy (Nov 6, 2006)

Oh Carrissa, I am very sad to read this turn. I hope it turns out to be nothing. You and fable are in my prayers.


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## mckennasedona (Feb 20, 2007)

Carissa, I'll be keeping you and your precious Fable in my thoughts and prayers.


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## Lina (Apr 26, 2007)

Carissa, I am so sorry to hear these news of Fable! I hope the liver biopsy will give you some good answers as to what's going on. :hug:


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## pjewel (Apr 11, 2007)

I'm so sorry to hear about Fable's test results. I hope the issue can be resolved with diet and that he can live a perfectly normal life. It's so scary when our babies have issues. My prayers are with you both for a quick resolution.


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## Chasza (Dec 10, 2008)

I, too, am very sorry to hear about this. I don't personally have experience with liver issues, but I have spent the last few years on nutrition and other sites learning how to deal with my two guys on-going serious health issues (non-havs).

It might be best to pursue a home cooked diet. One of the best places I have learned about home cooking is at the yahoo group k9Nutrition. The list owner, Lew, also writes newletters for b-naturals. Go to b-naturals site, and at the top is the newsletter link. I do know that she has some diets for liver shunts. I don't know if this is applicable to your case or not, but it might be. I strongly suspect that your dog will do better on homecooking. There is a bit to learn at first (how much liver and how much calcium), but once you get the basics down, it gets easier. Any questions you have, you can shoot to the list, with 'liver problems' or something in the title. I think these diets start by using a white fish to help the load of the liver at first...information like this should be there. Either way, I am quite sure that homemade will be better than kibble.

Also check out dogaware, because Mary Strauss might have some info on liver issues. I know she has some basics with home cooked and raw, and it's also a great learning place.

Again, I don't understand much about liver issues, but wanted to mention the following just in case. I spent about a year on the tick-l list (very smart people) b/c I had thought that one of my dogs might have tick related issues (turned out to be something else). Anyway, I've learned that ticks carry lots of nasty bad organisims that can really cause lots of havoc. Apparently for many of these dogs, their ALT levels go sky high. Many people have used a product by Bio-Chem Country Life called Liver Support Factors (can get online at iherb as well as other places). Apparently this product has worked well for many tick related ALT issues, so it could possibly help with your guys ALT levels.

Go to: http://blackgsd.googlepages.com/
Look on the right hand side, follow down to treatment, and hit on 'liver support' and you will find out more. This is Gil's site and it is very informative. While on the tick list, I did read of several others that used this product effetively for this purpose.

Since you don't know what has caused the liver values to rise, I would start looking into possible causes. For example, if it might be tick related, you could send out bloodwork to Protatek in Arizona. If it could be tick related, then this would be important to discover the best medication to give. You could also send off bloodwork to see if it is Lepto related (I am assuming that Lepto might cause increased liver values). My point is to start educating yourself on what the possible causes could be, b/c there may be treatments available that might be applicable and helpful. I can't make specific suggestion since I am unfamiliar with liver issues......maybe even shoot Lew, the list owner of the k9Nutrition group a question if she knows things that might cause the level to rise. Could also email Gil, the owner of the tick information. She is very smart, and very likely to know of the possible causes of high ALT levels. Go to the online Merck manual and read up on liver issues, ALT, etc. and then start going down the line of testing.

I am sorry you are going thru this, and I hope you can get some answers soon. For general home prepping questions, I might could help as I must cook for my two medium sized dogs. I wish you both well,

Lynn


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## marb42 (Oct 19, 2008)

Carissa, I missed the orignial thread, as I joined after. I am so sorry to hear about Fable's tests. He looks and sounds so sweet. Please keep us posted.
Gina


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## lfung5 (Jun 30, 2007)

I am so sorry to hear about Fable. I know how you feel. i went through this with Bella about 4 years ago. She did not act sick at all. Her only symptom was increased thirst. If it makes you feel better, she is fine now. She had the surgery. The surgery couldn't have gone any better and she was back to herself in no time. Please feel free to PM me if you want. Fable is in my prayers.


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## FablesMom (Jul 13, 2008)

Thank you to everyone for your thoughts and prayers. I am just trying to love him up as much as possible ... do kisses count as medicine? *lol* We have to schedule the bleed test and liver biopsy still, and I will keep everyone updated as to what is going on.
On a side note, I lost a budgie today  His name was Moonbeam and he was 10 years old and the best bird I've ever had. I'm guessing he died of old age as he was completely fine last night. His mate, Sunshine, seems to be holding up okay but we'll watch her closely. As for me .. I've had a good long cry and am back to concentrating on Fable's health.
Thanks again!
Carissa


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## Sheri (Oct 11, 2008)

Carissa,
I'm sorry you lost your special bird, and I hope things go well with the upcoming tests, and that there is a simple answer!


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## marb42 (Oct 19, 2008)

Carissa,

I am sorry about losing Moonbeam. :hug: I hope Fable's tests/biopsy will go well and that he can get better.
Gina


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## ama0722 (Nov 28, 2006)

Carissa, I am sorry about the loss of your Moonbeam and I hope you get some answers on Fable soon.

Amanda


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## Havtahava (Aug 20, 2006)

Oh Carissa, I'm sorry to read about your budgie. That's so sad.


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## mckennasedona (Feb 20, 2007)

Carissa,
I'm sorry to hear of the loss of your bird. My condolences.


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## Leslie (Feb 28, 2007)

Carissa~ I'm so sorry to read about the loss of Moonbeam. :hug:

I hope Fable's tests/biopsy go smoothly.


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## FablesMom (Jul 13, 2008)

Me again ... Hubby and I have been thinking about the liver biopsy and have decided to hold off until we can do some more research. Fable isn't showing any symptoms at all and his ALT went up from 220 to 387 in 6 months. I don't have his bile acid test numbers, but have asked the vet to send them to us. I know that his bile acid test last year was okay ... his pre was normal and his post was only slightly elevated.
So, until we have all his numbers and have done some research, we're just not comfortable having him go for invasive surgery. Also, I would like to try altering his diet first as well. He's already on milk thistle and has been for 3 months, we'll continue with that as well.
This hasn't been an easy decision by any means ... but we just don't want our little guy to have to go through all this if it isn't really necessary.
Anyways, I've read that some have an ultrasound ... I wonder why our vet hasn't suggested that?
Will keep you posted 

EDIT: His Bile Acid pre was good and his post was 38 ... it was 25 last July.
What would you do?


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## JASHavanese (Apr 24, 2007)

FablesMom said:


> Me again ... Hubby and I have been thinking about the liver biopsy and have decided to hold off until we can do some more research. )


I think that's what I would do too since he was so very close to normal. There could be something he's getting into that's causing this or perhaps shots. First this, then your bird. I'm so very sorry for your loss.


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## MaddiesMom (Apr 1, 2007)

Carissa- I'm so sorry to hear about Moonbeam.

I'm sorry I never saw this thread before. Several of us have gone through this with our Havs. Some have turned out perfectly o.k., others have needed surgery or special diet/drugs. You said Fable is on milk thistle You might look into denamarin which is a combination for both milk thistle and sam-e. Both of those are usually recommended, not as a cure, but a support. Also, you might look into the Yahoo liver support groups, http://pets.groups.yahoo.com/group/canineliver-d/ and http://pets.groups.yahoo.com/group/...=1&t=search&ch=web&pub=groups&sec=group&slk=1 You'll need to register with them to read posts or post yourself.

Having gone through alot with my previous Havanese, I can tell you that liver disease does not always show in symptoms. My dog behaved perfectly normal until 90% of her liver was damaged. Others do eventually show symptoms such as drinking alot of water, low weight, poor appetite, etc. Its hard to know when you see this if it means anything, as many perfectly normal dogs show these symptoms. As to ultrasound, my dog had an ultrasound (which showed an abnormally small liver), and during the ultrasound, they proceeded with the needle biopsy. Other vets only want to do an "open" biopsy, as more tissue is gotten and they can visualize the liver. You do have options, though, and maybe a specialist can give you better advice? In any case, I'm sending both you and Fable positive thoughts and hugs. :hug:


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## ivyagogo (Sep 11, 2007)

Carissa - I'm sorry to hear about your little birdie. You are very good at naming pets. I love Moonbeam and Sunshine. That is beautiful. I will continue passing good liver karma to Fable.


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## marjrc (Jan 13, 2007)

*"His Bile Acid pre was good and his post was 38 ... it was 25 last July.
What would you do?"*

Carissa, the post level isn't high as far as what I've come to learn and what my vet told me. A 'normal' high is 50-55. Ricky had 98 and 99 in two BAT's. i wouldn't worry at all about a 38, but then it could be that your lab uses different ways to measure it, so ... I dunno.

I read your posts and feel like a repeat of what I went through all of last year! It is very stressful, though at the same time it's reassuring to see our dog not acting sickly in the least.

Having been through pretty much everything - change of diet, supplements, BAT's, bloodwork, ultrasounds, needle and surgical biopsies... I can sympathize with you and know just how stressful this can be. If you haven't already, you can read the thread "Hugs to Marj's Ricky" at: http://havaneseforum.com/showthread.php?t=2411&highlight=Hugs+Ricky but it's a LONG thread, so a lot of reading. lol

In the end, after all the tests, the change of diet, the great amount of money, worry and trauma to Ricky, we are still not in the all-clear, but I am no longer worried. I waited a long time before agreeing to a surgical biopsy, but it did tell us that his liver was healing from an infection/trauma (in his case, it was the vaccines he got). That was good enough to cause us to no longer worry, knowing Ricky was on the mend. There were no shunts, nothing wrong, just proof that yes, he did suffer something, but it was ending. This was in July, and two tests since then show that his ALT is taking forever to go down, but it is going down.

Diet, supplements and more BAT/blood work, can be enough. I agree that the Denosyl or the Denamarin can be a big help as can a diet. I went the homemade route for a while, as Lynn has suggested to you, but also used Fromm's "White fish and Potato" kibble. Another great site for more info on diet/liver issues, is by Monica Segal. http://www.monicasegal.com/health/liver.php


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## RikiDaisyDixie (Apr 15, 2008)

*Bless your heart...*

We send you cyber hugs...and lots of TLC.


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## Cheryl (Mar 17, 2007)

Carissa--I hope you received my PM a few days ago. I am glad that Fable continues to feel well. It is a much more difficult decision to do a biopsy when you are not already doing a surgery. Roxie had an ultrasound (which could show an abnormal size liver or a shunt) and hers was normal. We did the open biopsy when she was spayed. It showed minor MVD. What kind of diet are you considering? Some vets will try antibiotics to bring down an elevated ALT. How old is Fable and how big is he? Has Fable had a panel of additional blood tests (blood count, etc?)

Keep us posted on your adorable Fable!


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## FablesMom (Jul 13, 2008)

Thanks Marj 
I'll be reading through your story soon.
It's very encouraging to hear about someone else dealing with this and things going good  I hope that Ricky continues to improve!


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## Lynn (Jan 2, 2007)

Carissa, I am sorry for your lost of Moonshine, how is Sunshine doing today?

My Casper has high ALT also and it has really been a big help to come to the forum and get advice from those that have experienced it with their dogs.

Casper's ALT was 347 in Dec and the vet went ahead and neutered him. I am going to have the bile acid test done this week. He hates the vet, so I am not looking forward to it.


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## FablesMom (Jul 13, 2008)

I know what you mean about hating the vet .. Fable is "okay" with the vet .. it's the car ride that he hates. Let me know what his BAT results are!

We're going to be changing Fables diet this week and adding denosyl / denamarin (after I email our vet). Then we're going to have his ALT and BATs redone in a couple of months. We'll see from there where we're going to go.

He's still asymptomatic, always has been, so that's a good thing.

Also, his BAT test was slightly "hemolized" ... which I've read means that the sample was taken wrong and that we should be retesting.

Ohhh the joy of being a Mommy of a Hav


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## marjrc (Jan 13, 2007)

As to the Denosyl (which is SAM-e) and the Denamarin (SAM-e and Milk Thistle), you can likely find it a LOT cheaper online. My vet was selling it for $83 cdn./month which was very pricey - over $2 a pill! Someone, I think it was Connie from Ontario, sugg'd www.petrx.com and it was so much cheaper. It is exactly the same product, same pkging, everything.... so keep that in mind if you're interested. We used the supplements for 6 months so it adds up!

Good luck with the BAT ! Try to make the car ride a very joyous experience. I like to leave early, walk around out front before piling into the van, then arrive and walk around the vet clinic premises, outdoors, for a while. It's best they don't associate every car ride with being poked and prodded by vets!


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## FablesMom (Jul 13, 2008)

Thanks Marj  and especially for the suggestion about going to the vet. We'll try that next time around


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## FablesMom (Jul 13, 2008)

More info ... I had my current vet send me Fable's test results from last summer (he was with another vet then) and I was shocked at the numbers! I have no idea why I didn't remember this .. I have a feeling that they didn't tell me the July number!
June 2008 - ALT 318
July 2008 - ALT 611, BAT 6.6pre 24.7post
January 2009 - ALT 378, BAT 5.7pre 38.6post (with the sample being slightly hemolyzed)
Anyways, from that information, at least his ALT is going down! wow! finally a little bit of good news 
Carissa


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## marjrc (Jan 13, 2007)

Hmmm... I wonder if Fable had a flea/heartworm treatment just around the time of the July test..... it might explain the very high ALT then. Some dogs just react very easily to any toxin in their environment and/or systems. The key is having a dog that then recovers quickly and easily from that. 

The BAT from July and Jan. are good though, so that's a relief.  As you say, the ALT is going down. Always a good thing! :whoo:


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## FablesMom (Jul 13, 2008)

Thanks Marj  and yes, he had some shot about that time, I don't have his records here at work but will take a peek through them when I get home


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