Owners of Sadie, a 10-year-old spayed female Toy Fox Terrier, came to see me for a second opinion regarding what their regular veterinarian called “elevated liver enzymes.” Sadie’s vet had performed blood testing prior to a scheduled dental cleaning. According to her owners, the veterinarian found elevated liver enzymes on her otherwise normal blood profile and recommended a liver biopsy to determine the cause.
Because Sadie didn’t show signs of illness, and a liver biopsy is an invasive surgical procedure, Sadie’s owners wanted to verify that this recommendation was the proper course to follow for their beloved pet.
Ruling out possibilities
Upon reviewing Sadie’s laboratory results, I disagreed with the veterinarian who made the diagnosis of liver disease. It was true that Sadie had some abnormal blood results. I noticed that one of her enzymes, called alkaline phosphatase (ALP), was about three times higher than normal. However, blood results indicated that other enzymes that are typically associated with liver disease, including alanine aminotransferase (ALT) and gamma glutamyl transferase (GGT), were within the normal range.
Based on these blood results, I concluded that Sadie was not suffering from liver disease, and did not need a liver biopsy at this time.
Pre-Cushing’s syndrome
I see many smaller breeds of dogs, usually middle-aged or older, misdiagnosed with liver disease when they show no outward symptoms of illness. In fact, most of these dogs do not have liver disease, but instead they have pre-Cushing’s syndrome.
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