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ALT (SGPT), High

The patient with a history of asthma (on Flovent® and prednisolone), presented for an abdominal ultrasound due to persistently elevated liver enzymes since 3/2022, and losing weight despite increased appetite. CBC/Chem: AL:T 510, ALP 329, T. bili 1.4, leukocytosis with neutrophilia and monocytosis. Current meds: Denamarin 90 mgs q24 hrs, Metronidazole 50mgs q12 hrs, Amoxicillin 50 mgs q12 hrs. At the the time of ultrasound the patient was dyspneic and an SDEP® emergency echo was performed to assess the heart. Blood pressure post scan (tail) was 118/98 (99); patient was put in O2 chamber for support.

Patient presents for suspicion of possible Cushing's. LDDST did not support a diagnosis of Cushing’s, however the chemistry panel does have generalized increased liver values; all considered mild-mod. ALT, AST, ALKP all mildly increased. Mild thrombocytosis - likely excitement. SDMA mildly increased. BUN/Crea normal. Abdominal ultrasound was recommended.

Decreased appetite. Current meds: Metronidazole, Denamarin, Mirtazapine. ALT 393, T. bili 5.7, Mag 2.7, Chol 307, Amyl 1891, PSL 50, Lymphs 9, Mono 8, Neuts 11,680, Mono 1280,Eos. 1600, USG 1.048.

Weight loss, diarrhea, decreased appetite, occasional weakness. Glucose checks have been consistently in the low 60s. HCT over 60%, ALT 299, AST 141, BG 61. Recheck BG 64.

Patient was presented for ataxia, icterus, lethargy, and vomiting. History of atypical vaccine reaction after first DHLPP-ADR, enlarged peripheral LN. The patient has not been 100% since. Blood chemistry and CBC revealed BUN 3, TP 4.3, Alb 1.9, ALT 457, ALKP 869, GGT 20, Tbili 5.1, chol 84, amylase 216 and HCT 31%.

Possible intestinal foreign body, lethargy, weakness. Panting on presentation. Current meds: Cerenia, Unasyn, IVF, Barium series started at 5pm. CBC and blood chemistry from 2/15 showed: WBC 22.57, Neu 18.66, HGB 11.4, PLT 128,. Na 144, ALT 440, ALP 379, GGT 12. In house u/a- USG 1.062, 2wbc/hpf, no bacteria, crystals unclassified 1-5/hpf. U/A pending.

The patient was presented for vomiting, lethargy, and painful cranial abdomen. Blood chemistry revealed BUN 5, glob. 4.7, ALT >1000, Alk.Phos. 1342, GGT 25, and T. bili 2.8. A STAT ultrasound was ordered and performed by ASNW with interpretation done by SonoPath.

12-year-old MN DSH with a history uncontrolled diabetes mellitus was presented for evaluation of ravenous appetite, shaking, and restlessness. Current therapy was 9 IU PZI SQ BID.  Urinalysis showed SG of 1.024 and glycosuria. CBC was within reference range. Abnormalities on serum biochemistry were hyperglycemia, elevated ALT and ALP activity, and hypokalemia. T4 was within reference range.

An 11-year-old MN Maltese mix was presented for evaluation of progressive elevation of liver enzyme activity. Blood work showed elevated ALT (530) and ALP (1255) activity and mildly elevated cholesterol.

A 10-year-old FS Australian Shepherd was presented for evaluation of acute hematemesis, vomiting, diarrhea, and lethargy.  Abnormalities on physical examination were lateral recumbence, dehydration, and pyrexia (106.8).  Blood work showed thrombocytopenia and elevated ALT (655) activity. On survey radiographs possible mass in mid abdomen and hepatomegaly was evident.

The patient was presented due to panting, urinary accidents, PU/PD, +1 polyphagia, hepatomegaly on radiographs. Urinalysis revealed hematuria, pyuria, and hyposthenuria. U/A: USG 1.002, protein +2, WBCs 4-10, RBCs 11-20, rods 26-50. Blood chemistry results: ALT 283, Alk. Phos. 226.

A 1-year-old, FS, Australian Shepherd mixed breed canine was presented for acute onset of collapse/dizziness. This was the first episode that the patient ever had; patient was BAR prior. Hepatomegaly was seen on radiographs. Blood chemistry showed an elevated ALT, CBC/UA were WNL. 4DX heartworm test was positive, Lepto test was negative.

An 8-year-old DSH feline was presented with an acute presentation of jaundice and decreased appetite. He was also pyrexic (40.6 celsius). Blood chemistry: ALT 669, AST 177, TBil 34, ALKP 48, PLI 50, SDMA 14, T4 22. CBC: normocytic normochromic anemia HCT 28% with reticulocyte 11 (<50) non-regenerative. Urinalysis by cysto; spec. gr 1.047, ph 6.5, Bil3+, prot 2+, RBC>50, WBC 3-5, sq ep 1-5, trans ep 1-5. FELV/FIV NEG. Abdominal radiographs clearly demonstrated the presence of a radiopaque density (3 mm) that appears to image in the vicinity of where the major duodenal papilla would be located. The cat has lost almost 0.9 KG (1.9 lbs) over the last year. An abdominal ultrasound was ordered to evaluate the cause of the elevated Tbil and jaundiced appearance of the individual.

The patient is a 14 month old M Miniature Australian Shepherd dog who presented with an acute case of vomiting, lethargy and ataxia.  The owner was unaware of any exposure to toxins or ingestion of obstructive material. Physical exam: 10% dehydrated; mm pink but tacky; abdomen tender on palpation; weight wnl. CBC/Chem: WBC 21,120, decreased cholesterol and protein; elevated CK, ALKP, ALT, BUN and ammonia. Lepto negative.

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 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.

A 1-year-old MN DSH cat was presented for evaluation of vomiting for a duration of 3 days. The patient has a known history of frequently eating innapropriate things around the house (strings, foreign objects, etc…). The owner reported no urination or bowel movement for 2 days. No vomiting, coughing, sneezing, or diarrhea was noted. The physical examination was unremarkable. CBC and blood chemistry found an very elevated HCT of 52.7%, eosinopenia, thrombocytopenia, mild hyperglycemia, elevated BUN, elevated calcium, low albumin, and slightly elevated ALT.


An 8-year-old FS Maltese was presented for evaluation for severely elevated pre and post-prandial bile acids and mild ALT elevations and subnormal BUN. In addition, the patient was positive for Rocky Mountain spotted fever. Seizure activity was present in the history.

A 12-year-old M intact Shih Tzu dog was presented for polydipsia of several months' duration. The serum biochemical profile revealed an elevated urea, increased ALT, increased GGT enzyme activities, hyperphosphatemia, hyperkalemia, hypercholesterolemia, and elevated triglycerides. Thrombocytosis was present on the CBC.