LIVER ENZYMES TO MONITOR
TO PREVENT LIVER FAILURE
Chemistry panels can be intimidating but there are three very important things
you MUST do to protect your pup from liver failure if he or she takes phenobarbital
(Pb) for seizure control.
1. You SHOULD have a chemistry panel with liver enzymes done every 3 to 4 months
2. You SHOULD get a copy of the chemistry panel results from your vet or Dr.
Jean Dodds. (You should actually get copies of all the blood work you have done.
You have paid for the blood work and you can tell your vet that you need to have
the results for your files.) Please do not rely completely on your vet to say
"everything looks fine" or "a couple of levels are a little high but itís ok."
YOU need to see the results for yourself and make that determination and/or call
Dr. Dodds for her opinion.
3. You SHOULD look at the three liver function-related enzymes in the chemistry
panel [ALT (SGPT), alkaline phosphatase, GGT] to understand if your
epileptic dog has early warning signs of liver dysfunction from drugs such as phenobarbital
or due to other reasons.
According to Dr. Jean Dodds, there are three liver function-related enzymes in a
chemistry panel you should pay close attention to: ALT( SGPT), Alkaline
Phosphatase and GGT.
ALT ( SGPT) - This test is specific for liver cell damage. Antech Lab's
reference range is 12 - 118 IU/L, but the ranges for other labs may be slightly
different. If it is over 150 IU/L and the other two liver enzymes are also
elevated, then you should review any other drugs or preventives being given to
see if they could be a factor, and switch your dog to Dr. Dodds' liver cleansing
diet along with herbs such as milk thistle and/or SAMe. However, if these
enzymes are significantly elevated, consult your veterinarian as an abdominal
ultrasound may be indicated.
If the other two liver enzymes are NOT elevated, then you there is less concern
unless the ALT level is 300 to 400 IU/L or more. Using the liver cleansing diet
and the herbs listed above should be helpful here.
Alkaline Phosphatase - Antech's range is 5 - 131 IU/L, but other labs may
have different ranges. The level could be 150 to 200 IU/L, but if the dog is on
phenobarbital and less than nine years old, there is little, if any, clinical
significance as pb induces liver metabolism which non-specifically increases
release of this enzyme. If the dog is older, mild elevations of alkaline
phosphatase are normal as they typically reflect the effects of increased
release of adrenal sex steroids associated with aging.
GGT - Antech's range is 1 to 12 IU/L. Have this level rechecked if it is
between 15 to 20 IU/L. This enzyme level reflects the influence of bile flow on
AST (SGOT) Antech's range is 15 - 66 IU/L, but other labs may have
different ranges. Elevations in AST reflect a non-specific release from any
injured cell, not just liver cells.
If the GGT and other liver enzymes are elevated, you should send a urine sample
to have Dr. Dodds or your vet's regular lab to measure the urine bile acid level
to assess your dog's liver function. You can send the sample yourself by going
to our website to read how to prepare it:
By following the directions on how to read your pups liver enzymes you may save
your dog and yourself from dealing with liver failure. If liver dysfunction is
caught early it can be turned around. There is nothing as sad as losing a pup to
W. Jean Dodds, DVM - Antech Diagnostics