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 without fail.

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 it’s 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 liver function.

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:
http://canine-epilepsy-guardian-angels.com/urine_bile_acid_testing.htm

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 liver failure....

REFERENCE:
W. Jean Dodds, DVM - Antech Diagnostics