Elevated Liver Enzymes In Cats – Should You Be Worried?

The liver is the largest internal organ in the cat (and in humans, too!) and has many important functions. You can read all about what the liver does in cats and the related potential health problems in our article Liver Disease In Cats. These health issues include things like liver cancer, inflammation of the gallbladder and even poisoning.

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When something goes wrong with your cat's liver this can be a serious problem. So, if Kitty's blood tests show elevated liver enzymes, how alarmed should you be? We talked to veterinary expert Dr. Letrisa Miller - an award-winning veterinarian with more than twelve years’ experience as a feline-only practitioner - and have some answers for you!

What are liver enzymes anyway?

First, a recap on what an enzyme is. In a nutshell, enzymes are proteins that can break apart specific large molecules into smaller ones. They can also create specific new compounds by putting together smaller molecules. Essentially, they are one of the body's tools to manage its biochemistry.

The liver itself is a wondrous biochemical factory where some molecules get torn apart into smaller more manageable pieces, while others get put together into larger structures used for storing energy or other purposes. It's no wonder that the liver uses many types of enzymes to manage this factory.

How can your veterinarian diagnose liver problems?

There are many ways to check the liver, blood tests being just one of them. Other tests include -

  • Touching the cat's abdomen to feel the liver and its size.
  • Looking at the cat's gums, the membranes under the eye and other tissues to look for jaundice.
  • Using an ultrasound to look for changes in the liver's inner structure.
  • Taking a biopsy and look at the liver cells under a microscope.

Your vet will also take into consideration your cat's age and the overall condition of their health. He or she may ask you about what you feed your cat and inquire about changes in your cat's appetite and eating and drinking habits, as well as overall behavioral changes.

It's important to remember that the liver functions blood tests are just one tool. The results are usually not enough on their own.

What liver enzymes are usually tested in cats?

Many "in-house" blood analyzers don't have all of these enzymes included in their profiles, but have the benefit of results in 10-15 minutes rather than 24 hours. Dr. Miller says that the following enzymes are usually covered in a liver functions blood test -

GGT (gamma-glutamyl transpeptidase)

GGT is often elevated in any liver disease, but it is markedly elevated in hepatic lipidosis.

ALT (alanine transferase) ALT is very specific to leaking, damaged liver cells, but is otherwise pretty non-specific.

ALP (alkaline phosphatase) ALP is fairly specific for biliary (bile ducts and gallbladder) damage in the cat, but it can come from the tiny bile ducts in the liver or the gallbladder and large ducts outside the liver.

AST (aspartate aminotransferase)

AST can be more sensitive in cats for some types of liver disease such as the granulomatous inflammation found in FIP, but is also produced by muscle damage.

Bilirubin is also included in the test. This is not an enzyme, but a product of hemoglobin breakdown that becomes part of the bile. A cat with high levels of bilirubin is jaundiced, but Dr. Miller warns against assuming that jaundiced cats necessarily have liver disease. There may be other reasons for jaundice, such as red blood cell disease.

Elevated liver enzymes in cats - what could they mean?

According to Dr. Miller, the results can be indicative of many conditions. It's important to look not just at the separate figures, but at the ratios between them and the overall pattern they create.

The list of possible health conditions that cause liver enzyme counts to go up is very long. Here are the common ones:

  • Hepatic lipidosis
  • Cholangiohepatitis
  • Biliary obstruction
  • Inflammatory bowel disease (triaditis)
  • Pancreatitis
  • Lymphoma
  • Endotoxin producing infections
  • Hepatitis (there are different types of hepatitis)
  • Biliary stasis
  • Septicemia
  • E. coli enteritis
  • Hyperthyroidism

Clearly, the source of the problem is not always the liver itself. In fact, sometimes the enzymes aren't coming from the liver, because other organs produce the same enzyme.

Read more on Hepatic lipidosis: Why Has My Cat Stopped Eating And Is It Dangerous?

Could this be nothing?

Dr. Miller says that benign elevation of enzymes is rare in cats.The exception would be with elevated levels of ALP (Alkaline Phosphatase) in kittens. This can happen due to rapid bone growth, as osteoblasts - cells involved with bone formation - also produce ALP. In kittens, this can be a benign finding.

There are a few drugs that can elevate enzymes. If this happens, your vet may suggest that you stop the medication. Please note that you should never stop a course of medication without asking your vet first as in some situations, the benefit from the drug could still outweigh potential risks.

What's the prognosis?

The prognosis -- or expected outcome -- depends on the actual diagnosis, which is based on your vet's overall assessment of the cat. Dr. Miller has encouraging words for you:

The liver is an amazing organ with a lot of different functions, and it is remarkably good at repairing itself when damaged. While cats that have liver disease can look like they are dying (or want to die), given enough supportive care and specific treatment, most survive and become healthy again. </blockquote >

The diseased liver brings about loss of appetite, but without food, things will only get worse. That's why helping the liver to heal may include tube feeding, a procedure which scares many owners. Dr. Miller cautions against opting for force feeding instead of tube feeding, saying it could lead to long-term food aversion. "Feeding tubes are quickly and easily placed and allow all food and medications to be given without stress to the cat", she says.

What you should do

Elevated liver enzymes in cats are not the end of the world, but are an indication that something is wrong. The results of the blood tests require expertise and experience to decipher, as the overall pattern and ratio between the various enzymes need to be taken into account. You have to work with your veterinarian on getting a proper diagnosis. It may take further testing and some time, but it is the key to getting your cat better.

As always, if you don't feel comfortable with the medical care given to your cat, it's perfectly ok to seek a second opinion, preferably from a feline specialist.

You're not alone. Many cats have suffered - and recovered - from liver disease. Share your experience in our cat health forum to get the support of other cat lovers.

Dr. Letrisa Miller is a feline-only veterinarian who owns and operates the Connecticut Feline Medicine and Surgery, LLC at Manchester, CT.

Dr. Miller is a founding fellow of the International Association of Cat Doctors and has served as president in 2012 and 2013. She is also a member of the American Veterinary Medical Association, the Connecticut Veterinary Medical Association, the International Society of Feline Medicine, and the Veterinary Information Network.

From 2006 through 2011 Dr. Miller was a board member of the American Association of Feline Practitioners AAFP) and for several years she was the chair of the AAFP's research committee. In 2010 she represented the AAFP at the founding of the Cat Health Network, a collaboration among the American Veterinary Medical Foundation, Morris Animal Foundation, Winn Feline Foundation, and AAFP to fund and promote research in feline medicine. You can read more about Dr. Letrisa Miller on her website.

30 comments on “Elevated Liver Enzymes In Cats – Should You Be Worried?

Wendy January 18, 2022
Our 13 yr old DSH has lost 4# since his checkup in June. He had appt yesterday (Jan 17, 2022). He has UTI and ALP is 95. ALT 341, which is quite high. She put him on antibiotic and liver protectant. Of course we are worried. Will reck urine in 2 weeks. Vet will reck in 1 month. He had elevated kidney enzymes in June 2021, but they were in normal range yesterday.
    Robin September 19, 2022
    Hi, my cats ALT is 193 when his blood work came back at his annual vet visit. The vet put him on a 3 week antibiotic and in 4 weeks will do repeat of BW and see results. I am glad I asked for BW since he is only 7 years old and I wanted to catch something early, so happy I asked. Wendy how did the results turn out for your kitty after treatment? Is this something I should be really worried about? I love my kitty so much and I want him around for a long time to come, thank you Robin
    Linda Bellefleur Polich November 17, 2022
    Hi Wendy, My cat has elevated liver enzymes. She's 14. Has your cat's water intake greatly increased? In the past few weeks GG is always at the water bowl. How is your cat doing? Linda and GG
shea8 July 13, 2021
We took our 6 year old cat to the vet after he had a seizure last night. His blood work came back with only slightly raised ATL (103) but the vet doesn’t think that’s what cause the seizure. He’s starting a 2 week medication for the ATL levels, but does anyone have diet change tips? He’s a picky 9 pound kitty. He has dry food out all day and got wet food at night and the vet only said to stop feeding him the wet food.
    MomoKumo September 13, 2021
    Hi, Cats are obligate carnivores and dry foods should not be given to any cats at all cause. My cat got diabetes because of this. Dry food causes a lot of sickness both in cats and dogs, as they are not healthy foods, no moisture, and highly processed. After switching her to a balanced gently cooked chicken (organic, human grade), she is now in remission. Please visit Youtube- Jackson Galaxy, the food, the bad and the ugly for better, healthier cat nutrition.
    Kate January 20, 2022
    Hi! I hope your cat is doing better! Did you find the reason behind his seizure? I have exactly the same problem with my cat and she has exactly the same ALT number and vet said they don’t know what’s causing seizures.
Marcia Shorter June 23, 2021
Don't think I've seen what normal cat liver levels should range. My 8 year old was just diagnosed with slightly high levels.
Kim April 24, 2021
We have a 6 month old British Shorthair Kitten which came out with High ALP level, 132. Normal range is 10 to 90. Blood test was done because I will need him to get castrated soon. Is this because of rapid bone growth development? British Shorthairs are large breeds and he is gaining 1kg every month. Is this causing ALP level to be slightly higher? I don't think that it's liver problem.
    Whitney May 17, 2021
    We are in the middle of the same experience with out Main Coon kitten (high numbers before her spay surgery). We have an ultrasound scheduled tomorrow to just to make sure. I hope it works out to be much ado about nothing for us both.
      AP August 27, 2021
      Yes, I too am experiencing this very same thing. Took my Exotic Shorthair kitten for her spay yesterday and her ALT is high at 166. Last month it was 190, so it has come down a bit. Any ideas?
      John October 19, 2021
      Whitney, I came across your comment and we too are in a very similar situation. Our Maine Coon kitten had bloodwork done prior to being spayed and her liver enzymes came back elevated. We've scheduled additional bloodwork for this week. I'm curious what you kittens final diagnosis was? Best, John
    Jess October 19, 2021
    Our 6 month old British Shorthair just got spayed today and the vet called to let us know that it went well but her liver values were high. I came across this page because i was trying to get more information. I was thinking the same thing since they are large breed of cat. We are going to get her blood drawn again in a month to compare.
Lesley Mackie January 15, 2021
I found article very interesting as my 17 year old has liver problems.
    rasbeary March 17, 2021
    Hi Lesley.. I so hope you and your kitty are doing well .. and wishing you both lots of love and wellness! May I ask how you moved forward with caring for your kitty with a liver disease diagnosis. I too found the article informative, but there is so much more that we need to hear to be there for our little guys. Any positive results with any changes you may have made after the diagnosis in supplements and or dietary changes as these can sometimes regenerate the liver. My Mr. Wiggles 14yrs young, his bloodwork came back high. I'm at a loss of how I can help his liver to regenerate.. because I know the liver has the ability to do that. He was dehydrated and weak. I've been giving him RX Liquid Immuno for about a week or so, also ordered RX Vitamins Liquid Hepato I hear it might work to promote optimal liver function. I've been feeding him mainly chicken breast and salmon, as there is very little in terms of dietary changes specific to liver disease in cats available in Canada.. and already he presents more alert and stronger, not hiding from us anymore, more socially interactive with my other cats, and eating much more throughout the day. Follows me around everywhere and looks to me like I'm his saviour. Your thoughts would be greatly appreciated.
    Linda Bellefleur Polich November 17, 2022
    Hi Lesley, What type of symptoms are you seeing with your cat? The most bothersome one here is excessive thirst. Have you had that happen too? How is your cat doing?
Paula June 23, 2020
My cat had a blood test liver cams back at 118 Dr says it should be 109. The cat is 23 months old What us causing this? How worried should I be ? Dr says stop treAts. I was giving him temptations I live him so much I am so worried. I go back in a month for a recheck. Any ideas?
    Furballsmom November 28, 2020
    Hi Paula - hopefully your cat is doing better. If you come back to the site, please consider registering with us :)
    Jami Lee Greenville June 18, 2021
    My cat's just came back high too. He is 12 and have been feeding him temptations for a while.. How did this resolve?
      Lisa Cunningham December 22, 2021
      I took our cats off temptations. They are only should have them as a treat. I believe my husband gave them way to many. We started having trouble with uti and stones in our male cats bladder. I’m not saying this was the problem, but they no longer get them at all. So far health issues seem to be doing well. They got to the point if they heard the container open it was like a drug to them.
Daniel L Sloop March 11, 2020
My cat vet said liver was off the charts. Results came back at 1800
    rasbeary March 17, 2021
    Hi Daniel.. I so hope you and your kitty are still hanging in there.. and wishing you both lots of love and wellness! May I ask how you moved forward with caring for your kitty after you got the results with supplements and dietary changes as these can sometimes regenerate the liver. My Mr. Wiggles 14yrs young, his bloodwork also came back high. He was dehydrated and weak. I've been giving him RX Liquid Immuno for about a week or so, feeding him chicken breast and salmon and he presents more alert, more socially interactive with my other cats, and eating much more throughout the day. He looks to me like I'm his saviour. Your thoughts would be greatly appreciated.
    Cheri July 7, 2022
    how did this resolve for you? Mycats numbers are higher than they have charts for !!
      Dani July 19, 2022
      My cat is 12 years old and just got blood-tests yesterday and it came back with levels over a 1000. I noticed she wasn't eating her dry food so I switched her to wet and she has been eating that no problem. But she has not deficated in days. The vet says she isn't constipated but there are no signs of her going #2 anywhere. She is an indoor only cat. She is on a liver supplement now, but the vet said she may need a 24/7 clinic. I am just so unsure what to do for her. She is also having thyroid issues but they said they cant treat that until they get the liver under control.
      Linda Bellefleur Polich November 17, 2022
      Hi Cheri How is your cat doing? What is the treatment for your cat's high enzymes? Does he/she drink a lot of water?
Kathy Davidson January 19, 2020
My cat Suzie is FIV positive. She is 6 years old and over the last couple months she has been on antibiotics twice due to conjunctivitis. I also had to put terramycin ointment in her left eye. They did bloodwork twice because because her liver readings were off the first time. The second reading Her ALP and bilirubin improved but her ALT enzyme didn’t. The vet said as long as she is acting okay we won’t do anything else at this time. He thinks it might improve over time. Lately though after she eats she’s been vomiting. Not all the time but I’m worried. She’s acting ok though I have been trying other foods as she’s been being very picky. I don’t know if the change in food is upsetting her stomach or if something else is going on. The vet did say if she does start acting not her normal self he would do an abdominal ultrasound.
Rosie and Thomas January 22, 2019
I brought both Rosie (Himalayan) and Thomas (Orange Tabby) in for dental cleaning, but after blood work was done, they called & said Rosie's liver enzymes are too high to do dental work/anesthesia. "They" are a Spay & Neuter clinic, so they said go to regular Vet. Would antibiotics work? How about natural care medicines? Please let me know before I spend hundreds of dollars again at my Vet. KB
    Furballsmom February 13, 2020
    Hello @Rosie and Thomas and welcome to The Cat Site! As mentioned at the end of the article, a better place to ask questions and receive replies will be the forum titled Cat Health https://thecatsite.com/forums/cat-health.4/. That is where more members will see your post and will offer advice and support. If you aren't familiar with forums, this will get you started :) https://thecatsite.com/c/how-to-create-a-new-thread/
    Linda August 18, 2022
    My cat has lost a lot of weight,is was only tiny to start with I took to the vet and she did blood work . My cat is 14 yrs old and her liver function was 1000.
ccc3249 October 20, 2016
Thank you so much for this article!
leen and alice October 15, 2016
love this!!! this cute cat looks just like ALICE !!!!!!

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