Increased liver enzymes, what could it be?

[lwndlnd]

Hi there!
So, my oldest cat got diagnosed with early stage of CKD a month ago. Yesterday we were at the vets to check her kidney values to see, if it’s increasing, or dropping or staying the same after medication and diet changes. Luckily, they have dropped a little bit, which is a good sign, yay!
But we also checked her liver values. All within the normal range, except ALT. It’s twice high, 157 (19-79). Her liver also was a bit enlarged on her ultrasound, but echogenicity and echostructure were normal, no signs of any tumors or something were noticed. The vet who did ultrasound also said, that the liver had poor vascular pattern (idk what that means). That was it, nothing at all, no diagnosis. My cat is almost 12, so they said like well that’s the aging problem. Duh??
What could it be? How worried should I be? (Tbh, I’m already so anxious and scared for her health) And how can I help? If you guys have some valuable resources of recommendations I’ll be super grateful
Notice that she has no symptoms of some abnormality at all

 

[maggie101]

Hi there!
So, my oldest cat got diagnosed with early stage of CKD a month ago. Yesterday we were at the vets to check her kidney values to see, if it’s increasing, or dropping or staying the same after medication and diet changes. Luckily, they have dropped a little bit, which is a good sign, yay!
But we also checked her liver values. All within the normal range, except ALT. It’s twice high, 157 (19-79). Her liver also was a bit enlarged on her ultrasound, but echogenicity and echostructure were normal, no signs of any tumors or something were noticed. The vet who did ultrasound also said, that the liver had poor vascular pattern (idk what that means). That was it, nothing at all, no diagnosis. My cat is almost 12, so they said like well that’s the aging problem. Duh??
What could it be? How worried should I be? (Tbh, I’m already so anxious and scared for her health) And how can I help? If you guys have some valuable resources of recommendations I’ll be super grateful
Notice that she has no symptoms of some abnormality at all

If she has no symptoms just be sure she gets canned food mostly since it has less fillers. My cats litterboxes have no tops so I can watch them use it. Cats with ckd can have trouble eating. You could get a second opinion. They eat high protein food like weruva

 

[FeebysOwner]

Hi. There should have been a report generated based on the ultrasound, in conjunction with the blood work, especially if any correlation was made between the two. The information within that report might shed some light on what the vet said. Is the vet that performed the ultrasound your regular vet? If not, ask your regular vet for a copy of the report and for some of their time to explain the findings to you. Ditto, even if the vet is your regular vet. Poor vascular pattern should be explained, as well as possibilities of a higher-than-normal ALT level. Although, from all that I have read, vets are usually looking for the ALT to be elevated at least three-fold before they consider it to be concerning, especially if a cat is not demonstrating other signs of illness.

Some medications/supplements can elevate ALT - things like steroids, as one example. So, make sure to ask your vet about any meds/supplements your cat is on and if any of them could impact the ALT reading.

Not specifically related to ALT, but you may find this web site helpful as you try to learn more about your cat's CKD. Very thorough, detailed information, but don't let that intimidate you from taking time to read through it - even just a section at a time.
Tanya's Comprehensive Guide to Feline Chronic Kidney Disease - Everything You Need to Know to Help Your Cat (felinecrf.org)

 

[lwndlnd]

If it were me I would go to every vet in the area til I found a diagnosis and go from there. If she doesn’t seem uncomfortable, sometimes you can just wait, but if your bank account will let you try a new vet, I would recommend it.

I will talk to my vet in Thursday about all of it. She wasn’t the one who performed the ultrasound so we didn’t really talk about it. She said that as long as other liver values are okay, this isn’t a concern. Because ALT is not specific at all. But I’ll definitely ask about any possible causes or supplements that could lower the number

 

[lwndlnd]

If she has no symptoms just be sure she gets canned food mostly since it has less fillers. My cats litterboxes have no tops so I can watch them use it. Cats with ckd can have trouble eating. You could get a second opinion. They eat high protein food like weruva

She is on raw diet and eating fine, thankfully! My cats can go outside supervised, so I can’t always see what’s going on with their toilet habits but I’m trying. We will do her urinalysis soon, hopefully it will shade some light on her liver and how kidneys are doing. Thanks!

 

[lwndlnd]

Hi. There should have been a report generated based on the ultrasound, in conjunction with the blood work, especially if any correlation was made between the two. The information within that report might shed some light on what the vet said. Is the vet that performed the ultrasound your regular vet? If not, ask your regular vet for a copy of the report and for some of their time to explain the findings to you. Ditto, even if the vet is your regular vet. Poor vascular pattern should be explained, as well as possibilities of a higher-than-normal ALT level. Although, from all that I have read, vets are usually looking for the ALT to be elevated at least three-fold before they consider it to be concerning, especially if a cat is not demonstrating other signs of illness.

Some medications/supplements can elevate ALT - things like steroids, as one example. So, make sure to ask your vet about any meds/supplements your cat is on and if any of them could impact the ALT reading.

Not specifically related to ALT, but you may find this web site helpful as you try to learn more about your cat's CKD. Very thorough, detailed information, but don't let that intimidate you from taking time to read through it - even just a section at a time.
Tanya's Comprehensive Guide to Feline Chronic Kidney Disease - Everything You Need to Know to Help Your Cat (felinecrf.org)

Yep, I have that report. Nothing specific there, just all the things I said in my previous text. Like, there was said that there are some chronic processes going on due to my cat’s age. When I asked the vet about it, she said everything is fine.

This wasn’t my regular vet and this is a problem now. I will talk to my vet in Thursday about lab results and that ultrasound. If needed, she’ll perform another one, so she could see herself what’s going on and explain it to me. She mentioned that liver could get bigger in size when there is any inflammatory process, even the mild one. And she told me not to worry as long as echostructure and echogenicity are fine. I will ask her about poor vascular pattern tho cause I have no idea what does it mean.

About ALT, she didn’t give me any possible causes but she said that this can’t be used as diagnostic tool if other liver values are ok. My cat did eat before that blood test (she stole some food). Idk if it could affect the numbers

Thanks for the resource about CKD. I’m currently learning a lot from it

 

[FeebysOwner]

I will talk to my vet in Thursday about lab results and that ultrasound. If needed, she’ll perform another one, so she could see herself what’s going on and explain it to me.

Your regular vet can also obtain the actual ultrasound images too, so she could look at them directly - should that help avoid having another one done.

 

[lwndlnd]

Your regular vet can also obtain the actual ultrasound images too, so she could look at them directly - should that help avoid having another one done.

Oh I will ask about it. Hopefully, it can be done. My vet and the vet who did ultrasound are working in different clinics, so Idk about that possibility. But I’ll definitely ask

 

[FeebysOwner]

Oh I will ask about it. Hopefully, it can be done. My vet and the vet who did ultrasound are working in different clinics, so Idk about that possibility. But I’ll definitely ask

I actually asked for my cat's ultrasound images and they sent them to me. But they also sent them to my vet who is not in the same practice/institution/clinic.

 

[lwndlnd]

I actually asked for my cat's ultrasound images and they sent them to me. But they also sent them to my vet who is not in the same practice/institution/clinic.

Thank you

 

[fionasmom]

Vascular structure may refer to the fact that the liver has a dual blood supply that is unique to it. I would wait for your own vet to clarify this when they see the ultrasound.

Unless the vet who did the ultrasound was not competent enough to do it properly, I agree that asking for the report to be sent is the way to go. If you are refused, ask why it is not possible. In the US, medical records are the property of the person (or pet owner) who has been the patient.

 

[lwndlnd]

Vascular structure may refer to the fact that the liver has a dual blood supply that is unique to it. I would wait for your own vet to clarify this when they see the ultrasound.

Unless the vet who did the ultrasound was not competent enough to do it properly, I agree that asking for the report to be sent is the way to go. If you are refused, ask why it is not possible. In the US, medical records are the property of the person (or pet owner) who has been the patient.

Thank you! Don’t know how it works in Ukraine, but I’ll definitely try to make it work or schedule ultrasound with my vet