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My Shih Tzu has high ALP. What should I do when the vet is unsure?

Updated On September 23rd, 2025

Pet's info: Dog | Shih Tzu | Female | spayed | 9 years and 5 months old | 15 lbs

My shih tzu has had an elevated ALP (alkaline phosphatase) since December. She had a mild episode of pancreatitis that was successfully treated in January. ALP remained elevated but came down some after teeth cleaning. They put her on Denamarin and metronidazole when it was 778. On 4/17 (Monday), her ALP went back up to 820. Vet seems unsure how to proceed. He has suggested Ursodiol and Baytril or Ursodiol alone. He was hesitant, though, and so am I.Can you please give me your advice?

2 Answers

Most Helpful Answer

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Answered By Joy Fuhrman, DVM, MBA, CPA

Veterinarian

Published on April 19th, 2017

Further testing including abdominal ultrasound are appropriate at this point. If this testing was or will be done, the results of a fine needle aspirate of the liver will help direct the course of treatment. If you have further questions, please feel free to request a consult with an expert where more questions can be asked and diagnostic data can be provided.

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    Answered By Jacqueline Nobles, DVM, DACVECC

    Veterinarian, Board-Certified Emergency/Critical Care Specialist

    Published on

    An elevated ALP can be the result of inflammation in the liver or a result of anything causing inflammation in the liver. Furthermore, different types of ALP are expressed in the body and can be induced by naturally occurring steroids in the body or exogenous sources. In order to determine the underlying cause, I would advise you to discuss testing for hyperadrenocorticism (Cushing's) and an abdominal ultrasound of the abdomen.

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