My dog has Addison's and hypothyroidism. What do high ALT/AST mean?

Question

Hello, my dog has just been diagnosed with Addison's disease. He also has hypothyroidism. His ALT and AST values are very elevated (5.5x and 2x from higher baseline, respectively) in the blood panel that just came back. I would like to get your opinion about the high ALT and AST. Thanks. Background info: I adopted him 2.5 years ago and he had filaria. He was treated successfully with Immiticide and was negative after 3 months. Pet's info: Dog | Mixed Breed Medium (23 - 60lb) | Male | neutered | 4 years and 5 months old | 50 lbs

Ann Dion, DVM · Accepted Answer

Hello. I am sorry to hear about Iako. ALT and AST can become VERY elevated so the values that you have listed are elevated, but only mildly/moderately so. The AST is mildly elevated. These enzymes need to be >2x for us to even look at them. ALP is usually elevated if the liver is irritated or 'upset'. This can also go up with exogenous steroid administration (which you likely got with the Addison's disease) so it depends on when these bloods were taken in relation to his diagnosis. Dehydration (which often occurs with an Addisonian crisis) or hypotension (also occurs) can make these values elevated. They are sensitive. I would recommend just getting the medications under control for the hypothyroidism and the Addisons, and rechecking the liver values 2 weeks after everything has settled down a bit. Good luck with Iako. The alternative is getting a liver biopsy, however I would just monitor and recheck the liver values first. I am not too concerned with these values.

My dog has Addison's and hypothyroidism. What do high ALT/AST mean?

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