My senior dog is sick with high liver values. Should I re-ultrasound?

Question

My 13 year old previously healthy Maltese mix was not feeling well a week ago. She hadn’t eaten in a couple of days and was lethargic. Went to the vet. BW done and AST 793, ALT 1899, ALP 216, tbili 8.2. ?Neoplasm Abdo U/S showed no tumors. ?Cholangihepatitis vs infiltrate. Started metronidazole, clavamox, ursodiol, zentonil, cerenia, Vit K. This week AST AST 300, ALT 998, ALP 815, tbili 130 ? GB Mucocele. Not well enough for liver FNA or Bx. Any Advice? is it warranted to re u/s? Pet's info: Dog | Mixed Breed Small (up to 22lb) | Female | spayed | 3 years and 7 months old | 5.06 lbs

Rodrigo Roca, DVM · Accepted Answer

Hello, I am sorry to hear about Ginger. Based on the recheck liver values I would be concerned that Ginger has a problem in her biliary system, such as a GB mucocele or potentially a biliary duct obstruction. I would recommend rechecking the ultrasound to look for either of these developments. One thing that is interesting is that the other values are improving. Did your vet have any concerns about the blood sample when he ran/submitted the bloodwork. If there is a large amount of hemolysis (or breakdown of red blood cells) secondary to a traumatic blood draw or mishandling of the blood tube, this can lead to a false elevation of bilirubin. Although this value seems quite high to be due solely to sample error, I wonder if it may be contributing somewhat. If Ginger has a repeat ultrasound it might also be wise to recheck her total bilirubin level. Hope this helps, good luck!

My senior dog is sick with high liver values. Should I re-ultrasound?

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