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My cat is 16 years old. He’s had some weight loss, but has a good appetite and is playful. In May ‘18, at his annual exam, the doctor did blood work. Results came back with elevated liver enzymes. The ALT was 344 and ALK Phosphatase was 121. 3 days later we had an ultrasound of his liver and other organs. Everything looked good, so we put him on Denamarin. 10 weeks later we rechecked his levels again. His numbers comtinued to increase from 344 to 399 and from 121 to 164. Any suggestions?

My cat is 16 years old. He’s had some weight loss, but has a good appetite and is playful. In May ‘18, at his annual exam, the doctor did blood work. Results came back with elevated liver enzymes. The ALT was 344 and ALK Phosphatase was 121. 3 days later we had an ultrasound of his liver and other organs. Everything looked good, so we put him on Denamarin. 10 weeks later we rechecked his levels again. His numbers comtinued to increase from 344 to 399 and from 121 to 164. Any suggestions?

Updated On August 18th, 2018

Pet's info: Cat | Domestic Longhair | Male | neutered | 16 years and 3 months old | 11.2 lbs

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Answered By Chad Brown, DVM

Veterinarian

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Hello and thank you very much for your question. Because the liver enzymes are increasing, even with liver protectant medications on board, I now believe it is time to perhaps consider a liver biopsy. It is possible that when the original ultrasound was performed, there was a liver specific disease that was not detectable on the ultrasound. So at the very least, I would repeat the ultrasound, as well as try to get a liver biopsy. Make certain that your general practitioner feels confident with this procedure. If they are not, please have them refer you to an internal medicine specialist. Thanks a lot for your question. I hope you find the answer.

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