Elevated ALT levels, what does it mean?

[Meandmy]

A couple weeks ago my seemingly healthy 10-yr old cat had a seizure. I took her in to the vet and they did a complete blood workup. All levels were within normal range with the exception of her ALT.

According to the vet, normal ALT values are up to 130. Hers were 903! She was put on daily IV fluids and a prescription of Denosyl. After a week her ALT was down to 467. Better, but still not good. After another week of fluids and Denosyl her ALT was up to 927 today.

She's had an Xray that showed no masses. She's been acting a bit odd here and there lately, but nothing I would classify as worrisome if I didn't know about her ALT levels. No seizures after that first one.

Has anyone been in this boat? Do you have any suggestions? My regular vet is out until Wednesday, so in the meantime I thought I'd try to get some other info.

Thanks!

[AddFran]

I thought ALT was a liver enzyme in cats and dogs.

What types of things are you noticing that are different about your cat? When my dog had liver problems she started drinking A LOT more and had a loss of appetite - those were the first signs.

Has your cat recently lost a lot of weight or stopped eating for any length of time? Have you researched Fatty-liver disease in cats at all?

In my experience x-ray's haven't show much. Sometimes ultra-sounds are better. I personally have had no luck with ultrasounds or x-rays revealing the problem in situations like this. Nothing showed up for my dog or myself (had gallbladder disease) on either. A needle aspiration biopsy may be a lot more revealing, especially since your cat isn't responding to the current treatment and you need an answer.

These levels seem exceptionally high and often once a liver problem has shown symptoms there is already something significant going on. You really need to find out what the problem is.

Has this vet even suggested what they think it could be? Or did they just tell you the levels are elevated and leave it at that?

[AddFran]

Here's a link I found that may be helpful to you:

http://www.thepetprofessor.com/secArtic ... n_Cats.asp

[Meandmy]

Thanks for taking the time to respond. Lets see if I can answer your questions. Her eating and drinking habits are the same as always. In terms of odd little things happening. She's been howling all hours of the day and night. Not an "I'm in pain" kind of howl, more like she would do if she caught something. Also, she is more restless. Can't seem to get comfortable. And her balance seems to be a bit off at times.

When this all started, the vet thought it could be liver degeneration or possibly a tumor. The xray showed that her liver is normal sized with no visible tumors, although that doesn't mean they aren't there. After her ALT levels went down so much the first week she was much encouraged. The vet that called with the test results today said it could be a liver or brain tumor. I'll be talking to my vet more about it on Wednesday.

Don't know if it matters, but she is an indoor only kitty and always has been, up-to-date on shots, etc.

Thanks again

[AddFran]

It could be liver disease in which case you may not see anything on pictures.
I hope you get better news than this on wednesday and I'd really press to get some answers sooner rather than later.

The howling could very well have been her cries to let you know something was wrong. Looking back, I now noticed so many little things my dog did BEFORE she seemed sick.

[Ianthe]

So sorry to hear this. I had a cat with liver disease, and her ALT levels were really high also. Is there any possibility she may have gotten into something poisonous?

[AddFran]

Good call, Ianthe. I was wondering that too, but then wouldn't her levels have stayed down rather than go back up again a week later?

[Ianthe]

Originally Posted by AddFran

Good call, Ianthe. I was wondering that too, but then wouldn't her levels have stayed down rather than go back up again a week later?

Oh yeah....that's true. Unless, maybe she is repeatedly getting into something...like a plant, or some kind of ant bait or something???

[AddFran]

That's true!

[Meandmy]

We also thought of the possibility of something poisonous. We don't use any kinds of chemicals in our home and don't keep plants or anything else easily ingested as our other cat eats *everything*. The vet also said it was unlikely, especially with the fluctuating ALT levels. Of course I realize it may still be a possibility, but I can't imagine what she could possibly get into. We've checked everywhere.

Poor Spook was up all last night again howling, although I still don't think it's pain, but restlessness and maybe hunger as she is not allowed to eat at night with the Denosyl. It breaks my heart. The vet is to call me first thing tomorrow and we'll figure out our next step. I've never gone through a major illness with any of my animals and am afraid I'll make a wrong move.

Thank you everyone for your thoughts.