A L K P

RE: A L K P

Julie Innes — Sat, 02 Jun 2018 13:30:28 GMT

I always thought that ALKP wasn't liver specific, so could be increased due to other inflammatory disorders, e.g. arthritis or dental disease. I tend to only worry if other liver enzymes are also raised or if there are other clinical signs.

In a similar vein, I find there are some dogs that always have a high temperature despite being clinically well! I ignore these too

RE: A L K P

Andrew Kent — Fri, 01 Jun 2018 19:48:18 GMT

Agreed.

In old dogs lots of the benign diseases that we don't worry about (vacuolar hepatopathy, benign nodular hyperplasia) elevate ALP so I often see it as a relatively benign change.

I often find myself convincing people with older dogs without any clinical signs that this is not necessarily something we should go charging after. Clearly a different story if there are other signs (e.g. of endocrinopathy) to give us something to investigate/try to improve.

Treat the dog and not the numbers and all that!

Andy

RE: A L K P

Judith Archbold — Fri, 01 Jun 2018 19:15:12 GMT

My two old labradors ( litter mates) ( both now running around on a beach in the sky somewhere) had ALKPs of over 2000 ! ( I kid you not) for the past two years of their lives. I scanned both their livers ....Melyn had a few ? benign modular hyperplasia areas. Darcy sadly did develop hepatic carcinoma in two lobes...but I think that was at least a year after I first found an elevated ALKP in her...and she lived for another year after that!

I’ve seen plenty of old dogs that seem to have really high ALKPs , usually with a concurrent mild ALT elevation for years and potter on. All vague “ something wrong with the liver” results.

If I scan them and find liver nodules I’m not usually brave enough to stick a biopsy needle into them for fear of haemorrhage....

Happy to biopsy under ex-lap.

( cue “ I’d check clotting factors ...then would FNA biopsy .etc. etc. comments)....

Loads of longterm drugs seem to push up ALKP levels too.

The older I get the less worried I am about mild , even moderate, elevations. Take it on a case by case / QOL basis....checking other liver enzyme parameters when necessary.