Excessive Hunger & Thirst - ALKP (Alkaline Phosphatase) WAY To high

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Excessive Hunger & Thirst - ALKP (Alkaline Phosphatase) WAY To high

This is a discussion on Excessive Hunger & Thirst - ALKP (Alkaline Phosphatase) WAY To high within the Dog Health forums, part of the Keeping and Caring for Dogs category; We need some feedback! We have a 14 year old Rat Terrier. She's been healthy all her life. We brought her to Vet to have ...

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Old 02-08-2012, 05:12 PM
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Excessive Hunger & Thirst - ALKP (Alkaline Phosphatase) WAY To high

We need some feedback!

We have a 14 year old Rat Terrier. She's been healthy all her life. We brought her to Vet to have a couple skin warts removed (only because she was chewing them and making them bleed).
Prior to the surgery Vet did a simple blood test and based on the results did a much more substantial battery of blood tests.

ONE 'marker' came back WAY too high: 'ALKP' - which apparently stands for Alkaline Phosphatase.
Normal score is between 5-131 and our dog scored a 326 !

The dog seems healthy EXCEPT her Appetite is almost obsessive and her thirst is double (or more ) what it usually is. Even at 12 lbs she'll drink steadily for at least a full minute.

This is supposedly an elevated Liver Enzyme. We feed our dog only the best best food, filtered water, all natural treats (organic chicken jerky mostly), and a couple of other supplements (Joint health, skin /coat).

We can't figure why in the world her liver could be under stress. Vet recommended bringing her to a specialist for a Sonogram test - which aside from the $350.00 price tag - makes no sense to us.

Would love to get your feedback.
Also - is there a way to 'cleanse' a dog's liver?

Thanks!
ButtonHead's parents
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Old 02-08-2012, 05:45 PM
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Im not good with the bloodwork stuf but excessive hunger and thirst points to cushings or hyperthyroid. Did the vet comment on these conditions?
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Old 02-08-2012, 06:03 PM
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Problem is Not 'Cushings'

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Originally Posted by Criosphynx View Post
Im not good with the bloodwork stuf but excessive hunger and thirst points to cushings or hyperthyroid. Did the vet comment on these conditions?
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Thx for Responding,
The 'original' blood test made the Vet think that Cushings MIGHT be the issue - the follow-up (extensive) blood test dis-proved that concern and put the issue squarely on ALKP.

thx,

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Old 02-08-2012, 06:08 PM
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The excessive hunger/thirst could be diabetes, even with the elevated liver enzymes. But, if all her other levels were normal then that would be ruled out. Does she take any medications daily? Did they do a liver function test on her to check if her liver is functioning correctly, and did he also say exactly how high her liver enzymes were?
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Old 02-08-2012, 06:15 PM
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Quote:
ONE 'marker' came back WAY too high: 'ALKP' - which apparently stands for Alkaline Phosphatase.
Normal score is between 5-131 and our dog scored a 326 !
A 326? That's really not that high, I wouldn't freak out about it toooo much.

Quote:
The dog seems healthy EXCEPT her Appetite is almost obsessive and her thirst is double (or more ) what it usually is. Even at 12 lbs she'll drink steadily for at least a full minute.
With a high ALP, this screams Cushings.


Quote:
This is supposedly an elevated Liver Enzyme. We feed our dog only the best best food, filtered water, all natural treats (organic chicken jerky mostly), and a couple of other supplements (Joint health, skin /coat).
This is more a cholestatic enzyme than a liver enzyme, meaning it is more related to decreased ability for bile to move from the gall bladder to the duodenum. Often times this is elevated in liver disease because the liver is enlarged and compressing the ducts leading from the gall bladder to the duodenum. Doesn't mean there isn't a liver tumor compressing, but odds are that the liver's FUNCTION is okay (if the BUN, Albumin, Cholesterol etc are normal...)

Quote:
We can't figure why in the world her liver could be under stress. Vet recommended bringing her to a specialist for a Sonogram test - which aside from the $350.00 price tag - makes no sense to us.
This makes complete sense because if it's a liver tumor, you may have caught it early enough to surgically remove it.

Quote:
Also - is there a way to 'cleanse' a dog's liver?
You can start a liver supplement called "Denamarin" that will help with liver function if that is compromised.



Two anecdotes: My own dog had an ALP of 2400. Her other liver enzymes were normal, as were her BUN, Albumin etc so her liver function was normal. She was not sick at all. Ultrasound showed a liver mass. We did surgery and although it was cancer, it was cured with the surgery. She lived two more years until she was 14.

I had a patient a few months ago that I did general bloodwork on because she was getting older. Her ALP was only mildly elevated (like 240 or something), but some of her other enzymes (GGT, also a cholestatic enzyme and her liver enzyme ALT were mildly elevated). Did an abdominal ultrasound that showed a small mass either associated with her liver or gall bladder, it was touching both so they could not tell. Unfortunately there were signs of disease in her lungs so she could not have surgery.


So, two extreme examples as to why pursuing further diagnostics like an ultrasound would be a great idea.


What test was done to rule out the Cushings??
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Old 02-09-2012, 08:34 AM
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Thanks for Replies - Will discus w/ 'Mom'

Emma and Holly

I appreciate your information A LOT !
I wanted to respond quickly - to say Thx - even though I can't answer all the (good) questions you've offered. ButtonHead's Mom - she's not home & the records are filed away at the moment.

The Vet suspected Cushing and that's why the extensive ($300.00+) blood work was done - which supposedly ruled out Cushings. After reviewing 2nd test results the Vet's best guess was a liver issue and recommended the ultrasound as our next step.

The ALKP marker score was 326.

Hopefully I'll have additional info to continue the conversation this evening.

Thx for caring!

ButtonHead's Dad
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Old 02-09-2012, 09:02 AM
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Okay, please keep us posted.
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Old 02-10-2012, 09:29 AM
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Update - ALKP WAY too high

Hello Again,

A bit more info:
Cushings: - As mentioned - although the initial blood test suggested Cushing - the Extensive follow-up blood test ruled it out. The Vet did NOT want to do any surgery if Cushing was an issue because apparently it either has a bad effect on a dog's ability to heal from surgery (&/or clot blood properly?).
ANYWAY -the point is the 2nd blood test ruled it out 99% and the fact that the dog healed well after her two warts were removed seems to underline those conclusions.

She tested A-ok for the issues about BUN, Albumin, and her Cholesterol was just a tad high - but not a problem.

Liver Test: Vet is out of town till Monday - and so her office did not have an answer for this.

Thanks Again everyone,
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Old 02-10-2012, 12:55 PM
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Quote:
The Vet did NOT want to do any surgery if Cushing was an issue because apparently it either has a bad effect on a dog's ability to heal from surgery
Yes, it does affect healing but surgery is still easily possible if needed.

Quote:
She tested A-ok for the issues about BUN, Albumin, and her Cholesterol was just a tad high - but not a problem.
Good!



I think what Emma is referring to is a Bile Acids Test, which is another test to see how the liver is functioning. Not sure if I'd say it is needed yet-- and if it were my choice I'd do the ultrasound over the bile acids test at this point.

Keep us updated!
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Old 02-10-2012, 01:50 PM
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Yes, Holly thats the test I was suggesting. But without knowing exactly how high the ALT is Im not sure its needed either. I would do an ultrasound at this point too.
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