Thread: "maggie"
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Old June 18th, 2008, 12:18 PM
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Dr Lee Dr Lee is offline
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An elevated white blood cell count indicated inflammatory response which is often the result of an infection. The elevations of the liver enzymes can indicate liver (hepatic) inflammation that may be either primary or secondary. Also it is common for many older dogs to have some liver enzyme elevation on their blood work. So to know whether the liver enzyme elevation is related to the elevated white blood cells, was recent blood work taken prior to her illness? Either way, repeat blood work following the antibiotic course can help answer this question and monitor the pet's response to therapy. Also to help answer this question along with 'what exactly' is going on, it is important to know which liver enzymes are elevated and how high. High Alk Phos with normal ALT, AST can be very different from the the reverse situation of high ALT and high AST with normal or slightly elevated Alk Phos. Also other perameters of BUN, blood protein, etc... can be useful in evaluating liver disease. Radiographs and urine can also help answer questions.

Sorry there isn't a quick answer to this but the liver can be a bit frustrating because while the elevation of the enzymes indicates a problem, it also opens up many unanswered questions. To answer these questions, additional tests such as bile acids (liver function test), urinalysis (is bile being released, is the urine lacking concentration due to liver disease, is ph affected), radiographs (is the liver large as if inflammed, is it small like cirrhosis, is it irregular like a tumor or abscess), ultrasound (what is the architexture like, is there gall bladder disease? abscesses or tumors within, is all or just part of the liver abnormal) and biopsy (this is where we find out exactly what is going on, on a cellular level) are all necessary for complete understanding.

Typically if a infection is suspected in the liver and the patient is still stable, then a course of antibiotics followed by repeat blood work is commonly pursued first. If the patient responds and the blood work returns to normal, then everything is great. If not, then some or all of the above tests may be needed to help 'get to the bottom of this' and find out treatment options.

I wish your pet the best and hope this information helps. If you can post a copy of the blood work, I will be happy to give you an opinion on them. Take care.
Christopher A. Lee, D.V.M., C.V.L.S.
Promoting surgical options and pet comfort through the use of lasers.
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