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Mocha
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Mocha has always had slightly elevated ALT levels (I think I put up a thread about this a while back). 1 year ago, while doing a jr. wellness blood panel, her ALT was 187. 6 months later, it was 230 so our vet advised we start her on Denamarin to see if that helped. Now, 6 months later, her ALT is 208 so although it hasn't gone up any further, it also didn't drop a lot considering she's on the medicine.

All her other levels (bilirubin, AST, etc.) are perfectly normal and our vet says she's isn't too worried with Mocha's ALT being at 208. She said we could have her referred to the internal specialist for a biopsy if we wanted, but with the ALT only being 208, and not going up, and Mocha acting perfectly healthy, a biopsy isn't something she would push at this point. She recommends continuing the Denamarin and doing bloodwork on a regular basis to monitor the levels and asked what I thought, and for now, I agree with her but...wanted to come here to ask the experts.

Mocha doesn't drink excessive amounts of water, she has high energy, has a good appetite, stools are normal (yippee :) ); she is on Proin for the spay incontinence and gets the Rx rabbit and potato food.

Any thoughts? Thanks!
 
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Hairy Dog, RIP Caesar, Katana, Kip, Capri
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We used to call it SGPT. There are lots of liver tests--I always have to stop and remember which is which.

Just looked up some causes for slight elevation...one thing you didn't mention was whether or not she drinks (alcohol). Well? :)

But one thing I noticed when I looked stuff up is that hypothyroidism can cause an elevated ALT. Do you know if her thyroid function tests are normal? Some folks consider even low normal tests to be a sign of hypothyroid in dobes because they are so prone to it. It might be worth checking into that with a full thyroid panel...ask your vet. Vets don't always know about different breeds' specific tendencies; he may not be considering whether or not she could be having thyroid problems??

Anyway, I don't have any first-hand advice here. But I imagine other folks will chime in.
 

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I personally would let it ride - in the big picture, that 208 is not a big deal IMHO. My Jezebel is at almost 800 as of August - she was diagnosed with copper storage disease by biopsy at age 3 - and her ALT was high when I did her first bloodworkup at age 2. At age 6 3/4, she still has no symptoms of the disease. I never expected her to make it past the age of 6.... but knock on wood, she is doing fine. She takes Denamarin every day, and I keep her on a low copper kibble (Annamaet Aqualuk) and feed her 1/2 fresh foods - egg based (4 eggs a day) with yogurt, cottage cheese, fresh fruits and veggies.
You can put your girl on the RX liver diet, but the ingredients are pretty crappy. There are other options out there, and you might want to look up the "liver cleansing diet"
Without a biopsy, you can't know if she has liver disease, and what kind. So if her numbers continue to go up, I would recommend a biopsy. An ultrasound now can tell you if her liver is enlarged.
 

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Mocha
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I personally would let it ride - in the big picture, that 208 is not a big deal IMHO.
That's pretty much what my vet said too; she said it's not something we want to ignore, but she also didn't think it was worth having Mocha sedated and having the biopsy done (plus the cost). She said we can do bloodwork every 3 months if I want, I think she said they can do a simple check right there at the vet's office for just the ALT so it wouldn't cost me as much as a full blood panel.
 

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Kelly is 6 y/o and ongoing soft stools / indicating a possible Liver problem.
- last week blood tests / her ALT level was 158 (max. limit 118)
- months ago she was fed Orijen (meat protein 38-44% and no plant protein)
- she is now switched over to Royal Canin® Veterinary Diet Canine GASTROINTESTINAL LOW FAT dry dog food
^ Min. protein 20%
- our senior vet said Kelly suffered from too high a kibble protein
- and she needed a Low Protein / High Carb, diet Dr. Vern said, 24% max. protein
- stools have been absolutely perfect, lately

PS - the Vet Prescription id HILLS Science diet kibble, made Kelly vomit...3x in 2 days...garbage brand IMPO.
- given the diet change above, Kelly will have blood work checked again...in 2 months time
- so far / so good

https://www.royalcanin.ca/products/...-GASTROINTESTINAL-LOW-FAT-dry-dog-food/223025
 

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Mocha
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Discussion Starter #6
Mocha is on Royal Canin Rabbit & Potato; I just got this from their website

Crude Protein (min) 19.5%
Crude Fat (min) 10.5%
Crude Fiber (max) 3.7%
 
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Mocha is on Royal Canin Rabbit & Potato; I just got this from their website

Crude Protein (min) 19.5%
Crude Fat (min) 10.5%
Crude Fiber (max) 3.7%
Looks real good TNfisher - what was Mocha earlier food & protein % ?
- just curious here

Our Vet has been practicing for 40 years, knows his Dobermans and also sought our by Race Horse owners & breeders, across our province.

An earlier young Vet said Kelly needed probiotics, every time we took her in BS / and 2 weeks later, diarrhea again.
- Dr. Vern is now 1/2 retired, so we waited for his time slot, and glad we did.
- Some dobes, just can't handle rich Protein levels, and it over-taxes their Liver.

Dr. Vern also saved former Amy's life, in an emergency-extended surgery / she lived another 2.5 happy years and passed of old age, 23% over breed life-expectancy.
- so we have utmost faith & trust, in his prognosis / he has a gift, of being right
- a gifted surgeon, and also practices acupuncture, chiropractor & Chinese medicine

Often - fixing a dobes heath, is finding the right Vet....and we learned, some need a Low Protein / High Carb diet.
 

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Mocha is on Royal Canin Rabbit & Potato; I just got this from their website

Crude Protein (min) 19.5%
Crude Fat (min) 10.5%
Crude Fiber (max) 3.7%
Since you don't know what exactly she might have, I would call Royal Canin (or email) and ask what the copper content is. Copper is never listed in the ingredients & is sometimes very high. If she has copper storage disease, you will want to keep the copper very low.
 

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It will be listed - 99.9 percent of the time as Copper Sulfate - We have cut out all copper sulfate for Ali - for the same reasons as Fritzie

One other thing - Ali can not have high protein food either -
 

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Mocha
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Well, look at that :(
 
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Mocha
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Now the question is; are there any decent non-Rx foods out there without copper content?
 

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I don't think there's any such thing as a NO copper dog food. However, there is a HUGE range of copper contents in dog foods. This listing is kind of old, but it's a good starting place to look at the listings.

I know one reason way back that I changed away from feeding Orijen years ago was the high copper content in the food (among MANY other reasons). One of the reasons I like Fromm is it's a fairly low copper content. Certainly these should be checked because, like I said, it's an older list, but...decent place to start.

Copper Content in Dog Foods
 

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My Jossie will be 10 this month and was diagnosed with copper storage disease at 3 1/2. My suggestion for you is to keep a close eye on those liver panel levels for trends towards elevation and that if you see it going up, take her to an internal medicine vet.

Chronic liver disease in dobermans is either of metabolic origin (copper storage) or autoimmune. The treatment is very different depending on the type of disease.

While Denamarin is widely prescribed for liver issues, in my personal experience it doesn't have a big effect on liver enzymes.

Jossie was under 1 when we started seeing the liver values towards the top of normal ranges. We kept the close eye on them and at 3 1/2 the biopsy confirmed accumulation of copper in the liver tissue. She was on penicillamine for 2 years to clear the copper. We maintained her levels normal with diet alone (prescription hepatic Royal Canin + added cooked chicken breast) for 6+ years. Liver values started escalating again this year. She recently was in surgery (foreign body) so we took another biopsy of the liver and it showed copper accumulation so she's back on the meds to clear it.

My other doberman with liver issues did not live past 4. I personally believe that being more proactive this time with Jossie is what has made her live this long.

People say that the prescription hepatic diets are crap, to me these diets have been a godsend. We tried to find a different diet for Jossie by consulting with the Cornell veterinary nutrition service. They designed a home cooked diet for her that included some very expensive specialized supplements. When we tried to transition her into it, we found out that she's very sensitive to rice and her poops were awful. They advised us to put her back on the prescription diet and add the chicken so that she would have more protein. It was an expensive lesson learned.
 

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Dobe_Mom --- Great advice ! It sounds about like what we went threw with Ali -- As you said - The internal Vet is a must - After we got her on the road to recovery - Our general Vet admitted - he did not much knowledge on copper storage - it damn near cost her - her life - and we were pretty proactive with her - they go down hill very fast .


Give Jossie a ear rub for me :wink2::grin2:

Doc
 

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Jalyn Live in the Moment ‘Helo Agathon’ Harper x Godric DOB 3/4/2019
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Helo Agathon is dealing with high ALT right now. Back in April it was 600 non-fasting, repeated 2 weeks later fasting was 257, then in May repeat fast back up to 573 so my vet sent us to an internist. He performed a bile acid test, abdominal ultrasound and repeat blood work. All completely normal; ALT was 118 ref range 18-121 for IDEXX labs. The internist was scratching his head. Meanwhile, I found an FDA report from 2018 on NexGard listing high ALT as one of the complaints. Well, Helo was on NexGard for 6 months to control some localized mange and he had been off it for almost 2 months prior to the visit with the internist. He has not had any NexGard since.

So, he just had repeat blood work this week and unfortunately, his ALT is up again to 191. Not as high as before but enough to have the internist recommend a liver biopsy which is scheduled for end of this month. It's the only way I guess we will know what is going on.

I have been researching copper content in foods. Most companies will tell you if you ask. Helo eats Annamaet Extra chicken which has a copper content of 12 ppm. I was thinking of switching to Annamaet option which is salmon (Helo doesn't like the chicken right now). It has a copper content of 13.4 ppm. Purina Pro Plan shredded salmon is 17.6 ppm but the lowest I found is Nature's Logic distinction sardine at 7 ppm copper which is almost as low as the prescription diets. I've also been feeding Helo cottage cheese and yogurt recommended by Fitzmar thanks :2smile:

I'll wait to see what the biopsy results are and discuss with his internist.
 

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Mav had an elevated ALT of 204 about 2 years ago, my vet takes a more holistic approach to things and suggested milk thistle. I gave him 1000mg of milk thistle a day for 6mo. and it brought him down to 125. I haven't tested him in about a year but I'm hoping it will be even lower. I talked to Sharon Marinelli of Sharjet about it and she highly recommends trying milk thistle, not just for dogs but even for people who have elevated numbers.

I'm def. not an expert on liver enzymes but this worked for us.
 

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Jalyn Live in the Moment ‘Helo Agathon’ Harper x Godric DOB 3/4/2019
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Thanks! I knew about the milk thistle but they want to confirm what the exact cause is before treatment. They mentioned copper storage, however, he is only 16 months old so it could be something else.
 

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Kelly is 6 y/o and ongoing soft stools / indicating a possible Liver problem.
- last week blood tests / her ALT level was 158 (max. limit 118)
- months ago she was fed Orijen (meat protein 38-44% and no plant protein)
- she is now switched over to Royal Canin® Veterinary Diet Canine GASTROINTESTINAL LOW FAT dry dog food
^ Min. protein 20%
- our senior vet said Kelly suffered from too high a kibble protein
- and she needed a Low Protein / High Carb, diet Dr. Vern said, 24% max. protein
- stools have been absolutely perfect, lately

PS - the Vet Prescription id HILLS Science diet kibble, made Kelly vomit...3x in 2 days...garbage brand IMPO.
- given the diet change above, Kelly will have blood work checked again...in 2 months time
- so far / so good

https://www.royalcanin.ca/products/...-GASTROINTESTINAL-LOW-FAT-dry-dog-food/223025
Hey Beau,

Not all prescription diets agree with all dogs but I got to wondering why Kelly was on Hills ID? at all. If there was a question about liver and your vet wanted to prescribe a Hills product why didn't he prescribe LD--designed specifically for dogs with liver issues.

The Royal Canin GI low fat diet is one that takes care of a number of non-specific problems but thought it was interesting that your vet chose that one rather than than the LD.

It isn't just curious minds who want to know all of us nosey folk also want to know.

ABTLH
 
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