Q: One of my cats has a very high ALT of 222. This has been progressing for the past five years. She is playful and my vet says to have it checked again in six to eight weeks. What can I do for this? She is an almost 7-year-old Bengal.
A: ALT stands for alanine aminotransferase, an enzyme arising from the liver that is present in the blood when the liver is damaged. An elevated ALT suggests that there may or may not be a liver issue going on with your cat. Your veterinarian should run a bile-acid test. This is a simple blood test that gives more information.
The bile-acid test tells if the liver is functioning properly. If the bile-acid test is abnormal, then further investigation, such as an ultrasound and possible ultrasound-guided liver biopsy, should be considered. If the bile-acid test is normal, then the condition should simply be monitored, and supplements should be given that have been shown to aid the liver in self-repair, such as Denosyl or a newer product called Denamarin.
The fact that this has been going on for five years, however, makes me think that we’re past the point of simply monitoring the situation. Your cat should have a blood clotting profile performed, and if these bleeding tests are normal, an abdominal ultrasound and ultrasound-guided liver biopsy should be performed.
Regards,
Arnold Plotnick, DVM