Liver problems, raised enzymes and biopsys

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Erin

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This summer Reena had been really itchy and had been showing 'warning signs' of laminitis when she had more than a couple of hours of muzzled grazing a day.
So I requested a blood test as something wasn't right.

Got the results of the first blood test 22nd Sept which showed:
Pony has elevation in liver enzymes.
Low grade liver disease.
Liver function normal.
White blood cells abnormal (should be 70/30, Reena was 50/50)
Suggests Viral/Bacterial infection.

So she had a 3 week course of ABs (norodine) and a liver supplement (Equistro Legaphyton)

She had a 2nd blood test on the 24th October which showed that 2 of the liver enzymes where back to normal and the other 2 had greatly reduced. Vet was happy with that and suggest one more blood test just to check everything was still ok.

She finished the Liver Supp at the end of October (so about a week after the 2nd blood test)

3rd lot of bloods taken last Monday (21st Nov) which have shown that her liver enzymes have gone back up again.

Vet isn't sure what's causing it. She's been on box rest since the 16th September (due to her injury & operation on right fore). She has 24hr soaked hay, low protein & low sugar feed. Diet was changed when she started the box rest (as was concerned about laminitis) She was previously on Top Spec Lite and Hifi Lite, now on Fast Fibre, Hifi Mol Free and powdered supp.
As far as I'm aware, she's never eaten anything questionable, no ragwort etc.

Vet wants to do a biopsy and is speaking the the specialist (Tim Brazil) on Monday.

Has anyone ever experienced anything similar? Or have any idea what could be going on?
She's going back on the Legaphyton as it appears to have done its job the first time round.

Shes 7yrs old and to look at you wouldn't think there was anything wrong. She's bright, shiney coat, good feet, good appetite. Has spent most of the summer a bit fat and we struggled to get weight off her. In the past month she has lost some weight (15-20kg according to weight tape) but we were aiming for weight loss, so its not worrying as such (other than its more rapid that previous months)
 
Sorry to hear that your horse is having issues at the moment. And I hope you find out what causing the raised enzymes. the biopsy has the same risks as anything nowadays but it does give the best change of finding out what is causing the issue.

I'm going through something very similar with my mare at the moment. It all started off in July with my mare. She had a swelling in her throat and even tho it went down I didnt feel she was right. So 3 weeks after swelling came we had bloods drawn. Her bloods showed high liver and muscle enzymes. Along with that bloods we had allergy bloods run too (for the swelling). She was kept in a boxrest field or stable (weather depending for months) and her work was stopped. Her diet changed to a low protein diet speedibeet and barley on vet recommendations. She was restested every 3 weeks until a few weeks ago. Her second lot enzymes had decreased slightly and same happened next time. The 2nd last lot taken had high enzymes with inflammation and almost normal liver enzymes but last lot liver enzymes had gone back up. We then took bloods to make sure sle clotted her blood and a scan a biopsy was taken. The scan looked good and biopsy came back fine.
My vet went and contacted the local horsepital to get advice and they said restest horse again in few weeks. Vet said we have done so sinve July but the enzymes wont return to normal so they arent sure what is causing it.
We are looking into the allergy route as she showed up some allergies from her tests so it could be caused by a allergy but we have NO idea at the moment. Will be catching up with my vet this week to get more ingformation on things to see where my next step is from here.
 
Unless I have very much misundrstood your post I think you would be wise to have a second opinion. If your pony has low grade liver disease (often difficult to diagnose until the damage exceeds 70%) her liver function would certainly not be normal.
 
Sorry, I think the vet said that the results would suggest low grade liver disease, or possible low grade liver disease. (the poor pony has ha a lot of vet treatment this year for a number of things, so its hard to remember everything!)

The bloods where sent to Liphook for analysis, so I am confident in the results :)
 
Yeah your right from what my understanding is of the bloods. Is that they suggest low grade liver disease as the lab can only go with what the bloods come back with. For that reason the biopsy and scan is a good idea as it would tell you more about the state of the liver and how much damage is done at the present state.
You said the function of the liver was right. So from that the bile acids would have been within normal parimeters? As its the bile acids that deals with the functioning of the liver?
 
Forgot about the bile acids!

Bile acid was fine on first two tests, but raised on the most recent one - so does that mean something is up with her liver function now? (will be able to talk to vet tomorrow!)
 
Erin said:
Forgot about the bile acids!

Bile acid was fine on first two tests, but raised on the most recent one - so does that mean something is up with her liver function now? (will be able to talk to vet tomorrow!)
Click to expand...

Well I'll read this from my last blood report about bile acid. the elevatedbile acid result suggests a degree of compromise to gross liver function. She has had the biopsy and results were fine. How high are the bile acids reading?
 
It's weird how much of this seems to be around.
My mare came back with raised liver enzymes a few months ago. (a few others on the yard also had raised levels)
Since then she has been retested twice and the enzymes have been coming down of their own accord.
Since the last test I stopped using Hepaphyt Gold so I will have to wait and see whether her levels stay down on the next test or go back up again.
We haven't got to the root of the cause yet and haven't done a biopsy.
Mare seems fit and well and has a good glossy coat and no symptoms.
 
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