My horse has raised liver enzymes so worried

[flaxen tail]

She has just had her 2nd blood test and still abnormal results so may need a liver biopsy . Have treated for liver fluke and shes had a liver support tonic. I am going to worm for encysted redworm with equest and another month on the liver tonic.The good news if there is any is her bile duct result is now normal. There is no ragwort in the hay the vet thinks may be a toxin but we dont know where from.I have ordered mycosorb a in case its mycotoxins. Shes only 7 and had her all her life so no her full history, keep hoping the vet will say it could resolve itself but even the vet seems worried, any ideas please anyone am out of my mind with worry thanks

 

[Penny Eater]

Does the liver tonic contain milk thistle seed? It's the main herb used for liver support and detoxing.
Hope she comes right soon.

 

[flaxen tail]

Yes Penny it has milk thistle and vits and mins smells malty , yes hope she does come right such a worry.

 

[Penny Eater]

I don't know much about mycotoxins but there's a really interesting thread about it on Phoenix Horse Forum here http://phoenixhorse.myfastforum.org/ftopic7262-0-asc-0.php
With liver enzymes raised I'd be wary of giving anything at the moment that might put the liver under additional strain, so that means chemical wormers, vaccinations, high oil feeds etc. What liver tonic is it? Sometimes you're better off just buying whole or ground milk thistle seed on it's own, I often think the more they process something the less good stuff is left in it.
Is there anything else in the field she might be eating?

 

[flaxen tail]

Thank you for the link to the forum, yes i will be careful about chemicals I was going to do the equest because westgate said encysted redworms can cause raised enzymes ,I have got some ground milkthistle powder. Shes been on this grazing for 7 years I can see anything untoward in the field although liphook have said to check grazing and forage sources. The only thing is she has started to eat straw bedding which the farmer we got it from said was ok but I did read most straw has pesticides so am going to use shavings . The hay from the same farmer is fed to all his liveries so I would have thought he would get a problem on his livery if the hay was the cause. so its difficult to pinpoint anything. If she did have liver fluke and has just been treated for it I wonder if the toxin now showing is the liver fluke being absorbed by the liver as thats the way they leave the body. Will look at the pheonix forum ,thank you again for the link .

 

[Penny Eater]

Sounds like you've got all the possibilities covered, fingers crossed she's on the mend soon

 

[fatpiggy]

Thank you for the link to the forum, yes i will be careful about chemicals I was going to do the equest because westgate said encysted redworms can cause raised enzymes ,I have got some ground milkthistle powder. Shes been on this grazing for 7 years I can see anything untoward in the field although liphook have said to check grazing and forage sources. The only thing is she has started to eat straw bedding which the farmer we got it from said was ok but I did read most straw has pesticides so am going to use shavings . The hay from the same farmer is fed to all his liveries so I would have thought he would get a problem on his livery if the hay was the cause. so its difficult to pinpoint anything. If she did have liver fluke and has just been treated for it I wonder if the toxin now showing is the liver fluke being absorbed by the liver as thats the way they leave the body. Will look at the pheonix forum ,thank you again for the link .

The straw will definitely have been sprayed with a growth inhibitor when it was standing in the field. If you feed apples and carrots, please consider using organic ones. My vet told me that if I knew what was sprayed on them I'd never eat one again. My mare had epilepsy caused by her hormones, and had a seizure every tenth day. I changed her to organic carrots and she had no seizures at all for 6 months. I recommend Global Herbs Restore as well. My girl was treated with anticonvulsants that vets will tell you ruin the liver in a very short time. She was treated for 15 years and when she had a routine blood test a few months before she was PTS, her liver showed as being as healthy as any other horse of her age.

 

[CBAnglo]

There are lots of threads on here about liver problems; all 3 of mine have had raised liver enzymes for over a year; test last week shows one is back to normal and the other two are in range. They have had 2 months of antibiotics, bvits for 6 weeks and strong liver support supplement and milk thistle. They are likely to need another year to fully recover. I also changed grazing and hay as it was a toxin that they ingested not ragwort biopsy came back clear.

 

[flaxen tail]

thanks everyone ,yes i really hope she is on the mend soon its a worry not knowing the cause and im hoping it was liver fluke as we have sheep in the next field if its a toxin I dont know where its coming from apart from the straw ,she looks very bright and is eating and drinking as normal, just keeping my fingers crossed now.

 

[Mike007]

I keep hearing about this problem and have crossexamined a number of excellent vets who were treating such horses. The simple answer is that it is somthing we simply dont know about. There are many theories yet absolutely no facts.The Ragwort thing is always the first point to be raised and generaly dismissed. Then there are Mycotoxins . oils in the diet, other weeds in the pasture. The list is endless and to be honest we know so little. My best advice is cut out everything that is unnatural ,go right back to basics ,good hay (not even haylege),plain grass , no suplements . If you need hard feed ,only feed straights. Then see how things progress. This is a wide spread problem with no clear answer.

 

[Penny Eater]

Completely agree with Mike007

 

[Gloi]

What symptoms show when a horse has raised liver enzymes?

 

[flaxen tail]

Thanks again for replys .Yes there does seem to be a lot of horses diagnosed with high liver enzymes when you 'google' the problem. She mostly eats hay and has grass for 30 mins am and again pm ,the hay is soaked and spread around a large area so she isnt stabled . The hay comes from a farmer who runs a livery yard so lots of other horses on it. Have now stopped the straw as she was eating it . She has pure easy so not a straight but I would have thought it was ok. When she had her last blood test the vet took so much blood I asked if she had enough to test for tapeworm which she did . I had just done a the new tapeworm saliva test and she was clear on that. I have today had the tapeworm blood test result and she is high end infected with tapes and needs treating ! I am not sure if tapes would cause liver enzymes to raise. I am not really sure what symptoms horses show for liver enzymes but her symptoms were reluctant when ridden and didnt want to go forward and when her winter coat came through it looked dull over her barrell although ok on her neck.

 

[Montyforever]

My mare had this, still not worked out the cause years later! She had it picked up while in the hospital with an impaction, had regular tests over the next couple of months and levels stayed the same but had fallen slightly in the last one so vet said not to bother testing again unless symptoms returned (lack of energy, depression, impossible to keep weight on etc) as she's very difficult to get a needle into

Had another blood test in august this year as symptoms appeared to be back but liver function was completely normal. Turned out it was Cushings instead!

So i would say just give it time, biopsys etc would have aggravated it in my mares case as she's a stressy one so we were just judging by symptoms.

She's been on milk thistle ever since, fed only fibre feeds and linseed, hay adlib and grazing restricted (laminitis prone anyway) and looks great!

 

[Penny Eater]

I don't know if tapeworms could cause high liver enzymes, what did your vet suggest? Bit worrying that the saliva test came back clear and the blood test didn't, I thought the saliva test was supposed to be quite accurate.
Pure feeds contain soya which is thought to be pro-inflammatory. It might be worth cutting it out for a while and just feeding grass and hay to see if it makes a difference? At least then you can start pinpointing what makes things worse, or has no effect.

If the main part of her diet is hay then that would be the main culprit I guess, how long do you soak for and do you rinse the hay after soaking (I remember reading somewhere that the water has a similar composition to effluent after soaking). Does she need it soaked? Does the farmer spray anything on the hay e.g. fertiliser/herbicide? Is it ryegrass or meadow?
If she's on very limited grass because of laminitis for example, and her hay is soaked as well, I'd be worried she wasn't getting all the nutrients she needs from fresh food, and I don't believe they can be replaced by synthetic vitamin and mineral supplements no matter what the feed companies marketing blurb tells us.

Our laminitic Shetland lives on mostly hay most of Spring/Summer/Autumn, but he loves things like Hawthorn, he'll pick the leaves off the branches, or branches from Willow and Ash trees, as he struggles with grass it just gives him that bit of variety, like our 5-a-day I suppose. We've also been lucky to find a source of organic meadow hay, which has a lot of different wildflowers and grasses in it. The roots of wildflowers/weeds/herbs usually go down further into the soil, so the plants are able to bring up more minerals that shorter-rooting grasses, which the horse will then utilise when they eat it.

 

[flaxen tail]

Glad your mare is now ok Monty Forever and you didnt need a biopsy its something I want to avoid for the same reasons ie it would be very stressfull. I think my mares diet is similar to yours high fibre soaked hay linseed and restricted grazing. I did think of cushings but she is only 7 although it may be possible. She is on milkthistle from the vet and when it runs out I've got some milk thistle powder to continue with.I agree with you Penny about natural feeding and Pure feeds with the soya , I have emailed them twice to see if they would replace it with linseed but they say its a cost thing so I put my own linseed in to boost the omega 3. The hay doesnt really have any ryegrass in and its good quality. I emailed westgate about the results and they emailed back and are confident the saliva test for tapes is accurate and my vet is confident the blood result is accurate so although i was trying not to use wormers if not needed I will now have to use a tape wormer just to be sure.Your shetland is lucky with the organic hay and hedges ,weve got bramble hedges and I sometimes pick hawthorn and hazel for them.

 

[Penny Eater]

My boy loves picking blackberries off bramble hedges!
Keep us posted on how she gets on, I'd avoid a biopsy too if at all possible. Sure she'll be fine though, you've looked at everything possible, could be just one of those where you never find out what the cause was, and it goes away of it's own accord.

 

[flaxen tail]

Thanks Penny I hope I can avoid the biopsy not least because the vets is not that near to us. She is having another blood test in the new year so I will post with hopefully good news. Someone said today that she looks fantastic which she now does the dull coat look has gone so im hoping she has turned a corner in the right direction . Picturing your little shetland picking blackberries made me smile ,love shetland ponies.

 

[lcb]

Hi my pony has had raised ggt and ast level since October 2013 at highest ggt were 440 and lowest 65. Blood test yesterday has shown a marked increase again😞. Originally thought to be a virus in oct 2013 and was put on milk thistle. He showed good improvement with ggt levels reducing nicely however in June 2014 routine follow up blood test showed a dramatic increase. He was sent for a liver biopsy which showed low grade bacterial infection. Was put on antibiotics for three weeks and blood tested and levels had improved. Six weeks later routine blood test and levels all gone up again. Went in for second biopsy and again low grade bacterial infection. Antibiotics for six weeks blood tests again showed improvement AST levels back in normal range and GGT reduced to 220. Blood tested 08.12.14 all levels have soared again. He is fed steamed hay, supplier has been changed a couple of times in case mycotoxins, happy hoof as low protein and on milk thistle, vitamin e and a b vitamin supplement. Bedding is hunters shavings. Has daily turn out and looks in perfect health. Firm droppings, coat is soft and shiny without the blood test you wouldn't know anything wrong. Am so frustrated!!!

 

[lcb]

Flaxentail really interested in the liver fluke. How long did you leave between the liver fluke treatment and 2nd blood test? Was there any improvement in your horse's liver enzyme levels as my vet has told me GGT levels take a long time to come down.

 

[flaxen tail]

Hi lcb, wow looks like some of these liver problems take a long time to resolve, and yes i suspect many horses look good and have raised liver enzymes so the owners dont know. You must be so frustrated and worried its awful when the vet rings with the results your heart just sinks. My mare had a month on the vets milk thistle and vits supplement and then I treated her for liver fluke . The blood test is then taken 5 days after and again the vet was very concerned but her GGT had come down and her bile duct was back to normal which suggests it may have been liver fluke as they lodge in the bile duct , I am hoping the toxins they are now seeing in the liver are the fluke being absorbed but thats just my thoughts.Her red and white bloods are ok but another result not sure which one (so many) has gone up and apparently this one goes up during the healing process. The liver fluke treatment was from the vet its called fasinex and I put it in her feed although it can be syringed like a wormer.From what you have said though it looks like these liver problems are a real roller coaster ride .

 

[BBP]

My ponys GGT went as high as 800 over the last year and fluctuated up and down over the year. He had no treatment bar milk thistle and light work for first few months, then returned to full work as he was so hyper. After over a year his levels are now low but I will continue to feed milk thistle and blood test every few months. His bile was never affected. All 5 horses in our village were affected, we had them tested after one died of liver failure and found high enzyme levels in all, one with high bile (he had multiple biopsies, steroids, antibiotics and is also at good levels now). None bar the dead pony ever showed any symptoms. Good luck with your girl. We blame micotoxins in hay that was cut in the wet summer but who really knows.

 

[varkie]

lcb - re the mycotoxins, they can occur just on the grazing too - it doesn't have to be hay/feed that carries them. I lost my two horses a couple of months ago to mycotoxins - they were turned away without hay or hard feed. Pasture contained nothing poisonous - just grass & clover - no ragwort at all, just a few dead thistles & nettles.

That field is not currently in use, and will not be at risk times again (autumn), and we now feed a mycotoxin binder - mycosorb.

 

[lcb]

This is really helpful going to get my boy treated for liver fluke if only to rule it out and if bloods show no improvement will look at mycosorb.

 

[smokeyjo]

I am in the same same situation as the OP except that my boy is 27. Maybe raised liver enzymes are not quite so surprising at that age. It was picked up from a veteran MOT.

Don't want to hijack your thread FT, but I've got 4 questions that keep going round in my head (hopefully the answers will be helpful to you too):-

1. Is it OK/or even recommended to keep a horse on Milk Thistle permanently?

2. All advice says a low protein diet, but the protein which is fed must be of the highest quality. What feeds/supplements supply this high quality protein?

3. Is it OK to feed micronised linseed to a horse with liver damage? If so, how much per day for a 15hh horse?

4. Is there a widely available liver tonic that HHOers recommend? I've just finished up the tonic that the vet supplied and have bought some Global Herbs Restore - that one of the posters on here recommended but I'm floundering a bit as this is all new to me.

Thanks in advance for any replies.

 

[flaxen tail]

Hi Smokeyjo, sorry about your horse such a worry. All the questions you have raised are all the same questions Im wondering about so thats not much help. Yes ive heard good things about global herbs restore but mine is still on the vets milk thistle so havnt had to buy it yet. I think you have to give them food / supplements that are easy on the liver so that would be low in fat foods but if you need high quality protein then im not sure how you would feed that without any fat or oil . I have been told not to give the linseed for the time being .I havnt been any help I know it would seem finding and eliminating the cause of high liver enzymes is not easy although some causes are ragwort, liver fluke and possibly encysted red worms and also mycotoxins and maybe tapeworms. I have bought mycosorb a but have not started feeding it yet ,just done an equitape today and next an equest then I might start the mycosorb then a blood test in the new year. I hope someone may know some answers to your questions as i would be interested as well.

 

[Switchthehorse]

I am in the same same situation as the OP except that my boy is 27. Maybe raised liver enzymes are not quite so surprising at that age. It was picked up from a veteran MOT.

Don't want to hijack your thread FT, but I've got 4 questions that keep going round in my head (hopefully the answers will be helpful to you too):-

1. Is it OK/or even recommended to keep a horse on Milk Thistle permanently?

2. All advice says a low protein diet, but the protein which is fed must be of the highest quality. What feeds/supplements supply this high quality protein?

3. Is it OK to feed micronised linseed to a horse with liver damage? If so, how much per day for a 15hh horse?

4. Is there a widely available liver tonic that HHOers recommend? I've just finished up the tonic that the vet supplied and have bought some Global Herbs Restore - that one of the posters on here recommended but I'm floundering a bit as this is all new to me.

Thanks in advance for any replies.

My horse went into liver failure after two years of hepatitis but we managed to nurse her back to health. If you need to feed hard feed the best I was recommended was laminitis feeds such as happy hoof. Re the linseed basically you need to let the liver rest as much as possible.. So the fewer additives and supplements you give the better

Vitamin E is very good I just bought mine from holland and Barrett. Although I am not a qualified vet so just personal opinion

Interested to know how high everyone's raised levels are, mine were well over 1200 at times so there is hope no matter how high they go

 

[flaxen tail]

Hi and thanks for your response you must have had a worrying 2 years while your horse had hepatitis and heartening to know she recovered .My horses ggt was 734 and on the second test just over 300 I thought this was positive and hopeful but the vet was still very concerned and didnt say it was necessarily a good sign she just said it was all very concerning . I didnt know about vitamin e being helpful in these cases but I guess keeping things simple will help and stop the liver from having to overwork.On a good note my horse is now looking good especially as she is living out although I rug her at night, her coat looks better than it did a few weeks ago although I realise this doesnt guarantee shes now ok.

 

[smokeyjo]

Thanks flaxen tail and switchthehorse

My boy is now on a very simple diet of Happy Hoof, Fast Fibre, Milk Thistle Seed and Global Herbs Restore, and has been for about a month (he was on quite a high oil diet when he was diagnosed)

His levels are obviously quite low compared with some on here. They are:-
AST 601 - (should be <420)
GGT 375 - (should be <49
AP 615 - (should be <362)
These are the figures that the vet gave me from the initial blood test.

The next blood test is on Mon Jan 5th. I've asked the vet to do a an additional blood test for tapeworm & encysted round worm (I think these 2 types of worm problem don't show up on a poo worm-count?) so that I can maybe avoid worming altogether this time.

Glad to hear that your girl is looking a lot better now FT. She has youth on her side which should help with a very positive outcome. Fingers Xd for good test results next time. Please keep us posted as to how she gets on.

 

[flaxen tail]

Hope your next blood test is ok Smokeyjo , my next one is due in January as well. I did the tape saliva test and was all clear but also then got the blood test which showed she had tapes. I have now given her equitape. I let the worm test people know about the differing tape results and they sent an informed reply saying they are confident because of tests they have done that the saliva test is more accurate than blood testing , but I wormed her anyway. Did you do the liver fluke wormer? In the next few days am going to do Equest , I didnt know you could blood test for encysted worms. I have just read a post on the turmeric users facebook that someones 19 yr old welsh d was having seizures and they found high liver toxins. She was advised to PTS but she put him on turmeric and within weeks back riding him hes now ok . I have one horse on turmeric and keep wondering about using it for my horse with high enzymes just something to think about as am worried about throwing too much at her system. Yes will update on test results I think you will get yours before me so everything crossed for a good outcome .