Questions re liver results

[MissTyc]

Hi, first post here so hope this is not out of order!

Had some bloods run on my horse earlier this week as routine testing (we are in a high ragwort area and while all precautions are taken to remove all plants from our pastures, we like to keep an eye on bloods as well). Vet secretary has emailed me the liver profile results and there are some elevated/abnormal values, but there no vet able to speak to me until Monday, so I am pulling out hair with worry!!

Horse is a 5yo 14.2hh middle weight cob. Still growing/filling out, currently in moderate work (some schooling and hacking, nothing special)

Done lots of reading and worried myself sick! Any experience or advice welcome!

Albumin 33 (normal)
ALKP 281 (high)
AST 456 (normal)
D.Bilirubin 5 (normal)
GGT 43 (normal)
LDH 515 (high)
T. Bilirubin 27 (normal)
Total Protein 88 (high)

Many thanks for any help or advice you can offer. Please spare me from a miserable weekend!

 

[shazza283]

Albumin 33 (normal)
ALKP 281 (high)
AST 456 (normal)
D.Bilirubin 5 (normal)
GGT 43 (normal)
LDH 515 (high)
T. Bilirubin 27 (normal)
Total Protein 88 (high)

Usually enzymes need to be up by a factor of 2-3x before you would worry - the biggys for liver are GGT, Bilirubin, AST (and LDH, AlkP -but these are much more non-specific)

AlkP can go up slightly just from taking bood,( or in growing animals) as can LDH and it is involved with loads of tissues so does't implicate liver by itself - yours isn't that far off normal - you usually get low protein with liver probs- your horse's isn't that far off normal again so I wouldn't be worried.

Hope that helps you have a less stressful weekend!!

 

[Box_Of_Frogs]

Having rescued a seriously ill gipsy cob suffering dreadful liver damage from ragwort, it's my understanding that the only way to definitively say that liver damage is due to ragwort is through a biopsy. Prof Knottenbelt (that's Saint Knottenbelt) has been working to develop a less invasive test but finding has dried up before the work could be completed. Fingers crossed for your ned.

 

[MissTyc]

Thanks Shazza and box-of-fangs!

We've never suspected anything is wrong with Tyc, but the unusual values threw me a bit, esp as no vet to actually discuss anything with available! We run the tests every year on a sample of horses from the yard but this was my first time. I've had him for two years and he's five years old. I gather the blood results suggest that there is no evidence of liver disease, but the higher values obviously worried me as could be suggestive of **something** going on and have no clue what that might be!

 

[shazza283]

Some horses just have slightly out of the norm as their normal - you get extremes of the results which are normal to that horse - that's why from just blood samples alone you look for elevations that are more than twice the average high normal to say that *something* is going on - I don't think any of your results are in that bracket - hence looks like nothing to worry about.
Slightly high Alk phos and LDH could literally be as a result of taking a blood sample - and some younger horses just have slightly elevated total protein - the globulin bit - and again Tyc's is so close to normal and only slightly elevated that without any clinical signs it should be nothing to worry about.
Make sure everything is normal, check your worm egg count maybe? and then don't worry! (I know it's hard - worry about mine all the time - new one has a habit of sleeping flat out - 2 people have been to me and said they'd thought he was dead - I've spent ages chewing my heart as I've walked down the field shouting him to no avail to have him jump up when I'm about 3 ft away!!)

Liver biopsies are reserved for when you've got a pretty good idea there's something going on - i.e. the horse is sick - it more helps to differentiate what you're dealing with when you've got an animal which is showing some signs which could be attributed to liver problems - or you want to know if it's tumour or ragwort damage to sort out some sort of prognosis - and is more often than not supported by some fairly convicing evidence on the bloods

 

[MissTyc]

Thanks again, Shazza!
You were spot on -- finally got through to vet yesterday and she was quite apologetic. They had an emergency which she said was quite horrible, so that's why they couldn't speak to me earlier. As he looks like he is filling out at the moment, some of the level could have been influened by muscle changes. And she also reminded it was a very hot day when she took the sample so he might have been a little bit dehydrated.
We'll do one again at the end of the summer when the growing might have stopped, just to keep an eye on things because I am paranoid!

Mind sleeps flat out as well, and he won't even wake up when you walk over and touch him! He has his mouth wide open and he snores!!