Raised Liver Enzymes

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sam72431

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Hi All

My youngster has had what looked like mud fever for ages the vet has seen it a couple of times and on last visit i said its really not responding to normal treatment and she said it was probably Vasculitis so he was prescribed steriods and antibiotics and she also took blood to check for liver function although she said she thought by looking at him (he is in good condition) that she thought liver problems were unlikely! Anyway bloods came back with liver enzymes raised! So he was prescriped a course of Hypatosyl and then another blood test, she took more bloods on monday and they came back today saying that thet had stayed the same and one had gone up! The one thats gone up is LV5 so she is testing further, has anyone got any experiance of this? Its strange as the vasculitis has cleared up most of the scabs are off the skin is a bit pink but not dramatically so his legs have puffed up slightly since coming off the antibiotics but the vet said she didnt want to keep him on them. Also strange as he has always been a fairly laid back boy but this last week his energy levels are definitely higher so i thought that the hypatosyl must be working but obviously not! Has anyone had this? All very strange! Sorry for long post! Thanks
 
Hummn............I am not a vet but do have experience of liver problems in my competition mare.

I am presuming the vet took bloods to analyse liver function because she thought your horse may be exhibiting photosensitivity [a symptom of liver function abnormality] as I am not aware of a connection between vasculitis and liver problems - other than steroid use.

Hypatosyl, as I'm sure you're aware, is to treat liver problems.

Liver disease is pretty common in horses and may be a result of many specific diseases or pyrrolizidine alkaloid toxicosis (ragwort poisoning.) Ragwort poisoning causes irreversible damage so the outlook IF that, is not favourable and the horse would most probably not be able to sustain work, even if they look healthy.

However, Less frequently, it can be caused by steroid use!

A vet can perform a liver biopsy which may give you some clues as to cause.

Liver fluke can damage the liver and will most probably raise liver enzymes but it is very difficult to establish whether it's fluke that are causing damage as you have to collect one in the poo or from a biopsy which is rare.

Serum concentrations of liver-specific enzymes are generally higher in acute liver disease than in chronic liver disease where they can return to normal. Indeed, my mare's liver enzymes returned to normal but she was clearly anything but normal!

I don't know that enzyme you're referring to but commonly analysed ones are: GGT (which I think is specific to the liver), SDH, IDH, AST. Be aware that a 'normal' level reading may not indicate a LACK of disease for the reasons stated above.

For the horse to present with symptoms associated with liver damage (such as head pressing, depression, weight loss) the liver has sustained more than 75% damage. Therefore, when the horse begins to show symptoms there is very little that can be done as the organ has gone into failure.

Bilirubin and bile acids are commonly analysed to assess hepatic dysfunction perhaps after your horse has shown consistently high measures after one month's analysis.

I think I would question your vet as to her thoughts at this stage.

It could be a temporary blip for your horse and his liver will return to normal or it could be something more serious. Best of luck.
 
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I am about to set off to collect my mare who has just had a liver biopsy.

I called the vet out because of what looked like a sunburnt nose, but it wasn't healing, she then got really scabby on all her white legs. The vet took a blood sample which came back with raised liver enzymes, she then took another blood sample to check other enzymes (I can't remember which ones exactly but I'm sure there the same as mentioned by Tonks). These came back raised as well so she had to go in for a biopsy.

She is also in good condition, very healthy to look out. Were pretty sure it is photosensitivity, I'll let you know in a few days when I have the results what has caused it.
 
My gang started to show high liver enzymes about 3 months ago (one pony showed it a month previous to that), and this seemed to tie in with a change of supplements to (deliberately) high selenium to counteract a possible muscle problem, as well as high copper and zinc. It has not been possible to isolate what caused the problem, and the concentrations involved are not considered toxic.

However, the pattern in my gang was for GLDH to shoot up quickly, but return totally to reference levels within 3 months of the first rise. However, GGT seemed to peak in a fairly similar way, but is taking longer to reduce, and is still above reference levels. This is in a case where we believe we have been able to exclude the toxin (by changing diet/supplements) and where the challenge had only taken place for up to 2 months.

Alkaline phosphotase, LDH and AST, as well as bile acids also rose at a similar time. We also saw a challenge to white blood cells during this time.

I suspect my example may be different to yours, in as much as that with mine we are fairly sure of the time that the problem was caused, whereas it sounds as though yours may be more chronic (ie has carried on showing possible liver problem signs for a longer tim - eg with the photosensitivity).... but in case any of my experiences are helpful.

In essence, I'm glad GLDH has reduced to normal levels because apparently this is an enzyme which tends to return fairly quickly to normal once the liver insult has been removed. Whereas GGT is notoriously slow to become normal again. And I suppose also it'll all depend on how reversible any damage is.

I found one of Andy Durham, at Liphook's things on liver disease quite useful, here: http://liphookequinehospital.co.uk/wp-content/uploads/2012/03/LiverDiseaseandLiverBiopsy.pdf

I have absolutely no idea what LV5 is? Would be interested to hear what it is when you find out from your vet.

Good luck.

Sarah
 
Thanks everyone, all very confusing but has you have helped me! I'm just waiting for the second test to come back and I will let you know how that goes! He isnt showing any typical signs of liver disease other than his legs! The vet checked his gums and he hasnt got jaundice or anything, I just really hope we have caught whatever it is quickly enough! Thanks
 
The other thing just to add is that when the first blood test was done that the enzymes weren't dangerously high and he was only put on Hypatosyl as a precautionary measure so i'm really hoping its nothing too serious!
 
My mare had high liver enzymes, the initial test wasnt too bad, but the went up before they came down.
She was the picture of health and the only clue that thete was anything wrong was that she was getting low grade lammi symptons on hardly any grass when previously Id not had to restrict grass at all.
Hers were due to a batch of hay that was very high in Iron and Manganese (and high in selenium).
Once we got her onto a supplement with no iron/manganese/selenium with higher levels of copper & zinc and swapped half her ration of hay to horsehage high fibre her enzymes started to come down.
Then yard got in a new batch of hay that was much lower in Iron/manganese/selenium and we fed her minerals balanced to the hay and we got her liver enzymes back to normal.
 
You cannot tell the likely cause without a biopsy, my 5 have had 9 between them and the most normal blood test was actually almost fatal liver disease. Blood test an indicator. My Vet is Andy Durham! Low protein, low oil, low everything! Mine were on about 200 tablets a day each, so major treatment. Milk thistle only useful by the bucketful!
 
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