Raised Livery enzymes

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Tonks

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Hi everyone,

Would appreciate some help please.

About 6 years ago I had an issue with raised livery enzyme in 3 of my horses. I don't have the 3 horses concerned now (I lost one of them to this issue though.) However, I have a lovely ISH who having lost a bit of weight and is a little lethargic, I decided to get tested again, to rule out liver problems. Low and behold, her enzymes have come back raised and I'm in tears having to go through all of this again.

Does anyone have any advice on mycotoxins and where to get your land tested please? She will also start on a flukicide next week (as one of the original horses tested positive for fluke in poo sample.) I feel this issue has to be environmental with either fluke or mycotoxins (or a combination) and is something to do with her environment, given the fact that this is a reoccurring problems with our property.

Any advice on nutrition, soil analysis to include mycotoxins, liver fluke etc, would be VERY welcome as I don't want to loose another horse to this.

Thank you.
 
No knowledge of this thinking slightly outside the box. Forage Plus can test forage and hay and you can see what is missing. Might also be worth contacting ThunderBrook feeds. They are organic and very into reducing equine conditions through feeding. Just might be worth asking if they have come across this.
 
Tonks said:
Hi everyone,

Would appreciate some help please.

About 6 years ago I had an issue with raised livery enzyme in 3 of my horses. I don't have the 3 horses concerned now (I lost one of them to this issue though.) However, I have a lovely ISH who having lost a bit of weight and is a little lethargic, I decided to get tested again, to rule out liver problems. Low and behold, her enzymes have come back raised and I'm in tears having to go through all of this again.

Does anyone have any advice on mycotoxins and where to get your land tested please? She will also start on a flukicide next week (as one of the original horses tested positive for fluke in poo sample.) I feel this issue has to be environmental with either fluke or mycotoxins (or a combination) and is something to do with her environment, given the fact that this is a reoccurring problems with our property.

Any advice on nutrition, soil analysis to include mycotoxins, liver fluke etc, would be VERY welcome as I don't want to loose another horse to this.

Thank you.
Click to expand...
My pony was this last Feb and has only just started coming back to work now. Checked ragwort/sycamore etc you name, same field always. Then the vet said change her hay to haylage so I did and kept up with the Legaphyton and milk thistle and 4 sticks of licorice, and her bloods came down quite a bit. So must have been something in the hay.


Oh yes and dried nettles, and when they grow too pick (carefully) and serve as a treat
Lots of things can raise the liver, try changing to haylage give milk thistle/legaphyton.

Oh yes did lots of research and save so far what I have >http://horse-care-and-advice.weebly.com/l.html
 
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Hi so sorry to hear this, you must be very worried. We had a pony with raised liver enzymes, although we never really got to the bottom of it, he was treated for Fluke and made a complete recovery. Apparently, depending on the length of time a horse has been affected by fluke, it may or may not show in droppings. Our vet said he thought it was becoming more common and our land used to be grazed by sheep, so it may have been contaminated by them. Also, I understand it's more common on wet grazing, which ours is. I hope your horse starts to improve. sorry nothing to add about mycotoxins.
 
I had this after moving yards last year. My vet put him on milk thistle for 2 months and changed from hay to haylage. His second blood test came back much better. Will be getting re tested in June to check again when jabs are due.

He was having soaked hay before and was blood tested for a virus which came back clear but picked up raised liver enzymes like you. Vet was adamant on change to haylage ASAP. Not sure if it is because they seem to drink more and so flushes the system or .... I am no vet!!! Worth maybe mentioning though.
 
Our boy was awful last year with a mycotoxin infection - we changed his diet to a low fat low protein one, high sugar and carbs for calories, vitamin and mineral supplement, pre and pro biopics, milk thistle, echinacea tablets and mycosorb and was prescribed prednisone (steroids), within a few months of this, his bloods went back to normal and no recurrence this year xx
To add, mycotoxins could be anywhere, water, forage, feed, soil, Hay, you name it, we couldn't pinpoint ours and think it had been a lingering issue for a while xx
 
I'd feed a diet to support the liver: very low protein, what protein you do feed to be the highest quality you can afford, milk thistle, Yea Sac, . Prof Derek Knottenbelt of Liverpool University is a world expert on liver disease in horses and will always respond to enquiries from lay horse owners. He's knotty@liverpool.ac.uk and is brilliant.


Dr Teresa Hollands is chief nutritionist with D&H. D&H work hand in glove with Prof Knottenbelt of Liverpool Uni on liver damage in horses. The Prof is a world expert. I wouldn't hesitate to put your horse on a liver-support diet until you know what the most recent blood tests show. If there is any doubt as to whether your horse has an ongoing or serious liver problem then D&H can draw up a tailored diet for your horse. Should things deteriorate, the Prof is always willing to help the individual horse owner
 
Thank you for all of the input, much appreciated. This is the second time I've been through this just thought I would pass on what I've found out so far. Sorry if its a repeat of other threads.

From what I've read and experienced liver issues can be caused by;

Toxins:

1. Mycotoxins: There are so many and each live on different foodstuffs and each can produce different symptoms. However, aflatoxins and fumonisins appear the likely culprits for liver damage. Aflatoxins also cause COPD, so if any horse presents with liver problems and COPD, this may indicate aflatoxins?? I believe they can be present almost anywhere to include walls, bins and soil. I understand that mycotoxins can be found in ‘spots’ in the pasture, so testing may not provide any great insights. Stables, bins etc., must be cleaned with hypochorite cleaning fluid, which is what I’m doing next week. Outbreaks can be seasonal (terrible summer = contaminated hay/straw = liver symptoms when fed in aumtum/winter?). I’m also going to analyse soil/forage and I’ve already bought Mycosorb to feed to my mare. She’s also going to move pasture as liver fluke is also suspected. I’m going to assume it could be that as well and mycotoxins.

2. Iron toxicity: Horse, soil and forage needs to be tested for high iron levels which I’m going to try to do. Apparently, speedibeet does contain high levels of iron and perhaps should be avoided. But, they stated that washing the soaked beet with cold water eliminates any excess iron.

3. Alsike Clover: Causes liver damage. We do have loads of clover, but I’m getting a botany friend to identify the species. Apparently, this type of poisoning causes photosensitively first (but most liver damage does too) or at least ulcer type symptoms on inside of the mouth followed by abnormal blood results.

4. Alkaloids (Ragwort and the like). Irreversible damage but prognosis depends upon how much consumed. Biopsy is only way to confirm alkaloid poisoning. Supportive diet – I’m contacting D&H tomorrow. As state by another forum user, D Knottenbelt at Liverpool is an expert on alkaloid toxicity and he was so very helpful to me a few years back when I contacted him. I am going to contact him again, once I know my mare’s full blood results tomorrow. (knotty@liverpool.ac.uk) He stated that once liver problems are diagnosed, a supportive diet is paramount to prevent further insult.

5. Blue/Green Algae poisoning: Didn’t read much about this, as didn’t have time?

Parasites:

1. Liver fluke – Apparently hatching eggs shed onto pasture Jul-Oct and if we have a cold dry summer, contamination is less. Warm and wet produces higher contamination. Symptoms tend to appear mid half of winter onwards (in cattle at least) and it appears so with my mare?

I was advised that GLDH is an indicator of recent liver insults and I know one other HH forum user who uses this as a measure of whether to use a flukicide or not. This is due to resistant with overuse. Triclabendazole (Fasinex) is used for horses and is useful for killing all stages of fluke, but not licensed for use in horses. Horses get localised ‘obstructive bile stasis’ when they have liver fluke because the fluke live in the bile ducts (Dr Knottenbelt.) From what I’ve read when horses have cholestasis there is an elevation in ALP?

I will also ask for my mare to have an ultrasound as this is apparently useful in obstruction/cholestasis. Poo sample can only be helpful if shedding, otherwise a negative result, doesn’t mean no liver fluke. I understand that if you feel you have an ongoing issue with fluke dosing should be in Jan/Feb and then again in late summer. As this used to be a farm and a horse was confirmed to have fluke in her poo some years ago, I am going to get an agricultural vet to come and give me some advice about fluke and the like. I am also going to get my vet to contact David Sutton, as he has done quite a bit of research into fluke at Glasgow University, as he may be able to shed some light once a bit more in know about my mares status.

Suppurative cholangitsis/Cholangiohepatitis. I will also ask my vet about this as its an inflammation and/or infection of the bile duct and liver tissue because it can be caused by toxins or a problem with the immune system.

Liver analysis and procedures:

AST: This is specific for liver disease BUT also for skeletal muscle. But, Dr Knottenbelt did state that it does indicate current ongoing and chronic problems with the liver and apparently the majority of liver disease cases will have increased serum AST.

GGT: Again, a test that shows ongoing/chronic damage. But, it has limited diagnostic or prognostic value and the insults can be too minor to result in detectable disease when/if a biopsy is done. In other words, there may be other issues going on elsewhere in the body to produce these results and it may not be caused by liver disease. Apparently this is elevated when there is obstructive biliary disease, so it may indicate liver fluke?

GLDH: are considered specific for acute liver disease. In other words, this will go up if there is a current insult. But, in their literature (on line) Liphook state that mild insults can produce increased levels and many horses go on to overcome these events uneventfully, which is good news.

AP: Good at detecting severity of disease but is not specific to the liver.

Bile acids: highly specific for liver dysfunction but does not define the type of insult or disease present. In my email to Dr Knottenbelt in 2010, he said that this was a true indicator of prognosis with a higher score predicting poor recovery rates. So, total bile acid concentration remains increased in horses with chronic liver disease. However, Liphook argue that liver disease must be quite severe before higher levels are detected and most liver disease cases will be found to have normal serum bile acid concentration at the time of initial presentation.

Serum globulins: When increased serum globulins are found together with other elevated levels, it is apparently a poor prognosis. Serum globulin concentrations greater than 45 g/L are concerning and values as high as 60-70 g/L are very poor.

Serum bilirubin: useful to determine hepatic dysfunction in horses. Just as in humans, higher levels indicate disease.

Ultrasound: used to evaluate liver size, appearance (shape, texture), and location in horses. From memory, this may be a good diagnostic tool to assess for liver fluke in the bile ducts. I think diffuse diseases are harder to detect, so probably not much use where toxins are concerned, but would give an idea if its enlarged or not. Useful to access before/after to see if treatment is working.

Liver Biopsy: Does 3 things: a) to establish if liver disease is present, b) establish the type of disease, c) prognosis. I don’t think however, that biopsies work where there is a localised issue, such as liver fluke or perhaps a tumour. It picks up on fibrosis (scar tissue) and also how much inflammation there is. So, it’s good for diagnosing diffuse problems such as ragwort/alkaloid poisoning.

There are also other indicators a vet would use, but it’s already turned out too long!

Thank you.
 
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