Alkaline phosphatase is the enzyme that the abbreviation “ALP” stands for, which is something that many standard blood tests may detect. ALP is mostly made by the liver, though there are other sources as well. This will be covered again later in the article because it is crucial.
ALP can be discovered along the surface of the liver cells. It is connected to the liver cells that line the bile ducts even more specifically. The typical function of alkaline phosphatase in the organism is intricate and not absolutely necessary to comprehend in this context. ALP is a sensitive sign of liver or gallbladder dysfunction, which is crucial to comprehend.
A brief physiology lesson
According to several estimations, the liver is a remarkable organ with approximately 500 essential functions in the body. Among other things, the liver is in charge of
- detoxifying the bloodstream of toxins
- controlling blood sugar (with the help of the pancreas)
- removing stale red blood cells from the bloodstream
- letting clotting agents go
Bile is also produced by the liver and is transported through ducts from the liver to the gallbladder. The gallbladder subsequently releases bile into the GI system, where it aids in digestion.
Given all these crucial roles, it stands to reason that monitoring your dog’s liver is an essential aspect of keeping him or her healthy. Here, among other liver enzymes, ALP liver enzymes play a role.
How could a veterinarian find pets with high ALP levels?
It’s likely that a chemical panel will be included in the general wellness blood work your veterinarian performs on your dog, whether as part of an annual exam or as part of a pre-anesthetic check-up. Electrolyte and protein levels are determined by this test. Additionally, it contains data that can reveal information about how the pancreas, kidneys, and liver are working.
The vet or vet nurse will take a small sample of your dog’s blood and place it in a test tube for a chemical panel. The blood tests are then occasionally carried out by your veterinarian using a home laboratory unit. Alternatively, he or she can send your dog’s blood to a veterinary diagnostic facility that is not affiliated with them. Your findings can be available the same day if your veterinarian performs these tests in-house. But if your vet sends the blood out, it can take several days for the final results to be available.
ALP, ALT, GGT, and total bilirubin are some of the indicators found on a chemical panel that are associated with the liver. Glucose, cholesterol, albumin, and BUN are all produced by the liver. These levels can provide information about how well the liver is working.
A liver enzyme referred to as “hepatocellular” is called ALT, or alanine transferase. This enzyme escapes into the blood when the liver cells are destroyed. For veterinarians, elevated ALT is frequently more concerning than high ALP because it denotes continuous liver cell destruction.
Alkaline phosphatase (ALP), which is produced by the liver but also found in other parts of the body, was mentioned earlier. ALP produced in the bone (B-ALP), ALP produced in the liver (L-ALP), and ALP released in reaction to excessive corticosteroid levels (C-ALP) are the three most significant kinds. All three of these types are measured collectively as ALP by a chemical panel. Therefore, it is impossible to tell which form is mainly responsible for an increased ALP based just on the chemical panel.
L-ALP increases are frequently linked to liver problems, as the name suggests. The majority of the remaining text in the article focuses on this.
Young canines who are growing quickly frequently exhibit increased ALP activity because healthy bone growth releases B-ALP. These dogs are often younger than a year old. If the rest of the liver readings are normal and the dog is otherwise in good health, a small rise in ALP in a young dog is not a concerning result. However, conditions that cause ongoing damage to the bones, such as bone cancer (i.e. osteosarcoma) or infections within the bone (i.e. osteomyelitis), can also cause elevations in B-ALP levels.
In reaction to increased blood levels of steroids, the liver makes corticosteroid-induced ALP. If you have Cushing’s disease in dogs, your body may produce more steroids than usual, which would explain why your C-ALP levels are high, or you may be taking oral or topically applied treatments that contain steroids.
What causes high ALP in dogs?
Elevated levels of alkaline phosphatase (ALP) in dogs can be caused by a variety of factors, including liver disease, bone disease, and intestinal issues.
Liver disease is one of the most common causes of high ALP levels in dogs. Liver damage, inflammation, or disease can cause the liver to release more ALP into the bloodstream. Certain medications, toxins, and infections can also cause liver damage and elevate ALP levels.
Bone disease, such as bone cancer or abnormal bone growth, can also lead to elevated levels of bone ALP in a dog’s blood. Intestinal issues, such as inflammation or damage to the intestines, can cause an increase in intestinal ALP.
Additionally, certain factors such as breed, age, gender, and medication use can impact ALP levels in dogs. For example, certain breeds are more prone to elevated ALP levels, such as Scottish Terriers and West Highland White Terriers. Older dogs may also have higher ALP levels due to age-related changes in liver function. Certain medications, such as steroids, can also cause an increase in ALP levels.
It is important to work closely with a veterinarian to determine the underlying cause of elevated ALP levels in a dog and develop an appropriate treatment plan. This may involve further diagnostic tests, such as blood work, imaging studies, or a biopsy of affected tissues. Early detection and treatment can help manage the underlying condition and improve a dog’s overall health and quality of life.
Is a higher ALP always detrimental to dogs?
Not necessarily. While elevated alkaline phosphatase (ALP) levels in dogs can indicate an underlying health issue, it does not always mean the dog is in immediate danger. The significance of elevated ALP levels depends on the cause and the overall health of the dog.
For example, mild elevations in ALP levels may not cause any noticeable symptoms or affect a dog’s overall health, while more significant elevations may indicate an underlying health problem that requires treatment. The veterinarian will evaluate the dog’s overall health and any other diagnostic test results to determine if the elevated ALP levels are a concern and what treatment may be necessary.
It is important to note that high ALP levels can indicate a range of health issues, including liver disease, bone disease, and intestinal issues. Therefore, it is important to consult with a veterinarian to determine the underlying cause and develop an appropriate treatment plan. Early detection and treatment of underlying health issues can help improve a dog’s overall health and quality of life.
What are the next steps for a dog with a high ALP?
Your veterinarian will begin by conducting a comprehensive physical examination and medical history review if your dog has a high ALP. Many times, hints from the physical examination and medical history might guide your veterinarian to the next appropriate diagnostic procedure to carry out.
Although every situation is unique, comprehensive lab work is frequently the most frequent and least invasive next step. Complete blood count (CBC), full chemistry panel (if the ALP increase was discovered on a “short” panel), T4 level, and urinalysis are often included in this. Your veterinarian may decide to use the “watchful waiting” strategy if the rest of your dog’s lab work is normal, he or she is otherwise healthy, and the physical exam reveals no significant worrying changes.
This method would prevent your veterinarian from conducting any immediate additional diagnostic tests. To track changes in the ALP and other liver results over time, he or she will periodically repeat the lab tests. Together, you may decide to continue with “watchful waiting” if the ALP decreases or stays very slightly elevated. Your veterinarian will probably advise additional diagnostic testing if the ALP increase worsens, subsequent bloodwork reveals additional abnormalities, or your dog exhibits any new medical symptoms.
Testing liver function
A liver function test that analyzes bile acid levels is another non-invasive lab test that your veterinarian could suggest. After you or your dog consumes a meal, the liver produces bile acids, which are then stored in the gallbladder and released into the intestines to aid in the digestion of fat. These bile acids are drawn back out of the bloodstream by a healthy liver so they can be recycled and used once more. Bile acid levels will be high if the liver is not working properly because it cannot eliminate bile acids from the bloodstream.
Additionally, liver imaging may be advised by your veterinarian. Generally speaking, the two most prevalent imaging techniques available in veterinary medicine are X-rays and ultrasound. X-rays are a helpful tool for a variety of problems, but their capacity to assess the liver is somewhat limited.
In this case, an abdominal ultrasound is significantly more beneficial. A gallbladder ultrasound can check for infections, gallstones, or a mucocele as well as screen the liver for tumors or nodules. Additionally, ultrasound can be used to rule out the possibility that a high ALP is being caused by another medical condition, such as pancreatitis or Cushing’s disease.
A liver sample
One drawback of ultrasound is its inability to conclusively identify the root cause of tumors, nodules, or other abnormalities, even if it may assess whether the liver appears abnormal. While some nodules are cancerous growths, others are benign alterations. There may be clues on ultrasound that a mass or nodule is benign or malignant. However, the veterinarian needs to sample the liver to be certain. Fine needle aspiration or biopsy are the two methods for taking liver samples.
Your veterinarian can suggest a fine needle aspirate as the following diagnostic step if they discover nodules, masses, or other liver abnormalities. Your veterinarian will perform an aspirate by using an ultrasound probe to direct a small needle into the liver’s problematic region. The veterinarian will shoot the cells onto a glass microscope slide after collecting them in the hub of the needle. Your veterinarian will next send the slide to a veterinary pathologist for evaluation.
The only surefire approach to identify the root cause of elevated liver enzymes is through a liver biopsy. It is more intrusive than a lot of the other exams, though. The veterinarian will take a small sample of the liver and send it to a veterinary pathologist to perform a liver biopsy. Your veterinarian may collect the sample via laparoscopic or open abdominal surgery. Alternatively, instead of using a fine needle aspiration, your veterinarian may choose to utilize a large needle tool (such as the Tru-cut biopsy procedure).
The vet will always carry out the biopsy when your dog is under general anesthesia, unlike a tiny needle aspiration, which can be done while your dog is awake. A biopsy can be a very helpful tool, despite the fact that some dog parents may wonder if their dog is too old for anesthesia. It allows the vet to submit an actual chunk of liver tissue for evaluation. This can give a clearer idea of what is going on in the liver than a fine needle aspirate can.
In conclusion, alkaline phosphatase (ALP) is a critical enzyme that plays an important role in the liver and other parts of the body. Elevated levels of ALP in dogs can indicate underlying health issues, such as liver disease, bone disease, or intestinal issues. Monitoring ALP levels through regular check-ups and diagnostic tests is essential to detect potential health problems and ensure the overall health and well-being of dogs. By working closely with a veterinarian and developing an appropriate treatment plan, dog owners can help manage and improve their pet’s health and quality of life.