The fasted ammonia concentration is <15 mcg/dL (normal range, 0–50 mcg/dL). Preprandial and postprandial (2-hour) bile acids are 2.9 mcmol/L (normal, 0–8 mcmol/L) and 14.5 mcmol/L (normal, 0–30 mcmol/L), respectively.

The list is very long (too long for the scope of this article!), but may include: hyperparathyroidism or hypothyroidism (other endocrine disorders), breed‐related predispositions, bone cancer, chronic liver inflammation (hepatitis or cirrhosis), liver infection/inflammation, toxin exposure, pancreatitis (inflammation …

ALT (alanine aminotransferase) If liver cells break down for any reason, it is released into the blood. When ALT levels in the blood are high, it tells us that liver cells are breaking down more quickly than usual.

Phosphorus (PHOS): Elevations in this test are often associated with kidney disease, hyperthyroidism and bleeding disorders. Total bilirubin (TBIL): Elevations in this test may indicate liver or hemolytic disease. This test helps identify bile duct problems and certain types of anemia.

The normal range for this enzyme is 5–160 U/L. It is common to see this enzyme become very elevated in dogs that are otherwise acting normally. I have some patients that have an ALP in the 1,000–2,000 range and clinically appear healthy. There are a variety of reasons that the liver will make more ALP enzyme.

In terms of primary liver issues, ingestion of certain toxins or chronic inflammation of the liver (due to infection, an over-reaction of the immune system, genetic disorders, etc.) tend to create the most significant ALT elevations.

The normal range of alkaline phosphatase in the blood is 20 to 140U/L, although this can vary from lab to lab. Children and pregnant women can have significantly higher levels of the enzyme in their blood [1]. Values above 130 U/L are usually considered to be high.

The normal range is 44 to 147 international units per liter (IU/L) or 0.73 to 2.45 microkatal per liter (µkat/L). Normal values may vary slightly from laboratory to laboratory. They also can vary with age and sex.

Although reference ranges can vary, most normal ALP values in dogs are between 5-131 U/L. The most trusted liver support supplement recommended by veterinarians is SAM-e. This is a supplement which is designed to support the liver by providing a source of rich anti-oxidants.

ALP values may be as high as 100 times higher than normal. ALP elevation occurs in over 80% of dogs with Cushing’s disease. The hallmark of Cushings’ disease is an elevated ALP on screening blood work.

A “normal aging” change in older dogs is an ALP rise of no more than 2-3 times the upper end of the normal range. ALP elevations are expected in puppies under 15 months of age as they are growing and their skeleton is maturing.

Certain cancers like mammary cancer, pancreatic cancer and bone tumors can over-express the alkaline phosphatase enzyme. Drugs that are well known to boost ALP production by the liver are most commonly anti-seizure medications (phenobarbital and primidone) and steroids.