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High ALP in a pug.

Species: Dog
Breed: PUG
Age: 5-8 years
Hi Dr. Marie,
I have a 7yr old female Pug. She was getting "pyoderma" every few months. Each time she'd get antibiotics and it goes away. The last visit my vet took a blood test. The vet is concerned about her "Akalilne Phosphatase" level because it is high at 735.
I see on her blood test (I have a copy) that the Platelet count is 447, noted "high."

At the time my dog weighed 37 pounds and was overweight. My vet advised us to put her on a diet and cut out the cookies, cheese, pancakes, etc. we'd give her bits and pieces. She also didn't get much exercise at all.

So for the last 3 weeks we've been walking her every day weather permitting, and reduced her food (we now measure out her allotment for the day). Instead of cookies when she goes out, she gets a small piece of boiled cauliflower or broccoli floret.

Her food has been Science Diet Prescription C/D since she was 1 or 2 years old because back then she got urinary crystals. The food is amazing and that's why she remains on it. We don't want to take a chance w/ any other food. We also started giving her Omega Fatty Acid tablets, hoping that would help with her skin (prior pyoderma problems).

Since her diet and exercise program began, her energy level has increased and her walking pace is great. She has lost probably a few pounds. Her stomach was very large but has lost as her coat fits better and her measurements are smaller.

My vet wants us to bring her back for another blood test after 4 weeks (of the diet) to see if the numbers went down.

Everything else on her blood test is good.

Is her 735 akaline phosphatase level really something to worry about? Especially if all else is normal?
Will weight loss effect the numbers to help lower them?

Thank you so much for your time.

Sincerely,
Kristin & Frank Falzon


Online vet, Dr. Marie

Dr. Marie replied:

Hi there Krissy and thanks for your question. It sounds like you are doing an amazing job with Phoebe!

I have seen a number of dogs who have a high alkaline phosphatase (ALP). Often we don't know why. But there are a few possible reasons and sometimes it can be hard to figure them out, but I'll give you an idea of what kind of things you could be looking for.

First of all, the ALP level is high enough that it warrants investigation. Sometimes if I see a number that is 300-400 I will just write it off as a variation of normal, but I don't believe this is the case.

The most common reason for a dog to have a high ALP is Cushing's disease. However, she is a little young for this, but it is still possible. Cushing's is caused by the adrenal glands producing too much cortisol. Dogs with cushing's tend to have an increase in thirst and appetite and often will have a pot-bellied appearance. And yes, dogs with Cushing's can be more prone to skin infections.

There are two ways to test for Cushing's. The most accurate is something called a low dose dexamethasone suppression test. It is a test where she stays in the hospital for a full day and has a few blood tests done. In my practice it costs around $200 or maybe a little less. There is also a quick urine test that is much less expensive but it is not as accurate.

Some dogs can have high ALP because of a problem with the bile duct. This could be mild pancreatitis (which would certainly be helped by the changes you have made in her diet). If so, then the next blood test should show a decrease in the level. It could also be caused by a gall bladder problem (although this is not terribly common in dogs), diabetes (although this would be evident in the initial bloodwork), or an infection in the liver (but we should be seeing elevation in other values, plus she should be not feeling well).

One other thought - Is Phoebe on any prednisone or other steroid? Steroids can increase the ALP dramatically.

I am not worried about her platelet level.

Hope that helps. Let me know if you have more questions and thanks for using my website!

Dr. Marie.



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Disclaimer: Although Dr. Marie is a qualified veterinarian, the information found on this site is not meant to replace the advice of your own veterinarian. AskAVetQuestion.com and Dr. Marie do not accept any responsibility for any loss, damage, injury, death, or disease which may arise from reliance on information contained on this site. Do not use information found on this site for diagnosing or treating your pet. Anything you read here is for information only.

Customer reply:

Hi Dr. Marie,

Thank you so much for your quick response. I appreciate your time. I have a few more questions but I will be adding more money to the account. As you can imagine, we’re worried sick and just have a few questions.

To answer your question, no Phoebe is not on any steroid or medication. She started taking Pet Tabs last month (but I stopped after a week or so bec her poo got soft) and she takes 1 Omega Fatty Acid tablet per day.

I am hoping the weight loss and diet help decrease her ALP levels.

Dr. Marie,
Instead of returning to the vet at the 4 week mark (2/25/10), we were thinking that instead we return for another blood test in an another 2-4 weeks as she will lose even more weight, thereby increasing her chances of lowering her ALP level. She’s great and has no ailments. She pees normally (not excessive at all, holds it for long periods of time) and is never really thirsty. I’m not refilling the water bowl. I add a little water to her meals. Question#1 What do you think about waiting another month to re-check the blood?

Question #2 Would a bag of baby carrots per week cause pancreatis?
Prior to her diet, she was eating one bag of baby carrots per week. We since took them out of her diet. Would the Omega Fatty Acid tablets she’s on cause a high ALP level?
(She gets one per day)

Question# 3
Are there any other low calorie foods you can suggest to mix in her food or use as treats? (She gets: lettuce, baby spinach, boiled cauliflower and boiled broccoli)
Can she have any baby carrots and if so how many?

We are just afraid to put her on any medication at all even if she Heaven forbid had Cushings, because she has no symptoms – she acts normal, feels great, excellent and improved energy level and we are afraid that medication could change that and give her other problems etc. (If it’s not broke, don’t fix it)
Question #4 Would I have to put her on medication if she did have Cushings? Since she’s acting fine, and everything else is ok…

Thank you again for your time. We sincerely appreciate it!!

Sincerely,

Krissy & Frank Falzon


Online vet, Dr. Marie

Dr. Marie replied:

You're very welcome! I will answer what I can, although some of these questions may need to be answered by your own vet.

Question 1:I would follow your vet's advice on when to retest the ALP level. I understand your reasoning that an extra month gives us more time to lose weight. However, on the off chance that there is a medical issue going on, (in which the ALP) may be increased, I don't know that I would want to wait 2 months before finding this out.

Question 2: Carrots are extremely unlikely to cause pancreatitis. Pancreatitis is usually caused by a fatty food such as bacon grease or butter, and lots of it. Also, dogs with pancreatitis tend to be really really sick and she doesn't sound sick.

Question 3: Generally any vegetable (other than onions or garlic) are good to add as treats. The ones that you have mentioned are all great. I am fine with baby carrots.

Question 4: It really does not sound like she has Cushing's as these dogs usually have very obvious signs of increased thirst, urination and appetite which she does not have. If this were my case and the ALP was not decreasing I would likely do the urine test for Cushing's just to rule it out for sure, but it is extremely unlikely.

I should add that I often do see dogs who have a high ALP with no known reason for it. What I generally do is recheck the value in a month or so and then recheck it 1-3x per year. As long as it is not continuing to increase dramatically and the dog is feeling well, then I simply keep an eye on things.

Hope that helps!

Dr. Marie.



Customer reply:

Thank you so much Dr. Marie!! We really appreciate it!
To close, with one final question, we were just curious if being fat/overweight might cause high APL. That's our final question! :)

You will be highly recommended to everyone we know. Thank you so much for your time. I found you through Womans World magazine. Glad I did!

Take care and thank you again. You were ever so helpful.
Sincerely
Kristin & Frank Falzon


Online vet, Dr. Marie

Dr. Marie replied:

Again, you're very welcome, and thank you for the kind words about my website!

As far as I know, just having extra weight should not directly cause an elevated ALP. In theory, if there was some extra fat around the liver or bile duct it could indirectly cause an elevation in ALP. However, this is not one of the "textbook" causes for an increase in ALP.

It's never a bad idea to lose weight though!

Thank you for recommending me!

Dr. Marie.



Online vet, Dr. Marie

Dr. Marie replied:

Thanks so much for the bonus! It is greatly appreciated!



Customer reply:

You're so welcome!!! Thank you!
I just remembered that YES Phoebe WAS ON medication prior to the blood test! She had her blood test on the 14th day of a 2 week antibiotic shot for pyoderma. !! We went to the vet on the last day of antibiotic therapy to make sure her skin was better and if she needed another round of antibiotics. That's the day the blood was drawn!

Do you think that raised the ALP??

Take care and thanks again!!


Online vet, Dr. Marie

Dr. Marie replied:

Hi again Krissy...antibiotics will not raise the ALP. Prednisone (which is a steroid that we use sometimes to help with itchiness) can raise the level, but not antibiotics.

Hope that helps!
Dr. Marie.



Customer reply:

Thanks so much! The vet might have given her an anti-itch, not sure, but I think since she has no symptoms we would rather wait until she gets down to 24 lbs and then bring her back for a weight check and blood test. I wouldn't want Phoebe to take medication when she's not sick. Each time we go to our vet we charge $200-300 each time. It is costly and seems unnecessary when the dog is fine.

Thanks again Dr. Marie and have a great weekend!!!!


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Dr. MarieDr. Marie is a veterinarian who practices in a busy animal hospital in Ottawa, Ontario. She created Ask A Vet Question as a resource for good, accurate veterinary advice online. Dr. Marie treats dogs, cats, hamsters, guinea pigs, and rats. She has been a vet since 1999.

Is an online vet visit just as good as a trip to your veterinarian? No! But, many times, asking an online veterinarian a question can help save you money. While Dr. Marie can't officially diagnose your pet or prescribe medications, she can often advise you on whether a vet visit is necessary. You can also ask Dr. Marie for a second opinion on your pet's condition.