dog with elevated alp level

How to Lower Elevated ALP levels in dogs?

A low concentration of Liver enzymes plays some very substantial roles in the body. However, an elevated level of liver enzymes could be dangerous. Elevated liver enzymes can cause several deadly diseases in dogs, including hepatitis. A slight increase in liver enzymes is found in almost all dogs, but a markedly high level of ALP is a common finding in young dogs. Now you must be wondering how you can lower the elevated ALP level in dogs?

Well, there are three versions of ALP in body 1. Liver-ALP, 2. Bone-ALP, and 3. Corticosteroid induced ALP. In other words, dogs' bodies produce ALP from three different sites. Hence, there are three root causes of ALP elevation in a dog. You need to adopt a different approach to deal with each. Successful treatment is only possible after finding the root cause of the ALP increase. For example, If serum ALP has elevated due to Bone-ALP, then specific supplements and medications are given, which will only help to lower the Bone-ALP level. However, generally, to lower the elevated level of ALP a supportive treatment and supplements are recommended.

VLet's discuss all three causes of ALP increase in detail. But before moving toward the treatment, let's first discuss the key function of the ALP liver enzyme. And why does the ALP level increase in dogs?

1. What is the function of the ALP liver enzyme in dogs?

Alkaline Phosphatase or ALP is an enzyme found in the blood. ALP helps the body to break down proteins. Other than this, the dog's body uses ALP for several processes. ALP plays a key role in bone development and liver function.

Like we have mentioned, there are different sources of ALP in the body. So ALP has a slightly high concentration in the blood as compared to other liver enzymes. The normal range of ALP is 8–76 U/L in dogs.

A two to three-fold increase in the ALP level is considered normal for dogs. But if your dog's ALP value is more than 100U/L, then you should contact the doctor. Although it is not alarming, it could worsen.

Dogs have different thresholds of elevated ALP. For example, there might be a dog that has a 300U/L ALP value but might appear normal. On the other hand, there might be a dog with a 200U/L ALP level and representing severe signs of disease.

2. Why does the ALP level increase in dogs?

Previously we have described that a little higher level of liver enzyme is not uncommon in dogs. The same is the case with the ALP level. A high level of ALP is more common than other liver enzymes because there are many sources of ALP in the body.

According to a study, almost 77% of all dogs have elevated ALP levels, but most dogs (83.9%) did not display abnormal clinical signs.

Causes

For better understanding let’s discuss individual causes that elevate the ALP level in dogs.

Advance Age

Growing age is one of the most common reasons that cause an increase in the ALP level. In older dogs, the liver sometimes develops benign areas of abnormal liver growth called 'nodular hyperplasia.'

Nodular hyperplasia is an abnormal growth of the liver. The larger the size of the liver through the nodular hyperplasia, the greater will be the number of liver cells, and eventually, there would be more production of ALP. Additionally, older dogs who have Cushing's disease have a marked increase in the ALP level.

Growing Age

Like in the older age, the elevated level of ALP is also common in the growing years. But the level of ALP is benign during the development or growth years.

During growing age, Bone-ALP increases the overall level of ALP in the body. During the growing age, the level of Bone-ALP is sky-high. In younger dogs of less than one year, almost 96% of the total ALP is the Bone-ALP. That is why during the growing age, an increase in the ALP level, doesn't need much concern. But, if there is like a 5-10 times increase in the ALP level, it is a matter of concern. Veterinary attention is necessary in this case.

Besides aging, there are several exogenous and endogenous factors that cause an increase in the ALP level. Let's discuss the exogenous factors that can increase the ALP level.

Medication

Almost all liver enzymes increase due to medicines. Phenobarbitone is the most common medication that causes an increase in the ALP level. Phenobarbital not only elevated ALP level, but this medication also causes liver damage.

Phenobarbitone is mostly used for treating seizures in dogs. When you stop providing phenobarbitone to your dog, the level of ALP starts to get down in 2-4 weeks.

Steroids

Some steroidal drugs in dogs cause an increase In the ALP level. Steroids medicines cause a chronic increase in the ALP level, and it can take several months to normalize the level of ALP after you stop using steroids for your dog. Dexamethasone and corticosteroids are the most common steroids used for dogs and cause a marked increase in ALP levels.

Diseases that Increase ALP Level

Several diseases cause an increase in the ALP level:

Gallbladder and liver diseases

Any primary disease affecting the gallbladder and liver causes an increase in the ALP level. These diseases will gradually disturb the gross and microscopic circulation of the bile.

Hepatitis

It is also one of the most common causes of the elevated ALP level. The yellow color of the eyes is one of the most common signs of hepatitis.

Toxicity

We have described that livers' main function is to remove toxic substances from the body. And liver enzymes help the liver to carry out this function. If there is a marked increase in toxicity, the liver starts to produce more than the required amount of the ALP.

Pancreatic disorders

Pancreatic disorders are also a common cause of an increase in ALP amount. Gallstones are also a potential source that causes an immense elevation in the ALP level.

Liver neoplasia

Any disturbance in the liver directly causes an increase in ALP value. Tumour, inflammation, injury cause a continuous increase in the level of ALP.

GIT infection

Although there is no role of GIT in ALP production still, there are some ailments of the GIT tract that causes an increase in the ALP level. Most commonly, cancer of the duodenum and inflammation of GIT causes an increase in the ALP level.

Endocrine disorders

Including an increase in the ALP value, the endocrine disturbance is the root cause of many liver diseases. Hyperthyroidism and hypothyroidism both can cause an increase in the ALP level.

Blood cancer

Blood cancer is also a common cause of ALP increase.

3. Sources of ALP Production

We have explained above three sources of ALP production. We are interested to know which disease is specifically associated with the specific increase in the liver enzyme. Let's start with L-ALP:

Liver-ALP

L-ALP is the most prominent ALP in dogs over one year of age. Liver-ALP levels increase in response to various diseases like hepatobiliary disease. Cholestasis also causes a marked increase in the L-ALP. In medicines, phenobarbitone is the important source that causes an elevation in the ALP level. Glucocorticoid also causes an increase in L-ALP level.

Corticosteroids-ALP

In adult dogs, 10-30% C-LAP is present. Hyperadrenocorticism is the most common cause of C-ALP increase. Among the total, hyperadrenocorticism accounts for a 70-100% increase in the C-ALP level. Other causes of increased C-ALP include phenobarbital therapy, diabetes mellitus, primary liver diseases. Any acute or chronic stress or illness associated with increases in endogenous glucocorticoids causes ALP elevation. It is thought that Progesterones also cause an increase in C-ALP.

Bone-ALP

Increased B-ALP is associated with bone growth in young dogs. In osteosarcoma, nutritional bone disease, and fracture healing, there is a marked increase in ALP. In dogs, increases in B-ALP due to osteosarcoma is mild. A Marked Increase in ALP is found in the case of tumors with increased osteoblastic activity. In Siberian Huskies, Benign familial hyperphosphatasemia is a rare condition, and it also causes a marked increase in the B-ALP.

Now let see, what are the common signs and symptoms of ALP increase in dogs.

4. What are the Signs of ALP increase in dogs?

Signs of the ALP increase vary from species to species. In some species, they are very apparent, while less apparent in others. However, the signs and symptoms of the ALP increase appear very late. Or you can say that early signs of ALP increase, are not properly diagnosed by pet parents. The late signs occur when 75% of liver damage has occurred. Some common signs, of the elevated ALP are:

  • Ascites, accumulation of fluid in the belly
  • Seizures
  • Haematuria and blood cells in the poop
  • Loss of activeness
  • General weakness and lethargy
  • Jaundice, yellowish eyes, and tongue
  • Confusion
  • Frequent urination
  • Unstable gait
  • Vomiting and diarrhea
  • Frequent vomiting
  • Weight loss

The signs and symptoms of the elevated ALP level can become severe In later stages, and they can affect the health of the dog in several ways. That's why; it is crucial to lowering the elevated ALP levels in the dog.

Including the observation of signs and symptoms, several diagnostic tests are available that help in the diagnosis of elevated ALP levels in dogs. The most common test used to know the level of ALP in serum is 'the liver function test.' Read more about liver function tests.
Other than this, several tests can help to know the elevated level of ALP.

5. How to lower the elevated ALP level in the dogs?

So far, no specific medicine can lower the elevated level of ALP in dogs instantly. Prevention is the best treatment. So, be very careful, avoid exposure of your dog to the environment that can cause an increase in ALP level in dogs.

Here are a few things that you can do to lower elevated ALP level:

Diet change

Diet change is also very beneficial. A change in diet will help to lower elevated ALP levels in dogs. Avoid using food that has phosphate as an active ingredient.

Supplements

Supplements are one of the best and the only trustable treatments for elevated ALP levels. Supplements, such as SAM-E or milk thistle can help the liver, bone, and corticosteroid-ALP to recover soon.

Antibiotics

The use of antibiotics can also treat elevated ALP in dogs.
If certain diseases have caused the increase in ALP level, treatment of that diseases will help to lower the elevated level of ALP in dogs.
If the tumor or cyst is causing the problem, the surgical removal of the tumors and cysts is necessary.

Conclusion

ALP is a liver enzyme in the dog, it performs several crucial functions in the body. ALP is released from three different sites from the body. Several conditions can cause an increase in ALP levels. Also, the elevated level of ALP causes several diseases in dogs. Until now, no specific treatment is available to lower the elevated level of ALP in the dog. However, asymptomatic and supportive treatment is working well.

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