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  Discussion on Elevated liver enzymes and anemia
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Posted on Friday, Aug 4, 2000 - 10:09 am:

My son's ten year old quarter horse gelding stopped eating and drinking. When he would eat or drink he was taking in very small amounts. The vet thought he had early pneumonia, gave him a shot of gentamycin and oral antibiotics (sulfa type) for a week. He did not improve and I called everyday that week, I was told he would start eating again. Well he didn't and we went back yesterday and had bloodwork drawn. He is anemic with a HCT of 27 and hemoglobin of 8, his WBC was 13,000. His alkaline phosphatase is over 700. He gave him a B-12 shot (said he will need one every 3 days) gentamycin and the oral antibiotics again. He also gave me something to put in his feed he said was to help the liver, it starts with a "M" I can't remember the exact name. He never really told me what is wrong, I asked if it was hepatitis and he said yes, prob. due to a case of stangles in the distant past. Please give me any advice you can, this horse is very dear to us and he has lost about 200 pounds in the last week. The vet told us to feed him alfalfa hay, I stopped this yesterday, I feel it would put more stress on his liver.

Posted on Friday, Aug 4, 2000 - 5:16 pm:

Hello Lisa,
I am afraid I cannot tell what is troubling your horse from here, the only symptom you list is inappetance and weight loss and none of the laboratory work is really that bad. Also a lot of different tissues give off AP. This could be a virus that is going through your horse and he will be fine or serious failure of an organ, I just cannot tell by looking at your post. If you are uncomfortable with the lack of diagnosis (I would be) get a second opinion.
DrO

Posted on Friday, Aug 25, 2000 - 1:16 pm:

I hope someone can help me. The gelding I wrote about is now eating great, gained back all of his weight and is no longer anemic. I did get a second opinion and was told an elevated alk. phosphatase could be due to a viral infection and not to worry and have it re-checked in a month. Well it was re-checked today and is now 1,400. I am trying to get him to a vet at teaching facility to see what is causing this, as the vet who just took the lab doesn't know. Does anyone know what can elevate this enzyme? How serious is this?

Posted on Friday, Aug 25, 2000 - 3:44 pm:

I assume we are still talking alkaline phosphatase or AP. AP can originate from any tissue though in the horse is usually associated with the liver. There are many causes of AP elevation and the absolute number is not indicative of the severity of the problem. Just knowing the AP is elevated in a horse that has gone from inappetance and weight loss to no symptomolgy still does not get close to being able to tell us why or if this is severe or not. If there is still concern about the health of this horse perhaps the referral istitution is best for further diagnostic work. I have to admit if it were my horse and he was absolutely normal other than this one value, I might still be taking a wait and recheck position but it is not without some small risk of some ongoing process being missed early.
DrO
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