I am updating my article on the usefulness of the SDMA kidney test.
If your vet  has followed SDMA levels in your pet, perhaps you would 
share those values with me. RSH email
What To Do When Your Dog Or Cat's Liver Tests Are High

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Ron Hines DVM PhD

For 16 years Dr. Hines didn’t run Ads on this site. Readers sent him sufficient donations to pay the bills that keep this website on the internet. But in 2017, Google informed him that his website needed to be reprogrammed to be “mobile-friendly”. You see, times have changed: Today, 82% of his readers view the articles on smart phones and tablets. Less than 20% do on full size personal computers like his. PCs are less common now but days are still only 24 hours long. If he took the time to redesign all his webpages he wouldn't have time to update or write new ones - let alone care for the animals that depend on him. His hope is that these ads (selected by Google, not him) will generate enough revenue to have others make the website coding changes for him that Google desires.

The blood test results most indicative of a potential liver problem in your pet are elevations in its ALT, AST, GGT, and ALP enzyme levels. Its not that unusual for one or more of these tests to be a bit high; but for your dog or cat to appears healthy. Those moderate elevations are often found in “wellness” checkups or suggested yearly health exams.

The first thing you need to understand is that although we associate these enzymes with the liver, there are many non-liver health issues that will also cause these enzyme levels to rise. Things like pancreatitis, infections (like lepto), gall bladder disease (bacterial cholangitis) , portosystemic shunts, intestinal disease or failing heart. Medications (like corticosteroids) anti-seizure medications (ref) or NSAIDs, like Rimadyl® , that your pet might be taking can also be responsible. So can herbal supplements. (ref) My approach is to retest these pets in 4-6 weeks. Many times, the second round of tests will be normal.

If its still abnormal, a bile acid test is in order. If the bile acids test is high, veterinarians often place pets on a trial course of antibiotics and usually throw in some “liver support” products like Denamarin® or Denosyl®. They might even suggest a prescription diet such as l/d® Liver Care with the suggestion to repeat the blood test in 4-7 weeks. There is certainly no harm in giving those unproven products.    

If the elevation is still there, your veterinarian needs to determine if the underlying issue is some non-liver problem or if the problem is indeed in your dog or cat’s liver. Symptoms like jaundice (icterus, yellowish skin), fluid buildup in the tummy (ascites), a mass or lump felt in the liver or seen on x-rays or any changes in the pet’s mental state (ie hepatic encephalopathy) make a primary liver problem more likely. If no non-liver problem could be found, most vets would then recommend x-rays and ultrasound examination of the pet’s abdomen. If those exams were not sufficient to make the diagnosis, most vets would suggest that a fine, long needle be entered, under anesthesia, through the pet’s body wall and into its liver and a tiny plug of liver tissue removed. That tissue would be sent to a pathologist to determine what abnormalities were present at a cellular level (fine needle aspirate).