Content continues after advertisement

Differential Diagnosis: Elevated ALT

Marie Chartier, DVM, DACVIM (Internal Medicine), VCA Roberts Animal Hospital, Hanover, Massachusetts

Internal Medicine

|November 2022|Peer Reviewed

Sign in to Print/View PDF

Following are differential diagnoses for patients presented with elevated ALT.

  • Hepatocyte damage
    • Hypoxia (eg, anemia, cardiopulmonary disease, thromboembolic disease, seizures, ischemic myopathy [cats])
    • Portosystemic shunt
    • Portal vein hypoplasia 
    • Hepatic lipidosis (cats)
    • Diabetes mellitus
    • Hyperthyroidism
    • Hyperadrenocorticism (usually only mild to moderate elevation, less common than ALP elevation) 
    • Neoplasia
    • Inflammatory (eg, copper storage disease, chronic hepatitis)
    • Infectious (eg, leptospirosis, bacterial cholangiohepatitis, FIP, histoplasmosis, canine infectious hepatitis [adenovirus type 1])
    • Drugs (eg, acetaminophen, azathioprine, carprofen, tetracyclines, methimazole, trimethoprim–sulfonamides, amiodarone, chronic phenobarbital administration) 
    • Toxicity (eg, blue-green algae, Amanita spp mushrooms, aflatoxin, xylitol, sago palm, azole antifungals) 
    • Reactive hepatopathy (eg, enteritis, chronic enteropathy) 
    • Pancreatitis
    • Trauma 
    • Muscular dystrophy (dogs) 
  • Induction (independent from toxicity) 
    • Phenobarbital 
    • Glucocorticoids
  • Other
    • Liver lobe torsion

For global readers, a calculator to convert laboratory values, dosages, and other measurements to SI units can be found here.

All Clinician's Brief content is reviewed for accuracy at the time of publication. Previously published content may not reflect recent developments in research and practice.

Material from Clinician's Brief may not be reproduced, distributed, or used in whole or in part without prior permission of Educational Concepts, LLC. For questions or inquiries please contact us.

Podcasts

Clinician's Brief:
The Podcast
Listen as host Alyssa Watson, DVM, talks with the authors of your favorite Clinician’s Brief articles. Dig deeper and explore the conversations behind the content here.
Clinician's Brief provides relevant diagnostic and treatment information for small animal practitioners. It has been ranked the #1 most essential publication by small animal veterinarians for 9 years.*

*2007-2017 PERQ and Essential Media Studies

© 2022 Educational Concepts, L.L.C. dba Brief Media ™ All Rights Reserved. Terms & Conditions | DMCA Copyright | Privacy Policy | Acceptable Use Policy