--- title: "Elevated Liver Enzymes: Could Ultrasound Help This Patient?" description: Targeted GI Ultrasound Insights for Veterinary Practices --- [![Oncura logo High Res](https://blog.oncurapartners.com/hs-fs/hubfs/Oncura%20logo%20High%20Res.png?width=6191&height=1721&name=Oncura%20logo%20High%20Res.png "Oncura logo High Res")](https://www.oncurapartners.com/) - [Products](https://www.oncurapartners.com/product) - [Testimonials](https://www.oncurapartners.com/testimonials) - [Training Videos](https://www.oncurapartners.com/educational-videos) - [Sonographers](https://www.oncurapartners.com/sonographers) - [Education](https://blog.oncurapartners.com/blog) - [Telehealth Portal](http://telehealth.oncurapartners.com/) - [Contact](https://www.oncurapartners.com/contact) - [Products](https://www.oncurapartners.com/product) - [Testimonials](https://www.oncurapartners.com/testimonials) - [Training Videos](https://www.oncurapartners.com/educational-videos) - [Sonographers](https://www.oncurapartners.com/sonographers) - [Education](https://blog.oncurapartners.com/blog) - [Telehealth Portal](http://telehealth.oncurapartners.com/) - [Contact](https://www.oncurapartners.com/contact) ## Post Sign Up - [All Posts](https://blog.oncurapartners.com/blog) All Posts Log in / Sign up [Oncura Partners](https://blog.oncurapartners.com/blog/author/oncura-partners) - Oct 1 - 2 min Share Post ## Share Post ## Share Link Cancel Copy Link # Elevated Liver Enzymes: Could Ultrasound Help This Patient? ![](https://8772207.fs1.hubspotusercontent-na1.net/hub/8772207/hubfs/Screenshot%202026-09-18%20at%2012.16.57%20PM.png?width=1200&length=1200&name=Screenshot%202026-09-18%20at%2012.16.57%20PM.png) ![](https://8772207.fs1.hubspotusercontent-na1.net/hub/8772207/hubfs/Screenshot%202026-09-18%20at%2012.20.05%20PM.png?width=1200&length=1200&name=Screenshot%202026-09-18%20at%2012.20.05%20PM.png) ![](https://8772207.fs1.hubspotusercontent-na1.net/hub/8772207/hubfs/Screenshot%202026-09-18%20at%2012.21.20%20PM.png?width=1200&length=1200&name=Screenshot%202026-09-18%20at%2012.21.20%20PM.png) ![](https://8772207.fs1.hubspotusercontent-na1.net/hub/8772207/hubfs/Screenshot%202026-09-18%20at%2012.22.53%20PM.png?width=1200&length=1200&name=Screenshot%202026-09-18%20at%2012.22.53%20PM.png) ![](https://8772207.fs1.hubspotusercontent-na1.net/hub/8772207/hubfs/Screenshot%202026-09-18%20at%2012.21.51%20PM.png?width=1200&length=1200&name=Screenshot%202026-09-18%20at%2012.21.51%20PM.png) ## Could Ultrasound Help This Patient? Elevated liver enzymes are one of the most common abnormalities identified during wellness screenings and routine diagnostics. Bloodwork can tell us that something is changing, but it cannot tell us why. Ultrasound helps bridge that gap by providing real-time information about the liver, gallbladder, and surrounding structures, allowing veterinary teams to move beyond abnormal laboratory values and begin identifying the underlying cause. This month, we encourage teams to ask a simple question: **Could ultrasound help this patient?** For many patients with elevated liver enzymes, the answer is yes. ## Elevated Liver Enzymes Are a Starting Point, Not a Diagnosis Liver enzyme elevations can be associated with a variety of conditions, including: - Hepatitis and inflammatory disease - Gallbladder disease - Biliary obstruction - Vacuolar hepatopathy - Liver nodules or masses - Endocrine disorders - Toxicities - Pancreatic disease affecting the hepatobiliary system Bloodwork alerts us to a problem. Ultrasound helps identify the cause. Rather than simply monitoring values over time, ultrasound can provide valuable diagnostic information earlier in the process, helping teams make more informed treatment recommendations and create a clearer path forward for pet owners. ## October Case Spotlight A canine patient presented with **severe acute polyuria and polydipsia (PU/PD)** and significant liver enzyme elevations identified on routine bloodwork. Laboratory findings included an ALP of 13,756, ALT of 725, GGT of 82, and elevated cholesterol levels. The patient also had a history of hypothyroidism and seizures.  At first glance, bloodwork confirmed there was a problem. The next question became: **What is causing these abnormal values?** The doctor elected to perform an abdominal ultrasound to further investigate the patient's elevated liver enzymes and clinical signs. Ultrasound revealed: - Diffuse hepatomegaly with abnormal liver architecture - Gallbladder wall thickening - Organized gallbladder contents consistent with a gallbladder mucocele - Additional hepatobiliary changes requiring further evaluation The final ultrasound assessment identified findings most consistent with a **gallbladder mucocele and significant hepatobiliary disease**, providing a likely explanation for the patient's clinical presentation and bloodwork abnormalities. Without ultrasound, the team would have known the liver values were abnormal. With ultrasound, they were able to identify the underlying pathology and discuss appropriate treatment options with the owner. ## Why Ultrasound Matters Cases like this highlight an important reality: Bloodwork rarely tells the entire story. Elevated liver enzymes may indicate that disease is present, but they often cannot distinguish between inflammatory disease, biliary disease, endocrine-related changes, neoplasia, or other hepatobiliary conditions. Ultrasound allows clinicians to: - Visualize the liver and gallbladder directly - Identify structural abnormalities - Detect changes earlier in the disease process - Improve diagnostic confidence - Develop more targeted treatment plans When questions remain after bloodwork, ultrasound frequently becomes the next logical diagnostic step. ## The Ultrasound Takeaway Bloodwork tells us something may be happening. Ultrasound helps us understand why. Whether evaluating elevated liver enzymes, unexplained clinical signs, or monitoring chronic disease, ultrasound serves as an extension of the physical exam, helping veterinary teams move from suspicion to understanding. ## Featured Promotion: Hepatobiliary System Focus Exam Not every patient requires a complete abdominal ultrasound. When liver enzyme elevations, gallbladder concerns, or hepatobiliary clinical signs are identified, a **Hepatobiliary System Focus Exam** provides a targeted diagnostic approach that allows clinicians to evaluate the structures most likely involved. Ideal candidates include: ✓ Elevated ALT, ALP, AST, or GGT ✓ Suspected gallbladder disease ✓ Vomiting with elevated liver values ✓ Decreased appetite ✓ Unexplained weight loss ✓ Chronic liver monitoring ✓ Incidental bloodwork abnormalities ✓ Patients presenting with clinical signs suggestive of hepatobiliary disease By focusing on the liver, gallbladder, and biliary structures, teams can often gather meaningful diagnostic information earlier and guide treatment decisions with greater confidence. ## October Ultrasound Mindset Challenge For every patient with elevated liver enzymes this month, ask: **Could ultrasound help this patient today?** Over time, consistently asking this question helps transform ultrasound from an occasional diagnostic tool into a routine part of patient evaluation. Because the goal is not simply to identify liver disease. The goal is to build the habit of using ultrasound to answer clinical questions, provide earlier diagnostic insight, and improve patient care. 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