# Raised liver enzymes



## duckling (29 October 2017)

Really hoping for some HHO knowledge here, as this is all very new to me and Im worried...

Long story short, my horse had been feeling very flat for the past few weeks and was not his usual self. Vet came and took bloods, which have shown raised liver and muscle enzymes. 

Bit of background - horse is a 5yr old 16hh cob, came over from Ireland at 3 and doesnt seem to have had the best start in life. He lives out in a herd 24/7, field has ample grass but is surrounded by trees (no sycamores though) and does have other plants growing in it, although were always v careful with ragwort. Worked 4-5 times a week, mix of schooling and hacking, fed chaff and a scoop of Saracens Shape Up balancer.

On vets instruction, he has now been wormed with Equest in case of encysted redworm, and Ive moved him into a smaller private paddock which has no trees around and nothing but grass for him to eat. The grass is quite poor so Ill put hay in for him too.

She advised me to cut the Shape Up from his feed to just 1-2 handfuls of chaff a day, and feed hay not haylage. Hes a v good doer, always hungry, and is a bit fatter than Id like him to be at the moment.

Ive been doing a lot of reading this weekend about raised liver enzymes and have read good things about Global Herbs Restore and milk thistle powder, so am planning on getting these to add to his chaff. The vet will come out to take his bloods again in a month to see if the levels have gone down. 

I really want reassurance that this sounds like the right things to be doing? Also, whether I should still be riding him? The vet said to carry on working him but not doing anything to strenuous as he needs to lose weight, but he just feels so lethargic...

Any help / advice gratefully received.


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## ester (29 October 2017)

All sounds right to me, definitely get him on the milk thistle. 

It was about a year ago that Frank's showed up and in some ways it's a tricky time of year because plant wise there isn't much about to be attributing it to generally, certainly not the 'usual suspects' anyway. 

We haven't had any lethargy so did keep riding, but did minimise his diet like you are going to, and put him in a smaller paddock that had no hogweed in (that was the only possible vegetation wise). He didn't show any improvement after the month (he had some expensive vets brew for 2 weeks), he was marginally better in the spring but by then I had started feeding him his normal ration again. For him we've decided it is likely a result of older age (first thought was virus) but it is frustrating not to be able to pin it on anything. 

There have been some posts recently with someone who had a pony in the critical range but even she seems to be coming back so at the very least it is manageble and often resolvable.


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## duckling (29 October 2017)

Thank you Ester, good to know that all sounds right, and that Frank is doing well enough with it. Have ordered the milk thistle on next day delivery! I think Ill continue to exercise him lightly and see how we go...
The vet said if Tonto hadnt improved within a month then shed want to do a liver biopsy, keeping everything crossed that the changes were making will bring the levels down. 
Ill search out the thread on the pony that was critical and have a read. Thanks again


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## ester (29 October 2017)

yup that is definitely the next step, we haven't done so for  few reasons, age and the fact that other than the photosenstivity he has seemed fine in himself but I would certainly do so if your doesn't improve.


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## JillA (29 October 2017)

Liver is very good at regenerating after damage, so long as you catch it early enough. Just don't take any chances, once it is showing several definite symptoms it is often too late


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## BBP (30 October 2017)

When you say raised enzymes what sort of numbers are you talking about? Is the bile high also? I have a theory that there are certain mycotoxins or spores on grass at certain times of year that the horse ingests that put pressure on the horses liver, same with the spores in hay from certain fields cut in certain conditions. My friends mare has exactly the same as yours, raised enzymes and bile and was tested as she&#8217;d seemed a bit quiet. My horse had raised levels for a couple of years. If it was me now I would switch all the forage the horse was getting, especially if the hay isfrol the same property I would switch to hay sources from somewhere else. If horse was just eating grass I would put it onto ad-lib hay just so it&#8217;s eating less of what may have spores on it. Then milk thistle as you are doing. Take it very easy if the horse is s bit quiet, I only worked mind when he was feeling full of himself.


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## ycbm (30 October 2017)

Raised liver and muscle enzymes together can be a result of PSSM, which is increasingly being recognised in cobs.

My two horses with it got worse with age and need more vitamin E than they used to. It's possible that yours has it and that the dying back of the grass is causing him to have a lack of vitamin E, bringing on symptoms you haven't seen before. 

It might be worth looking up the symptoms and seeing if they fit, and discussing with your vet, though some of them don't know much about it.  The high vitamin E/low carb/alcar diet which seems to help most of them is harmless, so if you find no other reason it might be worth a try just to see if it changes anything.


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## tallyho! (30 October 2017)

My old boy had this as well as LGL. Restore is good but there's also another company which do a great herbal detox call trinity consultants.  Worth calling or looking up.

Mine was on this for 10 days and nothing but hay and soaked grass nuts. He improved massively and when bloods were done again it was more ch better and he no longer had the puffy legs and face.


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## duckling (30 October 2017)

JillA said:



			Liver is very good at regenerating after damage, so long as you catch it early enough. Just don't take any chances, once it is showing several definite symptoms it is often too late
		
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Thanks Jill, that gives me hope. The only symptoms are his lethargy and lack of sparkle, so hopefully we have caught it early enough. So glad I called the vet, most others on the yard thought I was being daft and he was just being lazy! 



KatPT said:



			When you say raised enzymes what sort of numbers are you talking about? Is the bile high also?
		
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The vet didnt give me any numbers or mention bile and I didnt know to ask, although having read round it now Im going to call back and find out. 

Hes on grass 24/7, and just had about 1 net of haylage that would last a week (when I bought him in and tied him up), but I am now giving him hay in the paddock as the grass there is poor.



ycbm said:



			Raised liver and muscle enzymes together can be a result of PSSM, which is increasingly being recognised in cobs.

My two horses with it got worse with age and need more vitamin E than they used to. It's possible that yours has it and that the dying back of the grass is causing him to have a lack of vitamin E, bringing on symptoms you haven't seen before.
		
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I will look it up now, thanks ycbm. Trying to inform myself as much as possible so I can be prepared when the vets next out.



tallyho! said:



			My old boy had this as well as LGL. Restore is good but there's also another company which do a great herbal detox call trinity consultants.  Worth calling or looking up.

Mine was on this for 10 days and nothing but hay and soaked grass nuts. He improved massively and when bloods were done again it was more ch better and he no longer had the puffy legs and face.
		
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Ive ordered the Restore but will look up the others too. A friend actually mentioned that she gives her oldie a bottle of the restore when the seasons change and said it really seems to make a difference to him, so fingers crossed. Glad your old boy recovered so well


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## ILuvCowparsely (30 October 2017)

duckling said:



			Really hoping for some HHO knowledge here, as this is all very new to me and I&#8217;m worried...

Long story short, my horse had been feeling very flat for the past few weeks and was not his usual self. Vet came and took bloods, which have shown raised liver and muscle enzymes. 

Bit of background - horse is a 5yr old 16hh cob, came over from Ireland at 3 and doesn&#8217;t seem to have had the best start in life. He lives out in a herd 24/7, field has ample grass but is surrounded by trees (no sycamores though) and does have other plants growing in it, although we&#8217;re always v careful with ragwort. Worked 4-5 times a week, mix of schooling and hacking, fed chaff and a scoop of Saracens Shape Up balancer.

On vets instruction, he has now been wormed with Equest in case of encysted redworm, and I&#8217;ve moved him into a smaller private paddock which has no trees around and nothing but grass for him to eat. The grass is quite poor so I&#8217;ll put hay in for him too.

She advised me to cut the Shape Up from his feed to just 1-2 handfuls of chaff a day, and feed hay not haylage. He&#8217;s a v good doer, always hungry, and is a bit fatter than I&#8217;d like him to be at the moment.

I&#8217;ve been doing a lot of reading this weekend about raised liver enzymes and have read good things about Global Herbs Restore and milk thistle powder, so am planning on getting these to add to his chaff. The vet will come out to take his bloods again in a month to see if the levels have gone down. 

I really want reassurance that this sounds like the right things to be doing? Also, whether I should still be riding him? The vet said to carry on working him but not doing anything to strenuous as he needs to lose weight, but he just feels so lethargic...

Any help / advice gratefully received.
		
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We have  had a few recently with raised liver enzymes, vets don't know what causing it and said it might be a virus or it might be the hay.   They suggested Legaphyton or/and milk thistle - 4 sticks of licorice twists (my research).  No oil no straw related feeds - and put them on haylage, which i did and fter a week on haylage the biopsy showed the beginnings of the liver trying to  repair.  


   Another livery is on a liver tonic made by their vets, but it is early days with him as his urine is a redish brown colour which is what alerted me to something being wrong, so the owner had a blood test done.


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## tallyho! (31 October 2017)

duckling said:



			Thanks Jill, that gives me hope. The only symptoms are his lethargy and lack of sparkle, so hopefully we have caught it early enough. So glad I called the vet, most others on the yard thought I was being daft and he was just being lazy! 



The vet didn&#8217;t give me any numbers or mention bile and I didn&#8217;t know to ask, although having read round it now I&#8217;m going to call back and find out. 

He&#8217;s on grass 24/7, and just had about 1 net of haylage that would last a week (when I bought him in and tied him up), but I am now giving him hay in the paddock as the grass there is poor.



I will look it up now, thanks ycbm. Trying to inform myself as much as possible so I can be prepared when the vets n

I&#8217;ve ordered the Restore but will look up the others too. A friend actually mentioned that she gives her oldie a bottle of the restore when the seasons change and said it really seems to make a difference to him, so fingers crossed. Glad your old boy recovered so well 

Click to expand...

that's what I ended up doing... my "new" girls get it at the change of season twice a year.


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## duckling (8 February 2018)

Im resurrecting this thread with a bit of an update (and another plea for help)...

I had Tonto blood tested again 5 weeks after his first test, to see if the changes of management had helped - he was put onto hay, in a smaller paddock with no plants, feeding just Topchop Zero and milk thistle, very light work... It thankfully seemed to be working. The results came back and levels had decreased significantly to a little above what they should have been. 

He seemed miles better in himself, and on vets instruction I slowly increased his work load and reintroduced his balancer whilst continuing to feed the milk thistle. He then began jumping out his paddock to join the horse next door - it started with being just odd occasions, then became a daily occurrence (this is not going down well with anyone, not least the person whos horse he is jumping in with...) 

I started to introduce haylage again - the reason being that his usual herd has haylage over winter and I was hoping I could put him back in with his pals and stop the fence hopping. 

(To be continued)...


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## duckling (8 February 2018)

He seemed fine, working well with lots more energy. Had another blood test just to check, and found out that the muscle enzymes are raised again... 

AST was 486 in Nov, now 513
CK was 777 in Nov, now 926

Vet has advised that I add Vitamin E and Selenium to his diet, and cutting back his exercise to 10 mins of walk & trot per day to start. 

She didnt say it, but after YBCM mentioned it before I read up and now Im thinking he might have PSSM... Im going to do the genetic test (although hes hogged, so hoping tail hair is ok?) and follow PSSM diet to see what happens. 

Firstly, hay or haylage...
I would love to put him back with his usual herd (out 24/7), who will have haylage until April. The farmer did get his haylage tested last year, and it was lower in sugar than the hay. However, if me introducing haylage again has caused this increase in levels, then obviously Ill keep him on hay and try to find ways to stop/live with the fence hopping... 

Hes currently on 2 large handfuls of Topchop Zero, a scoop of Saracens Shape Up, tbsp salt & milk thistle once a day. If I add the vitamin E and selenium, does this sound like a feasible diet for PSSM? What about Alcar?

Ive read so much the last few days that my brains gone into meltdown... Any help or advice much appreciated.

ETA this is the nutritional breakdown of the Shape Up:

Nutritional Info
Oil	         6.5%
Protein	10.0%
Fibre	16.5%
Digestible Energy	11.5 MJ/kg
Starch	8.5%
Vitamin A	        30,800 IU/kg
Vitamin D3	5,800 IU/kg
Vitamin E	        750 IU/kg
Selenium	         1.3 mg/kg
Sugar	8.9%


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## BBP (9 February 2018)

Just as an initial thought, the combined sugar and starch of shape up is over 16%. If your horse isnt too fussy you might be best switching to one with lower levels (the ones recommended for barefoot also seem to suit pssm, like equimins or forage plus). Then something like linseed to provide protein and healthy fats, and a low sugar chaff. Im sure a pssm expert will come along to correct me, I read up a lot on it when my horse was suspected of having it (also raised enzymes) but he was then diagnosed via biopsy with RER instead which has different requirements. I blood tested for vitamin e and selenium, my horse was deficient for vitamin e but fine for selenium so i only add vitamin e and not selenium.


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## missmatch (9 February 2018)

My horses ggt levels raised considerably on shape up. His last biopsy also showed fibrosis on his liver. His behaviour on shape up was also bewildering at best. I am not claiming the shape up caused that but I don&#8217;t believe it helped. He hasn&#8217;t been on it now for three months and his ggt level was near normal when last tested.


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## duckling (9 February 2018)

Interesting, thank you both. He is far from fussy, eats anything, so will look at switching him off the Shape Up. His chaff is unmolassed already.


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## SEL (9 February 2018)

PSSM 'expert' (cough) here & no doubt Casey76 will be along shortly when she's finished with the rather entertaining argument on the PSSM FB forum right now. Apparently all of our horses' problems are just because we aren't being tough with them and we need to learn to rope cows off their back. I'll be borrowing some off the local farmer this weekend 

Shape up looks a bit high in starch and sugar to me as well. In fact if you are having problems getting those enzyme levels down then whether it is liver or muscles I would pull back all feed to the very basics. Just hay as many PSSM horses don't do well on haylage despite the lower sugar levels. Haylage does have high digestible energy and horses tend to eat a lot more of it - so take in more sugar that way compared to hay. Plus if the enzymes went up on the haylage then I think you should play safe.

Until you've got this under control can you get away with just hay and maybe some chaff and speedibeet? High dose vitamin E (forage plus, equimins) and keep going with the milk thistle. Usually PSSM horses have oil added to their diet but given the liver history I wouldn't go down that route for now. I also would leave the Alcar out for the time being. 

Cheap to test at Animal Genetics and will rule in / out quickly.


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## duckling (10 February 2018)

Thank you SEL - thats so so helpful. 

Im off to talk to my YO today about the possibility of another pony from my horses old herd sharing my paddock and giving them both the hay. Hopefully this will stop mine jumping out! Fingers crossed she goes for it. 

Ive got my tweezers at the ready to take some tail hair, eek!


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## SEL (10 February 2018)

duckling said:



			Thank you SEL - thats so so helpful. 

Im off to talk to my YO today about the possibility of another pony from my horses old herd sharing my paddock and giving them both the hay. Hopefully this will stop mine jumping out! Fingers crossed she goes for it. 

Ive got my tweezers at the ready to take some tail hair, eek!
		
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I remember the tweezer exercise well. I did both horses at the same time and was paranoid about not getting a root on the hair. I was convinced I was sending them dandruff and lice!! Keep us posted.


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