Symptoms of cystitis first occured 2weeks before urinalysis. Urinalysis revealed numerous WBCs, RBCs, and bacteria. Amoxicillin failed to alleviate frequent urination, straining, and then dripping urine. Lateral radiograph revealed enlarged liver, several large kidney stones in 1 kidney and possibly 1 small stone in the urinary bladder. Subsequent bloodwork = increased alkaline phosphatase, other blood chemistries normal, CBC normal.
A low dose dexamethasone suppression test was performed due to increased alk. phos. suspecting cushings disease but was negative for cushings.
My question(s) Is there any correlation between an increased alkaline phosphatase and kidney stones? And if there is no correlation what other causes for increased alk. phos?
What would be the next step as far as diagnostics.
In conclusion I will tell you that the above information refers to my 12 year old female/spayed dog. I am hopeful that this does not hinder my chances for an answer to my questions. I am curious to any and all information i can gain. Most often human conditions, medications, and treatments are very similar, if not the same. If need be please answer the questions as if they were referring to a "theoretical human patient" Thank you
I am going to answer this question as if it applies to a human. I claim no veterinary knowledge.
I am not aware of a direct connection between kidney stones and an increased alkaline phosphatase.
Alkaline phosphatase normally comes from the liver or the bones. A GGT level can be done to determine the source (i.e. elevated GGT suggests a liver source). Bone diseases can include bone growth, healing fracture, acromegaly, osteogenic sarcoma, liver or bone metastases, leukemia, myelofibrosis, and rarely myeloma.
Regarding liver causes, the most common causes include partial bile duct obstruction, primary biliary cirrhosis (PBC), primary sclerosing cholangitis, adult bile ductopenia, and certain drugs such as androgenic steroids and phenytoin. Infiltrative diseases include sarcoidosis, other granulomatous diseases, and less often unsuspected cancer metastatic to the liver.
Next step would be a liver ultrasound as well as an AMA (anti-mitochondrial antibody - suggestive of primary biliary cirrhosis). This can be discussed with your personal physician.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
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