Interpreting senior cat blood work

Hi all. Daisy is 9 and usually very picky, but she's been eating less than usual. I took her in for routine bloods and the lab sent back a panel where her ALT is slightly high, but her BUN and creatinine are perfectly normal. The vet said it might just be stress from the car ride, but I'm worried. How do I interpret this? Is a single high liver enzyme something to panic about or just watch and wait?

I know I shouldn't diagnose myself, but the numbers are confusing. reference ranges for feline blood panels was helpful but I still don't know if this is a trend or a blip.

I work as a vet tech so I see a lot of these panels. In my experience, a single slightly elevated ALT with normal kidney markers is often noise, especially if the cat was stressed. Stress can spike liver enzymes transiently.

I would not panic. I would re-test in two weeks to see if it goes back down. re-testing single abnormal liver values covers this exact scenario. If it stays high or climbs, then we look at other causes. For now, keep an eye on her appetite and weight.

Was Daisy fasted before the blood draw? My vet insists on 8-12 hours no food for accurate results. Ziggy gets excited and paces, which messes up his numbers sometimes. fasting protocols for feline blood draws has a good chart on this. If she ate right before, that might explain the spike.

@ziggysdad I think she fasted, but I'm not 100% sure. The clinic rushed me in and out. I'll make sure to ask next time. @ptaylor I'm leaning towards waiting, but it's hard not to worry when she's a picky eater and I notice small changes. She did seem a bit anxious in the car, so maybe that is it.

I read symptoms of hepatic issues in senior cats and she doesn't have any of the yellowing or vomiting, just the lower appetite. Is that a good sign?

It is completely understandable to feel anxious, Holly. Daisy is lucky to have such a attentive owner. Since her kidney values are normal, that is a very good sign for her long-term health. Liver issues in cats can be tricky, but often they are manageable or transient.

I would definitely follow Pat's advice and re-test in a couple of weeks. In the meantime, you might look at dietary management for mild liver enzyme elevation to see if there are any gentle diet changes that support liver health without stressing her out. Keep her routine as calm as possible. If her appetite drops significantly or she stops eating entirely, that is when you call the vet immediately, as we discussed in temporary vs terminal loss of appetite in seniors.

Sending good thoughts to Daisy. It is a strange feeling when the numbers don't match how your cat is acting. My Olive has food sensitivities so I know how much the diet can affect blood work too. I hope the re-test comes back normal. Sometimes we just have to trust the process and keep enjoying their personalities while we wait for the results.