Elevated Level of Bilirubin in Dogs

Written By Grace Park
Published: 07/10/2017Updated: 07/07/2021
Veterinary reviewed by Dr. Linda Simon, MVB MRCVS
Elevated Level of Bilirubin in Dogs - Symptoms, Causes, Diagnosis, Treatment, Recovery, Management, Cost

What is Elevated Level of Bilirubin?

Bilirubin is produced from the breakdown of old red blood cells. It travels within the blood to the liver, where it is conjugated and mixed within the bile. Once this is complete, it is stored in the gallbladder until it is passed through the body through feces. Bilirubin is responsible for giving the stools their color, as the color of this substance is brownish to yellowish.

Bilirubin levels are important because it shows how much red blood cells are being broken down and are no longer needed. Bilirubin levels can alert veterinarians to many different health issues, so within the blood work your veterinarian may perform, this will be communicated to them via the results. When the level of bilirubin is too high, it may be a sign of liver problems. It may also be a sign of other health issues. 

Dogs with elevated levels of bilirubin may be checked for liver disease or other conditions related to his liver function. There are some diseases that cause rapid red blood cell destruction, and the veterinarian will check for these through blood work and serum panels.

An elevated level of bilirubin in dogs can be a result of a dog’s system breaking down red blood cells at an abnormal rate.

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Symptoms of Elevated Level of Bilirubin in Dogs

If your dog has elevated levels of bilirubin, this may be a sign that an underlying health condition is present. Symptoms your dog may be having include:

  • Yellow coloring of the eyes, gums, and skin (jaundice)
  • Lack of appetite
  • Lethargy
  • Excessive thirst
  • Vomiting
  • Diarrhea
  • Unusual coloring of urine
  • Change in overall behavior


There are several tests your veterinarian will run to check your dog’s liver function. There are different types of tests he will perform. These tests also check for the following types of enzymes:

  • Alanine transaminase
  • Gamma-glutamyltransferase
  • Alkaline phosphatase
  • Aspirate transaminase

Causes of Elevated Level of Bilirubin in Dogs

Causes of elevated levels of bilirubin in dogs may vary. There are several conditions in which this symptom occurs. Causes may include:

  • Autoimmune disorders
  • Toxins in the body
  • Infectious disease
  • Liver disease
  • Blockage of bile ducts
  • Red blood cell destruction

Diagnosis of Elevated Level of Bilirubin in Dogs

If you take your dog to the veterinarian and he notices, in the blood work, that your pet has elevated levels of bilirubin he will want to take a closer look.  The issue you took your dog to the veterinarian for may have caused the veterinarian to run a few tests. 

If your veterinarian determines that your dog has an elevated level of bilirubin, he may want to do additional exploration in order to see what the cause is. There are several different tests he will want to perform and look at to get to the main issue. 

Your veterinarian may take more blood tests to check for your dog’s liver values. He will check the level of other enzyme levels to see if the liver is showing signs of stress. Additional evaluation is necessary to find the specific cause of the increased bilirubin.

A urine sample will be analysed to assess the kidneys. The veterinarian may also perform imaging to check the liver size, as well as that of the gallbladder. Imaging may also check the gallbladder for gallstones. An ultrasound is performed to check the density of the liver, and the gallbladder may be further checked as well. 

The medical professional may choose to take a biopsy of the liver. This can determine which liver condition the patient has. A biopsy may be performed during exploratory surgery.

Treatment of Elevated Level of Bilirubin in Dogs

Treatment will depend on your dog’s diagnosis. Treatment may include:

Dietary Modification

For dogs with an illness of the liver, dietary modification may be needed. These are known as “liver supportive diets” and your veterinarian will explain to you what specific food your dog will need to eat. Your medical professional may also recommend a prescription diet for your companion as well as liver supportive supplements.

Medications or Supplements

Your veterinarian may recommend medications or supplements to aid in the treatment of the liver.  Supplements that can help your dog may be vitamins E, K, C, zinc, milk thistle, SAM-E and others. Medications and supplements will vary depending on your dog’s specific condition and his liver health.  

Other Medications

If your dog has other symptoms, such as ulcers or bleeding from his liver condition, medication can help. Ranitidine, omeprazole, and famotidine may be prescribed for your dog. The primary liver disease can be treated with medication that your veterinarian prescribes. Corticosteroids may be considered to help any inflammation while antibiotics will be given for infection.

Supportive Care

If your dog has a liver disorder, supportive care may help. Fluids will help with dehydration and restore electrolyte balance. There are medications, such as antacids, anti nausea medicine and appetite stimulants that often help. Your veterinarian will give you instructions on how to care for your dog over time in order to help manage his liver condition.

Blood Transfusion

If your dog has severe liver disease and low red blood cell levels, a blood transfusion may be needed. Some liver disorders cause severe bleeding and require fresh blood or fresh plasma in order to restore anaemia caused by the disease.


A liver mass or gallbladder mass can be treated with surgery. Your veterinarian will discuss optional surgical procedures for your companion, depending on his underlying condition.

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Recovery of Elevated Level of Bilirubin in Dogs

Recovery of any type of liver dysfunction or disease depends on your dog’s condition at time of diagnosis. Be sure to listen to your veterinarian’s advice and instructions on how to properly care for your dog at home. It is also very important to keep all future appointments with your veterinarian in order to understand how your dog’s liver is functioning and to determine if the treatments are making progress.

As with any disease, it is important to educate yourself on the condition affecting your dog, as well as the treatments that are being conducted. Being proactive in your dog’s liver condition can help you be more aware of what you can do as a loving dog owner to be sure your dog is not suffering. Every dog is unique, and their condition requires different types of at-home care.

Elevated Level of Bilirubin Questions and Advice from Veterinary Professionals


English Bulldog




6 Years


22 found this helpful


22 found this helpful

Hello! My 6.5 y/o English Bulldog Lilly began looming jaundice last weekend with decreased appetite. Took her to ER was admitted with bilirubin at 12, ALT liver enzymes over 3000 and another increased value. Lepto titer came back with values we could not distinguish between her vacc (due on 7/27 for new annual leptospirosis vacc) or a positive for lepto. PCR came back negative. She had an ultra sound done and only visible issues that were seen were fluid around the kidneys. The fluid was aspirated and evaluated as well as sent off to a lab to show no infection that was notable. Were seeing IM doctors at a specialty center but feeling so sad. We brought her home from the hospital thursday. Had a rough two days and shes been showing signs of appetite in the evening and playing. Bloodwork was done today (1 week from initial IM consult) and shows her ALT at 1400 (had dropped from over 3000 to 1100 upon discharge) and bilirubin up to 30 (from 20 at discharge on thursday). There is no longer fluid around the kidneys (which is great) but concerned about liver values. Doctor wants to do a follow up titer test to check for an increase. Shes currently on amoxicillin, enrofloxacin, mirtazipine (as needed), and maropitant. She jusy finished a 1 week cycle of metronidazole this morning. If lepto comes back positive, doctor would like to put her on doxycycline but will not without a positive result due to potential increase in liver enzymes. Any advice on where to go.

July 17, 2018

22 Recommendations

In a case like Lilly’s I don’t think I can add anything more than what your Internal Medicine Specialist is doing already, wait to see if there is any change in the titre and continually monitor bilirubin and ALT; I’m assuming that there is no issues with the gallbladder or biliary ducts after ultrasound. It is difficult to say specifically what is causing the increased bilirubin and ALT, but see how the levels go over the next few weeks since different enzymes peak and decrease at different times after liver injury. Regards Dr Callum Turner DVM

July 17, 2018

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3 Years


14 found this helpful


14 found this helpful

My pet has the following symptoms:
Red Urine
Discolored Urine
Possible Blood In Urine
Today, my medium poodle mix, Lucky, began peeing with what looked like blood. His entire urine was discolored bright red. This happened for the first time today and he didn’t seem to be in any pain. We took him to the veterinarian and they did blood work. Everything came out normal except they found high levels of bilirubin. His total bilirubin is 1.2 mg/dL and normal ranges 0.0-0.9 mg/dL. They also prescribed Enrofloxacin Tablets 68 mg, in the case that it’s blood in the urine caused by a UTI. They recommended an ultrasound to check his liver function and we are considering this option. Is there any information I should know to consider this option or anything I can do at home to prevent further symptoms?

June 25, 2018

Answered by Dr. Michele K. DVM

14 Recommendations

If Lucky's bilirubin is elevated, an ultrasound may be the next logical step to assess his liver structure. There isn't really anything to do at home for him other than give his medications as directed, and try to increase his water consumption. If he likes ices cubes, that can help to keep his urine more dilute.

June 25, 2018

To Lucky's Owner, this same exact thing happened to my German Short Hair Pointer, everything was high except for high bilirubin. The Dr. told us to stop feeding him onions (and mushrooms) which are apparently toxic to his red blood cells. I feel terrible but it has been 48 hours and he is now peeing regular urine and I assure you his onion (and mushroom) days are over.

June 25, 2018

R&M H.

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