• Although alkaline phosphatase is considered a “liver enzyme,” it is produced by other cells, too.
• Alkaline phosphatase levels can be affected by many things, including certain medications and a variety of illnesses.
• If your pet’s alkaline phosphatase level is abnormal, additional tests may be recommended to determine the cause.

​What Is Alkaline Phosphatase?
Alkaline phosphatase (ALKP) is an enzyme that is produced by many cell types. Although it is considered a “liver enzyme,” it is mostly made by the liver and bones.
The ALKP level is an important part of a blood screening test (known as a chemistry panel), so it is often evaluated during routine wellness checkups or pre-surgery screening in healthy pets.
Because a variety of illnesses can affect the ALKP level, your veterinarian may recommend testing your pet’s ALKP level if your pet has any of the following signs of illness:

• Vomiting
• Diarrhea
• Appetite loss
• Lethargy (tiredness)
• Increased drinking and/or urination
• Weight loss or weight gain
• Abdominal pain or enlargement 

How Is the Alkaline Phosphatase Level Measured?
To test your pet’s ALKP level, your veterinary team must obtain a small blood sample. This procedure is usually very quick; it may take only a few seconds if the patient is well behaved. For patients that are very frightened or not well behaved, your veterinary team may want to use a muzzle, towel, or other gentle restraint device. In some cases, such as in patients with very thick fur, it may be necessary to shave the hair from the area where blood will be drawn. The hair will grow back, and this is often a good way to find the vein quickly.

Sometimes, blood can be drawn in the examination room because some pets are comforted and well behaved when their owners are present. However, some pets are more excited and unruly when their owners are present, so your veterinarian may recommend that your pet be taken into a separate treatment area for blood to be drawn.

Some veterinary offices have in-house blood analysis equipment, so they can perform the test for ALKP in the office and have results the same day. Other offices send blood samples to an outside laboratory for the test to be performed. If an outside laboratory is used, results are generally available within 1 to 2 days. 
Because a recent meal changes the blood and may affect the ALKP level, your veterinarian may recommend that your pet not eat for 12 hours before drawing blood to perform the test. In most cases, you can still give your pet water. Please let your veterinarian know if this temporary fast will be a problem for you or for your pet.

Be sure to tell your veterinarian about any medications or supplements your pet may be receiving, as some products can alter the ALKP level.  

What Does the Alkaline Phosphatase Level Tell Your Veterinarian?
Many factors can affect the ALKP level. Certain medications, such as steroids, can cause this level to increase. Additionally, a variety of medical conditions can affect the ALKP level. 
There are no significant medical conditions that cause the ALKP level to be too low. Most of the conditions that affect this enzyme cause the blood level to become elevated. The following are a few conditions that cause an elevated ALKP level:

• Rapid growth (young animals)
• Pancreatitis (inflammation of the pancreas)
• Gall bladder disease
• Hepatitis (inflammation of the liver)
• Liver failure
• Cancer affecting the liver or bones
• Hyperadrenocorticism (Cushing’s disease)
• Diabetes
• Toxic injury to the liver

If your pet has an abnormal ALKP level, your veterinarian will combine that information with other vital information about your pet to decide if further diagnostic testing is recommended to investigate the abnormal result. Depending on your pet’s overall condition, your veterinarian may recommend medications, diet therapy, or other management.

If your pet has a history of having an elevated ALKP level (with or without signs of illness), your veterinarian may recommend rechecking the level at some point to monitor whether it is changing. Additional testing may be advised if the level does not return to normal.

Are There Risks Associated With Testing the Alkaline Phosphatase Level?
There are very few risks associated with testing the ALKP level. Drawing blood takes only a few seconds, and your veterinary team will take precautions to ensure that your pet is not injured during this procedure. Once blood is obtained, all further processing is performed at the veterinarian’s office or at a diagnostic laboratory, so there is no risk of harm to your pet.   

• Allergy testing is most commonly performed to determine if a pet has atopy, also known as atopic dermatitis or allergic inhalant dermatitis.  
• Allergy tests can help identify the specific allergens causing a pet’s allergy problem. Once a list of “problem” allergens is identified, a specialized serum containing small quantities of these allergens can be formulated specifically for your pet.
• Allergy testing poses minimal risk for your pet, and in many cases the information your veterinarian gains from this testing is invaluable.

​What Allergies Can Pets Have?
The most common types of allergies in pets are flea allergy, food allergy, and a condition called atopy. Atopy is sometimes called atopic dermatitis or allergic inhalant dermatitis, and it occurs when allergens that are inhaled or that contact the skin cause an allergic reaction in the body. In dogs (and, less commonly, cats), this allergic reaction is focused largely in the skin. Animals with atopy become very itchy; the resultant scratching can lead to skin injuries and subsequent skin infections. Atopy is usually first noticed in dogs younger than 3 years of age, although older pets can also be affected. Unfortunately, some pets that develop atopy continue to have problems throughout their lives.
​  
Many types of allergens can cause a pet to develop atopy. A wide variety of pollens, grasses, dander, insect proteins (such as in cockroaches), molds, and even house dust can cause animals to develop atopy. Animals can even develop allergies to multiple allergens at the same time. Once an animal develops atopy, the condition will continue as long as the animal is exposed to the allergen that is the source of the problem.

How Is Allergy Testing Performed?
Allergy testing is most commonly performed to determine if a pet has atopy. Allergy testing can also help diagnose flea allergy dermatitis. Most veterinarians do not use allergy testing to diagnose food allergies.
The two most common types of allergy tests used in pets are intradermal skin testing and serum allergy testing:

Intradermal skin testing: Intradermal skin testing can sometimes be performed at your veterinarian’s office. However, because the allergens used for this test are very specific (they vary depending on where you live), your veterinarian may refer you to a veterinary dermatologist for this test to be performed. Usually, an area of fur is shaved from your pet’s side or abdomen to expose enough skin to perform the test. Using very small needles, tiny amounts of each test allergen are injected just under your pet’s skin in different areas. After a brief waiting period, the injection sites are examined to measure the degree of local allergic response, such as redness or a small hive. Allergens that your pet is not allergic to will not cause a reaction, while allergens that your pet is allergic to will cause a reaction that corresponds to the severity of the allergy. Pets are monitored carefully during the procedure in case a serious reaction occurs and treatment is required.

Serum allergy testing: Serum allergy testing is performed at a laboratory using a small blood sample taken from your pet. Your veterinarian does not need to shave your pet or have special allergens on hand to perform this test. As with intradermal skin testing, the results of serum allergy testing can reveal which allergens are not causing an allergic reaction in your pet, which ones are causing a mild reaction, and which ones are causing a more serious reaction.

Depending on which type of allergy test is performed, you may need to discontinue your pet’s allergy medications for a period of time before the test. Otherwise, the test results may be affected. Your veterinarian will tell you which medications can be used and which ones may need to be discontinued.

What Does Allergy Testing Tell Your Veterinarian?
Allergy tests can help identify the specific allergens that may be at the root of a pet’s atopic dermatitis. Once a list of “problem” allergens is identified, a specialized serum containing small quantities of these allergens can be formulated specifically for your pet. Through injection of small amounts of the allergy serum over time, many pets experience a reduced response to the allergens. This treatment, called immunotherapy, generally must be continued for several months to years to achieve results. With immunotherapy, the pet owner usually administers the allergy serum injections at home. If you are uncomfortable giving the injections, ask your veterinary care team if the injections can be given at your veterinarian’s office. The first injections are more diluted, containing only tiny amounts of the problem allergens; each subsequent injection solution contains a slightly higher concentration of the allergens. Your veterinarian will schedule the injections according to specific guidelines—more frequently in the beginning, and eventually tapering to one injection every few weeks. Many pets respond to this program. Others may not, especially if they have other underlying conditions. 

Is Allergy Testing Safe?
Very few risks are associated with performing allergy testing. If serum allergy testing is performed, drawing blood takes only a few seconds, and your veterinary team will take precautions to ensure that your pet is not injured during this procedure. Once blood is obtained, all further processing is performed at the veterinarian’s office or at a diagnostic laboratory, so there is no risk of harm to your pet.
   
If intradermal skin testing is performed, there is a slight risk of an allergic reaction if your pet responds seriously to some of the allergens being tested. However, pets are monitored very closely during the testing procedure, and if a reaction occurs, medications can quickly be administered to treat the problem.
In general, allergy testing poses minimal risks for your pet, and in many cases, the information your veterinarian gains from this testing is very valuable.

• Rabbits require daily interaction with, and affection from, their owners.
• If a rabbit’s weight is not supported during handling, its back can be injured.
• Rabbits need to chew to maintain their physical and psychological health.
• Commercially available pelleted feeds can provide good nutrition at a reasonable cost but often do not have an adequate fiber content.
• Rabbits produce two types of droppings. One is firm; the other is soft. Rabbits eat the soft type of feces, which supplies protein, vitamins, and other nutrients.
• Rabbits that are kept outdoors in temperature extremes must have a shelter that is heated in winter and cooled in summer.
• Frequent removal of waste is important for preventing respiratory disease in rabbits.
• When your rabbit is outside the cage, he or she must be supervised and/or contained in a safe play area.
• Spayed and neutered rabbits have fewer health problems (related to reproduction) and are better adjusted, less territorial, and easier to litter train than intact rabbits.

​A clean, roomy cage and a nutritious diet are important to keeping your rabbit healthy and happy. Also important is the time you spend interacting with your rabbit: a bored and lonely rabbit can become destructive and even aggressive. Providing the interesting surroundings and companionship that your rabbit needs can help him or her be well adjusted and affectionate.

Handling
To pick up and hold your rabbit, grasp the loose skin over the shoulders with one hand while supporting the rump (and the rabbit’s weight) with the other hand. If a rabbit’s weight is not supported during handling, its back can be injured. Because rabbits can be fragile, they may not be suitable pets for young children.

Chewing
Rabbits need to chew to maintain their physical and psychological health. Provide your rabbit with a variety of chewable items, such as commercial chew toys that have been developed for rabbits. This can help prevent boredom and wear down the teeth, which constantly grow throughout life.

Diet
Rabbits are plant eaters (herbivores). Here are some guidelines for your rabbit’s daily menu:

• Feed unlimited quantities of fresh, green, dust-free, and mold-free timothy hay, brome, or other grass hay. This is crucial for keeping your rabbit’s intestinal tract healthy. Alfalfa can be fed to rabbit kits and, in restricted amounts, to full-grown rabbits.
• Feed high-quality food pellets formulated for rabbits. The pellets should have at least 15% to 19% protein and 18% fiber and should be fresh and plain, without seeds, nuts, or colored tidbits. Until your rabbit is full grown (around 6 months of age), he or she can have unlimited pellets. After that, pellets should be limited to 1/8 to 1/4 cup per day per 5 pounds of body weight. Pelleted feeds should be stored in an airtight container and kept cool and dry to prevent destruction of vitamins.
• Feed dark-green leafy vegetables (such as romaine lettuce, spinach, collard greens, parsley, cilantro, basil, mustard greens), which provide the fiber necessary to keep your rabbit's gastrointestinal system working properly. A minimum of 2 cups per 6 pounds of body weight is recommended. The following should be fed in restricted amounts: turnip greens, broccoli leaves, spinach, kale, and collard greens.
• Feed small amounts of fruits, such as apples (remove all seeds), pears, strawberries, peaches, raspberries, blueberries, and pineapple.
• Because fruits and vegetables with a high water content (such as cucumbers and grapes) may cause diarrhea, feed them to your rabbit in small quantities only.
• The following are toxic to rabbits: beans, rhubarb, potatoes, chocolate, corn, cauliflower, cabbage, apple seeds, philodendron, lily of the valley, calla lily, azalea, aloe. 
• Provide fresh, clean water in a bottle.

Housing
Rabbits may be housed indoors or outdoors, but prolonged exposure to temperatures above 80°F (26°C) can cause illness, including heat prostration. Domesticated rabbits should not be kept in temperatures below 50°F (15°C). Rabbits that are kept outdoors in temperature extremes must have a shelter that is heated in winter and cooled in summer.

Your rabbit will appreciate as large a cage as you can provide. The cage should be tall enough to allow your rabbit to stand up on his or her hind legs and long enough to allow your rabbit to hop at least three and a half times, but an even larger cage is better. The cage should allow room for a food dish, a water bottle, a large litterbox, and toys. It should have a nonslip floor. Straw or shredded paper covered with straw or hay can be used as bedding. Your rabbit also needs a soft blanket or pad on which to sleep. The cage and its contents should be periodically sanitized with a disinfectant such as household chlorine bleach diluted to 1 ounce per 1 quart of water. After cleaning the cage, rinse it well and make sure it is dry before returning your rabbit to it.

The litterbox should be filled with a rabbit-safe litter such as one made of alfalfa, oats, citrus, or paper. Unsafe litters include those that clump or that are made of cedar, pine, or clay. Frequent removal of waste is important for preventing respiratory disease in rabbits. The litterbox should be emptied and disinfected once a week.

The Play Area
A large cage is no substitute for daily time outside the cage. As you introduce your rabbit to his or her play area, start with a small area and gradually enlarge it. This will help your rabbit learn where to find the litterbox. A small room is a good place to start. Over time, you can expand the play area to include several rooms, if desired.

Rabbits are curious explorers by nature and chew on almost anything, including electric cords, wood furniture, books, and carpet. Rabbit-proofing the play area can help keep your rabbit—and possessions—safe. Tactics for effective rabbit-proofing include covering electric cords with conduit or tubing, blocking access to favorite targets of chewing, and spraying table legs with bitter apple. When your rabbit is outside of the cage, he or she must be supervised and/or contained in a safe play area. A large puppy pen can be an ideal playpen for an unsupervised rabbit. To keep your rabbit from damaging your valuables, provide more attractive alternatives, such as approved rabbit-safe toys, a box filled with paper to shred, or cardboard tubes from paper towel rolls.

Grooming
Rabbits frequently groom themselves and swallow their hair, which is usually eliminated in their droppings. However, rabbits can develop hairballs that block digestion or cause other problems. To help prevent hairballs, regularly brush your rabbit with a soft brush. Long-haired rabbits require daily brushing; short-haired rabbits should be brushed at least twice a week. Extra brushing may be required during shedding (every 3 months). To help your rabbit pass a hairball, you can offer fresh or frozen pineapple juice once or twice a day for 3 days; canned pineapple juice is not as effective because the canning process destroys an enzyme in the juice.

Veterinary Care
Spayed and neutered rabbits have fewer health problems (related to reproduction) and are better adjusted, less territorial, and easier to litter train than intact rabbits. Pet rabbits that have been spayed or neutered early in life and well cared for can live for up to 10 years.

Pet rabbits should be taken for an annual veterinary checkup. Rabbits don’t require routine vaccinations.
If your rabbit shows any of the following signs of illness, contact your veterinarian immediately:

• Discharge from the eyes and nose
• Drooling
• A lack of energy
• Loss of appetite and weight
• Diarrhea or no droppings for more than 12 hours
• A lack of normal movement
• Trouble breathing
• Fur loss and red, swollen skin
• Dark red urine

Routine Rabbit Care Schedule

Daily

• Provide fresh food and water
• Allow supervised exercise and play outside of the cage
• Brush long-haired rabbits
• Scoop out the litter-box

Twice a Week

• Brush short-haired rabbits

Once a week

• Clean and disinfect the cage and its contents
• Provide fresh bedding

Once a year

• Go for a veterinary checkup

​As needed

• Provide new chew toys