Our expert says:
Ok. I cannot comment to much on this case as I have not conducted a clinical examination.
Generally if I detect a cardiac mumur I listen to see if there is pulmnary congestion of the lungs. I generally put the animal on Vetmedin and frusemide. If there is pulmonary congestion then you will hear the dog coughing. This could account for the exercise intolerance.
With regard to the liver/pancreas. Routine chemistry of the liver generally just looks at ALT and ALKP. ALT is liver specific in that it is elevated with hepatocyte damage (liver cells) - note it does not tell you the amount of damage nor does it tell you that anything regarding liver function - to access this you need to do other testing. The pancreatic enzymes can be elevated if there is hepatitis as the pancreas is in close proximity to the liver - however please note that the these results are not reliable and it maybe advisable to do a Pancreatic lipase immunoreactivity test (this is a far better test.
If failing this the best way in the hands of a an experienced clinician would be to do an ultrasound scan of the abdomen to see if there is anything unusual.
If your vet is on hoilday then get a referral to see another practice / medical specialist.
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