In humans, serum miR-122 elevation precedes ALT increase in hepatic injury, making it an earlier biomarker of disease.21 Vliegenthart et al23 reported in humans with acetaminophen-induced acute liver injury that miR-122 had better specificity than other current biomarkers and better predicted the clinical course of disease than ALT alone.21,24 Of the few available miR-122 studies in companion animals, miR-122 has been demonstrated to increase in dogs with liver disease.20,25,26 Dirksen et al25 found miR-122 to be more sensitive for the detection of hepatocellular injury than ALT. Here, GPT is linked to liver disorder.