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Old 03-23-2013, 01:45 PM   #1
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Default Bile Acids Panel Test

I had my vet run some tests on Maya to try to figure out why her stools are lately soft and with traces of mucus. She also was losing her appetite and sleeping a lot. Everything came back normal except the BAPT the results were
34.7 resting and 45.5 post prandial. The vet diagnosis is possible microvascular dysplasia (mvd) I did a search on the internet and found that it can be treated with diet. Anybody has experience with this? The vet wants to run more tests to rule out liver shunt before changing anything. Other than the soft stools she seems like a normal puppy to me. She's 3pounds at 19 weeks. This makes me so sad any suggestions on what to do will be appreciated.
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Old 03-23-2013, 02:12 PM   #2
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Charlie has MVD and does well on the low protein diet (Royal Canin Hepatic) and meds (Lactulose and Flagyl daily) it is a very good idea to do the testing to check for an actual shunt, while the symptoms may be few it can go very badly if you arent treating the actual problem. Many members here have shunt babies so you will get allot of very good advise Do your research make sure to take questions with you to the vets office. I imagine that if they havent already they will want to do an ultrasound and unless they specialize in liver shunts they should refer you to a specialist. Keep us updated.
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Old 03-25-2013, 05:24 AM   #3
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Bumping and moving this thread to Sick/Emerg.
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Old 03-25-2013, 05:49 AM   #4
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I would ask about a referral to a board certified internal med specialist. You do need to find out if there is a liver shunt. A definitive diagnosis cannot be made based on the results of one bile acid test. Your vet is right about wanting to do further testing. Not so sure about the diet....I would think that should be changed now.
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Old 03-25-2013, 03:35 PM   #5
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She is still pretty young and mucous stools with blood in it does not mean MVD or Liver shunt. She could have an intestinal upset and may just need an antibiotic, usually metrondiazonal is prescribed. An inflammed bowel or putting them on an antibiotic will cause an elevated Bile Acid reading and mislead you into thinking mvd or LS. Has she been wormed for any intestinal parasites? they are not always shed until the worming and then you can see them come out a day or two later.
Are there symptoms of MVD or Liver shunt? A soft mucousy stool is not enoug to suspect it although Vets of 20 years ago jumped to that conclusion. Head pressing, anarexia, circling would be LS symptoms. MVD are not usually that dramatic.
The only definitive way to know for sure liver shunt is with colour doplar where dye is injected into the circulation to the liver and ultra sound is used to track the dye. BA's are too randomly wrong. Stress of blood draws, incorrect blood draws, other illnesses, recent medications especially the sulpha group will all produce a high BA that is a false reading.
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Old 03-25-2013, 03:49 PM   #6
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Quote:
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She is still pretty young and mucous stools with blood in it does not mean MVD or Liver shunt. She could have an intestinal upset and may just need an antibiotic, usually metrondiazonal is prescribed. An inflammed bowel or putting them on an antibiotic will cause an elevated Bile Acid reading and mislead you into thinking mvd or LS. Has she been wormed for any intestinal parasites? they are not always shed until the worming and then you can see them come out a day or two later.
Are there symptoms of MVD or Liver shunt? A soft mucousy stool is not enoug to suspect it although Vets of 20 years ago jumped to that conclusion. Head pressing, anarexia, circling would be LS symptoms. MVD are not usually that dramatic.
The only definitive way to know for sure liver shunt is with colour doplar where dye is injected into the circulation to the liver and ultra sound is used to track the dye. BA's are too randomly wrong. Stress of blood draws, incorrect blood draws, other illnesses, recent medications especially the sulpha group will all produce a high BA that is a false reading.
Just want to say that there are not always symptoms. My Teddy Bear who I have had for 7 years just had surgery for LS. He developed bladder stones and during that surgery they found the shunt. Teddy never had one symptom and had seven years of perfectly normal blood tests.
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Old 03-25-2013, 04:01 PM   #7
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I will also point out that 16wks is the preferred age to run BATS. And then a repeat at six months.

At this point I agree with the vet that more tests should be run, especially if there is no history of medication that can effect the liver values.

I agree with Linda that a referral to a specialist is warranted. Let them do the specialized testing, they should have the skills and the equipment necessary to give the best opinions.

To the OP, many threads on here about LS. There is also a Yahoo LS support group. Also often times I have heard that scintography is the best diagnostic tool for diagnosing extra hepatic shunts.

But first is not to panic. There probably is no harm in switching to a liver diet; but ask your vet first.

Also if you do decide to go with extra testing at your vet's, make sure by inquiring that any testing done at the general vet's will NOT have to be repeated at the specialist's.
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Old 03-25-2013, 07:43 PM   #8
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Stool with blood and mucous is also a symptom of coccidia.
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Old 03-26-2013, 03:11 AM   #9
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Quote:
Originally Posted by Lorraine View Post
She is still pretty young and mucous stools with blood in it does not mean MVD or Liver shunt. She could have an intestinal upset and may just need an antibiotic, usually metrondiazonal is prescribed. An inflammed bowel or putting them on an antibiotic will cause an elevated Bile Acid reading and mislead you into thinking mvd or LS. Has she been wormed for any intestinal parasites? they are not always shed until the worming and then you can see them come out a day or two later.
Are there symptoms of MVD or Liver shunt? A soft mucousy stool is not enoug to suspect it although Vets of 20 years ago jumped to that conclusion. Head pressing, anarexia, circling would be LS symptoms. MVD are not usually that dramatic.
The only definitive way to know for sure liver shunt is with colour doplar where dye is injected into the circulation to the liver and ultra sound is used to track the dye. BA's are too randomly wrong. Stress of blood draws, incorrect blood draws, other illnesses, recent medications especially the sulpha group will all produce a high BA that is a false reading.
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Old 03-26-2013, 03:28 AM   #10
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Yes, that is why the vet suggested other tests before changing anything. Nonetheless, I would still go to a specialist if it were my pup.
Symptoms are not used to diagnose nor is just one test.
Maya may be just fine, but further testing is definitely in order.
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Old 03-26-2013, 03:36 AM   #11
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Did you chage her diet or give her any chew treats? I gave Jessie some made in the usa bully sticks and a couple days after (I always kept it in a plastic bag and even cut the ends off) she developed loose mucous stools. I stopped all treats, threw away the bullies and on the advice of another wonderful yorkie mom to peanut here fed her boiled chicken wth either a little pumpkin or sweet potato for 5 days. Withing 2 days all loose stools and mucous were gone. Shes full of energy and stools are normal. I have now returned her to her royal canin with a little wet wellness and her treats are now only boiled chicken. Shes great...
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Old 03-26-2013, 06:49 AM   #12
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Thanks to all for your responses. She's doing well the vet gave her a pill to treat for worms just in case and metrondiazonal twice a day for 5 days. She's eating her kibble and is full of energy also her stools are fine now. I'm so happy, the vet wants to wait 6 months before doing the BAPT again. I was going to have her spayed next month but decided to do it around 8 months when her adult teeth are all in that way they can take out any retained puppy teeth at the same time.
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Old 03-26-2013, 07:37 AM   #13
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Quote:
Originally Posted by ladyjane View Post
Yes, that is why the vet suggested other tests before changing anything. Nonetheless, I would still go to a specialist if it were my pup.
Symptoms are not used to diagnose nor is just one test.
Maya may be just fine, but further testing is definitely in order.
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Old 04-01-2013, 06:10 AM   #14
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Default Update on Zoey

We got our results on Zoey (9 1/2 yrs. old) Friday and she has an acquired liver shunt. I have heard of liver shunt in yorkies for years but never an acquired shunt. We have her on 3 meds and the vet tells us that dogs can be maintained on special diets and meds now and don't always have to have
surgery, especially older dogs or weaker dogs who wouldnt make it through the surgery. This is the vet that Zoey's owner has used since she was a puppy and I don't think he was surprised by this. Her owneer was quite ill herself before passing away last year so I doubt he ever discussed Zoey's condition with her for that reason. Anyone else maintain one on meds and diet and have good success. Zoey seemed sedated a lot of the time but I am sure this is to keep her from seizing. Will she always have to be this sedated? Thanks for any info.



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Old 04-01-2013, 07:09 AM   #15
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Quote:
Originally Posted by Julia Howard View Post
We got our results on Zoey (9 1/2 yrs. old) Friday and she has an acquired liver shunt. I have heard of liver shunt in yorkies for years but never an acquired shunt. We have her on 3 meds and the vet tells us that dogs can be maintained on special diets and meds now and don't always have to have
surgery, especially older dogs or weaker dogs who wouldnt make it through the surgery. This is the vet that Zoey's owner has used since she was a puppy and I don't think he was surprised by this. Her owneer was quite ill herself before passing away last year so I doubt he ever discussed Zoey's condition with her for that reason. Anyone else maintain one on meds and diet and have good success. Zoey seemed sedated a lot of the time but I am sure this is to keep her from seizing. Will she always have to be this sedated? Thanks for any info.



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Personally, I would get a second opinion from a board certified internist.

a link that might help you regarding "acquired shunts"

http://www.vet.utk.edu/clinical/sacs/shunt/faq.php

Last edited by ladyjane; 04-01-2013 at 07:11 AM.
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