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Old 10-10-2014, 10:52 AM   #1
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I dropped lilah off for her comprehensive yearly exam this morning. I am on my way to pick her up, they just called and told me when her blood work came back her liver enzymes were slightly elevated and tha the rest of the blood work looked good. The next step is a bile acid test and it sounds like we will do that Monday, my concern is that the tech I spoke wth said that the dr had medications that can help her. Shouldn't we do the bile acid test first??? If we don know what it is should we just hop on medication? I'm kind of freaking out, I guess I will know more when I get there but I thought I would shoot this out to the yorkie talk sky so there is a possible chance of some replies accumulating by the time I have more information to share. I am so sad and nervous
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Old 10-10-2014, 11:04 AM   #2
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Originally Posted by Lilah Charm View Post
I dropped lilah off for her comprehensive yearly exam this morning. I am on my way to pick her up, they just called and told me when her blood work came back her liver enzymes were slightly elevated and tha the rest of the blood work looked good. The next step is a bile acid test and it sounds like we will do that Monday, my concern is that the tech I spoke wth said that the dr had medications that can help her. Shouldn't we do the bile acid test first??? If we don know what it is should we just hop on medication? I'm kind of freaking out, I guess I will know more when I get there but I thought I would shoot this out to the yorkie talk sky so there is a possible chance of some replies accumulating by the time I have more information to share. I am so sad and nervous

Don't panic, organize your thoughts, and then simply ask the question if this medication will affect in any way the results of a Monday BATS test.


The vet tech might be speaking in generalities, don't worry, we have some meds here to help right the liver if that is indicated.


How old is Lilah?
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Old 10-10-2014, 11:05 AM   #3
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One more thing ((((((Hugs to you))))))))))
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Old 10-10-2014, 12:05 PM   #4
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One more thing ((((((Hugs to you))))))))))
Thank you for your hugs Gemy, they mean a lot and you are always so sweet.

Just got out of the vet. Lilah's liver enzymes are more than 'slightly' elevated, they were at 570 (when she was shooting for under 100). Lilah is almost two, does not vomit or display strange behaviors on a semi regular or regular basis, additionally he has had no change in her behaviors. I asked if the elevated enzymes could reflect that lilah had possibly gotten into a toxin even though she was not displaying any indacative behaviors, she said that was a possibility. When I asked if she could have be asymptomatic and have an undiagnosed liver shunt, she said that would be very unlikely. She said that bile acid tests are usually ran to diagnose liver shunt and that based on behavior, age and history that she did not feel that a bile acid test was the thing to do at this time. The medication she prescribed lilah is called a nutrisutical (like a vitamin? A probiotoc? A digestive aid?) it is called Adenosyl. I will be looking that up. She recommended that lilah take this pill for thirty days and then we re check her enzyme levels and hopefully it was a random thing.
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Old 10-10-2014, 01:05 PM   #5
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I don't have any knowledge in this area, but I wanted to offer my support and well wishes for Lilah and you. Praying her liver enzyme test results will be normal when she is re-tested.
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Old 10-10-2014, 01:38 PM   #6
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Well okay, thanks so much, and I am sure you are glad to have her home with you!


As you know BATS do not definitively ddx Liver Shunt but is a good sign post along the diagnostic way. High results especially very high results gear or lean towards liver shunt, but then more diagnostic and more expensive tests like a scintography need to be done to affirm and see that liver shunt.


We have multiple threads on here about best practices with diagnosing and treating liver shunt, should the prelim results point that way. Univ of Tennessee as you know is a premiere leader in the field of the research, testing and surgery for LS.


I am not familiar with that drug your vet prescribed, and I am sure by now you have looked it up. But it sounds like your vet is doing a conservative treatment approach, which is probably good, as Liver values can be skewed for so many reasons.


When Magic had skewed values from the general blood test, we went with an expanded liver panel about a week later. Then everything tested normal and has had since 4 yrs later and 4 more blood work ups on his annual exams. I wasn't as worried for him, as a BRT I have never heard of a case of LS or MVD with this breed.


Hang in there, do the meds and I do know how hard wait and see is, but try to be patient and just enjoy each day with your pup!
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Old 10-10-2014, 02:09 PM   #7
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I hope Lilah will be ok. http://www.yorkietalk.com/forums/sic...questions.html
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Old 10-10-2014, 03:49 PM   #8
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I'm sorry about Lilah's elevated liver enzymes! I know it has you worried but hopefully it is a random thing. Sending prayers for your little one.
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Old 10-10-2014, 06:18 PM   #9
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I am just seeing this. . . I am not knowledgable in this area. Maybe Linda might be able to give you some insight. . . Galen and I are think about you and Lilah ! We hope that they are able to find out and treat her. So she can be back to her sweet little self . . Big hugs and lots of love. . xoxoxo
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Old 10-10-2014, 06:28 PM   #10
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Thank you very much for your warm wishes ladies. I also really appreciated that link Jenny

Sounds like (as is noted in jenny's link) the medication is considered to be a nutritional supplement - the dr said it was the most 'hippy dippy' thing they had, lol- to support liver function. Her first pill will be tommorow morning one hour before her first meal and we will retest on November seventh. If her enzymes are still high at that time then she said she would like to use ultrasound to examine the liver.

I will be crossing my fingers that this was a temporarily incited elevation and that her levels will be normal at the next blood work- thanks again for all of your warmth and support I will update as it goes
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Old 10-10-2014, 07:27 PM   #11
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Try not to get too upset over this. Liver enzymes are often elevated for unknown reasons. The number you gave sounds to me like it was the ALT ... 540 is high, but I have seen much much higher results in my pups. Recently I had a pup with 7,500. He was hospitalized and diagnosed with cholangiohepatitis. He was placed on antibiotics and he is fine now. We had his levels checked yesterday and the ALT was 100. It can go up quickly and also go down quickly. He is also on Denamarin which is similar to the Denosyl you have been given.

Hopefully she will have normal levels when you go back. The liver support is a good thing to do.

If you have any questions or concerns, feel free to message me. Please keep us posted!

Oh and BTW, often liver shunts are asymptomatic. I was not aware of that until last year when my Teddy Bear was diagnosed with one after I had him for 7 years. He had blood work every year and never had one elevation in anything! And, did not have any obvious symptoms...so it does happen! Not saying Lilah has one....just commenting on the fact that it can happen!
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Old 10-10-2014, 08:18 PM   #12
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Try not to get too upset over this. Liver enzymes are often elevated for unknown reasons. The number you gave sounds to me like it was the ALT ... 540 is high, but I have seen much much higher results in my pups. Recently I had a pup with 7,500. He was hospitalized and diagnosed with cholangiohepatitis. He was placed on antibiotics and he is fine now. We had his levels checked yesterday and the ALT was 100. It can go up quickly and also go down quickly. He is also on Denamarin which is similar to the Denosyl you have been given.

Hopefully she will have normal levels when you go back. The liver support is a good thing to do.

If you have any questions or concerns, feel free to message me. Please keep us posted!

Oh and BTW, often liver shunts are asymptomatic. I was not aware of that until last year when my Teddy Bear was diagnosed with one after I had him for 7 years. He had blood work every year and never had one elevation in anything! And, did not have any obvious symptoms...so it does happen! Not saying Lilah has one....just commenting on the fact that it can happen!
Thank you so much for your response Linda , I really appreciate your experience and am trying not to over react until we have had some time to re evaluate. I am glad to have the knowledge that liver shunt can actually be asymptomatic but gosh I hope that's not the case for lilah! We did talk about the hepatitis concern but looking at the levels the pup you worked with had and lilah's elevation perhaps that is why the dr didn't think that was the issue? That is a vast difference! I will have to do some reading about what other symptom presentation I would be looking for with that. I am also reassured about the supplement she is starting and I really hope that at her retest her levels are normal.

I really appreciate the outpouring of support and well wishes for lilah, it means a lot to me and Teri- you are a sweetheart
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Old 10-10-2014, 09:09 PM   #13
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Thank you so much for your response Linda , I really appreciate your experience and am trying not to over react until we have had some time to re evaluate. I am glad to have the knowledge that liver shunt can actually be asymptomatic but gosh I hope that's not the case for lilah! We did talk about the hepatitis concern but looking at the levels the pup you worked with had and lilah's elevation perhaps that is why the dr didn't think that was the issue? That is a vast difference! I will have to do some reading about what other symptom presentation I would be looking for with that. I am also reassured about the supplement she is starting and I really hope that at her retest her levels are normal.

I really appreciate the outpouring of support and well wishes for lilah, it means a lot to me and Teri- you are a sweetheart
I didn't share Teddy Bear's story to scare you. The point is that an elevated ALT does not mean LS. I have had so many pups over the years with elevations of their ALT....Teddy Bear is the only LS pup I have ever had and his ALT was not elevated! So, hopefully that might put your mind at ease.
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Old 10-11-2014, 12:45 PM   #14
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Thank you so much for your response Linda , I really appreciate your experience and am trying not to over react until we have had some time to re evaluate. I am glad to have the knowledge that liver shunt can actually be asymptomatic but gosh I hope that's not the case for lilah! We did talk about the hepatitis concern but looking at the levels the pup you worked with had and lilah's elevation perhaps that is why the dr didn't think that was the issue? That is a vast difference! I will have to do some reading about what other symptom presentation I would be looking for with that. I am also reassured about the supplement she is starting and I really hope that at her retest her levels are normal.

I really appreciate the outpouring of support and well wishes for lilah, it means a lot to me and Teri- you are a sweetheart
We are here for the both of you xoxox . . Thanks Linda !
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Old 10-11-2014, 04:22 PM   #15
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Lilah took her first liver support pill today- it was humongous! I actually called for advisement because it is time release, so I could not crush or cut it but I seriously thought it might lodge in her esophagus and block her airway. I smooshed canned food around it and she took it like a champ- first success! Woo hoo!!
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