YorkieTalk.com Forums - Yorkshire Terrier Community


Welcome to the YorkieTalk.com Forums Community - the community for Yorkshire Terriers.

You are currently viewing our boards as a guest which gives you limited access to view most discussions and access our other features. By joining our free community you will have access to post topics, communicate privately with other members (PM), respond to polls, upload content and access many other special features. You will be able to chat with over 35,000 YorkieTalk members, read over 2,000,000 posted discussions, and view more than 15,000 Yorkie photos in the YorkieTalk Photo Gallery after you register. We would love to have you as a member!

Registration is fast, simple and absolutely free so please, join our community today!

If you have any problems with the registration process or your account login, please click here to contact us.

Go Back   YorkieTalk.com Forums - Yorkshire Terrier Community > YorkieTalk > Yorkie Health & Diet
Register Blogs FAQ Calendar JavaChat Mark Forums Read

Reply
 
LinkBack Thread Tools
Old 10-24-2008, 07:58 AM   #1
Senior Yorkie Talker
 
GucciBear's Avatar
 
Join Date: Aug 2008
Location: Montgomery, AL, USA
Posts: 98
Default Liver enzyme

Gucci (morkie) was scheduled for his neutering this morning, but the blood test came back with an elevated liver enzyme, which apparently is common with yorkies? Our vet is taking precautions with him since he's only 4.2# and of course they love him over there! There's another test which I'm not exactly clear on, but it will enable them to see how and what to do in his case. She's pretty sure he'll be fine and able to reschedule, but I was wondering if anyone has information to share on this issue. Thanks,
Kathy
GucciBear is offline   Reply With Quote
Welcome Guest!
Not Registered?

Join today and remove this ad!

Old 10-24-2008, 08:10 AM   #2
And Rylee Finnegan
Donating Member
 
Ellie May's Avatar
 
Join Date: Apr 2007
Location: Metro Detroit, MI
Posts: 17,928
Default

His ALT was probably up and they are probably going to do a bile acid test to rule out liver function problems like liver shunt and microvascular dysplasia. If that it is the case, it sounds like you have a good vet for paying attention.
__________________
Crystal, Ellie May (RIP), Rylee Finnegan, and Gracie Boo🐶
Ellie May is offline   Reply With Quote
Old 10-24-2008, 09:02 AM   #3
Senior Yorkie Talker
 
GucciBear's Avatar
 
Join Date: Aug 2008
Location: Montgomery, AL, USA
Posts: 98
Default

The vet told me that normally they get VERY concerned when it's elevated to the 200 level. She said that high is around 75 and Gucci is at 97. In an average sized dog probably wouldn't be as concerned, but because of his size, 4.2#, they're being extra careful. They've always very careful with him.
GucciBear is offline   Reply With Quote
Old 10-25-2008, 08:58 AM   #4
Senior Yorkie Talker
 
Miss Magoo's Avatar
 
Join Date: Jun 2008
Location: Lexington, KY
Posts: 175
Default

Hi,

I just went through this 3 weeks ago with Bella. I had her pre spay bloodwork done and her levels came back slightly elevated. So my vet suggested doing the bile acid test and checked her urine for crystals and I had to leave her at the vet all day long. It was excruciating for me and her both. Well her levels came back perfectly normal with 1 slightly elevated again so my vet called someone who is a specialist regarding Liver Shunts in Dogs and they said she was all clear and her levels were actually perfectly normal. My vet was just being overprotective (which I adore)!!

So in all it took 4 days with the results and now I know I have a perfectly happy, healthy, recently spayed Yorkie.

Good luck!
__________________
Dana and Bella
Miss Magoo is offline   Reply With Quote
Old 10-25-2008, 10:56 AM   #5
Donating YT 2000 Club Member
 
Ladymom's Avatar
 
Join Date: Sep 2007
Location: North Carolina
Posts: 8,317
Default

Sounds like you have a great vet! Yorkies are 36 times more likely to have a liver shunt than all other breeds combined, so your vet is right to be extra careful and do a bile acids test.

97 is really only slightly elevated. (Normal is between 10-84) I'm sure he will be just fine.
Ladymom is offline   Reply With Quote
Old 10-25-2008, 11:47 AM   #6
Senior Yorkie Talker
 
GucciBear's Avatar
 
Join Date: Aug 2008
Location: Montgomery, AL, USA
Posts: 98
Default

Thank you all for your responses. It makes me feel a little better although still worried. Not sure if a bile acid test was done, but he's due for his ultrasound on Monday. Please keep him in your thoughts. Thanks again,
Kathy
GucciBear is offline   Reply With Quote
Old 10-25-2008, 01:38 PM   #7
Donating YT 2000 Club Member
 
Ladymom's Avatar
 
Join Date: Sep 2007
Location: North Carolina
Posts: 8,317
Default

Quote:
Originally Posted by GucciBear View Post
Thank you all for your responses. It makes me feel a little better although still worried. Not sure if a bile acid test was done, but he's due for his ultrasound on Monday. Please keep him in your thoughts. Thanks again,
Kathy
Why is your vet doing an ultrasound? He should get a bile acids test which is done by two blood draws. Depending on the result, the next step would be a Protein C test. Ultrasounds are not recommended for diagnosing a liver shunt as they can be as low as only 60% accurate, sometimes less. Scintigraphy is much more accurate. You are just wasting your money, especially with an ALT of 97.

Unfortunately, most vets just don't see enough cases to know the protocol for diagnosing and treating liver disease.

Here are a couple of good links for you:

Hepatic Vascular Disorders - WSAVA 2006 Congress

PSVA and MVD Research Summary

Portosystemic Shunts FAQ
Ladymom is offline   Reply With Quote
Old 10-25-2008, 06:41 PM   #8
Senior Yorkie Talker
 
GucciBear's Avatar
 
Join Date: Aug 2008
Location: Montgomery, AL, USA
Posts: 98
Default

Actually, we have been referred to another vet for the ultrasound and they asked to have the blood tests forwarded to them. Before an ultrasound, I intend to have a very detailed question and answer session. I also believe the ultrasound may be overkill, but if it's needed will do. I've thought about the expense as well, but he is part of the family. I'm really confused because Gucci shows no symptoms that point to a problem.
GucciBear is offline   Reply With Quote
Old 10-25-2008, 07:13 PM   #9
Donating YT 2000 Club Member
 
Ladymom's Avatar
 
Join Date: Sep 2007
Location: North Carolina
Posts: 8,317
Default

Quote:
Originally Posted by GucciBear View Post
Actually, we have been referred to another vet for the ultrasound and they asked to have the blood tests forwarded to them. Before an ultrasound, I intend to have a very detailed question and answer session. I also believe the ultrasound may be overkill, but if it's needed will do. I've thought about the expense as well, but he is part of the family. I'm really confused because Gucci shows no symptoms that point to a problem.
Just make sure you get a bile acid test done before you do anything else. That is the best test out there for liver disease.
Ladymom is offline   Reply With Quote
Old 10-25-2008, 07:21 PM   #10
Senior Yorkie Talker
 
GucciBear's Avatar
 
Join Date: Aug 2008
Location: Montgomery, AL, USA
Posts: 98
Default

He did have a bile acid test done and that's why we were referred to another vet who does have ultrasound equipment. I'm not sure what the reading was on that test, but they are faxing the results to him before we meet on Monday. Sounds like you either have medical experience or have been through this yourself. Thanks for your input.

Last edited by GucciBear; 10-25-2008 at 07:24 PM.
GucciBear is offline   Reply With Quote
Old 10-26-2008, 05:24 AM   #11
Donating YT 10K Club Member
 
bchgirl's Avatar
 
Join Date: Apr 2005
Location: at da beach
Posts: 15,444
Blog Entries: 2
Default

Quote:
Originally Posted by GucciBear View Post
He did have a bile acid test done and that's why we were referred to another vet who does have ultrasound equipment. I'm not sure what the reading was on that test, but they are faxing the results to him before we meet on Monday. Sounds like you either have medical experience or have been through this yourself. Thanks for your input.
What was the results on the bile acid test? The next step should be a protein c test...sometimes shunts aren't detectable on an ultrasound.
__________________
Deb, Reese, Reggie, Frazier, Libby, Sidney, & Bodie
Trace & Ramsey who watch over us
www.biewersbythebay.com
bchgirl is offline   Reply With Quote
Old 10-26-2008, 06:31 AM   #12
Donating YT 2000 Club Member
 
Ladymom's Avatar
 
Join Date: Sep 2007
Location: North Carolina
Posts: 8,317
Default

Quote:
Originally Posted by bchgirl View Post
What was the results on the bile acid test? The next step should be a protein c test...sometimes shunts aren't detectable on an ultrasound.


Ultrasounds are not recommended anymore, scintigraphy is. Ultrasounds can be as low as 60% reliable.

The next step is a protein C test, before imaging.

Recent studies indicate that protein C deficiency is a marker of liver disease in dogs. Protein C deficiency develops in dogs with hepatic synthetic failure and in portosystemic shunting disorders.

The protein C activity assay is especially useful as a non-invasive measure of portal blood flow. Dogs with congenital portosystemic vascular anomalies (PSVA) typically have low protein C activity, with values < 70% of normal. Although clinical signs and chemistry profiles of dogs with PSVA and microvascular dysplasia are similar, the finding of low protein C activity supports a diagnosis of PSVA. Furthermore, protein C activities can be monitored after shunt ligation to assess restoration of portal blood flow.


This link explains the protein C test.

Comparative Coagulation -- NYS Animal Health Diagnostic Center

A lot of research has been done on liver disease in the past few years and most vets just aren't aware of the advances and changes in protocol. You can waste a lot of time and money getting the wrong tests done and end up with no conclusive answers.
Ladymom is offline   Reply With Quote
Old 10-26-2008, 09:16 AM   #13
Donating YT 3000 Club Member
 
Yorkieluv's Avatar
 
Join Date: Feb 2005
Location: USA
Posts: 7,178
Default

There are a couple of things the ultrasound is useful for...It can help determine if the liver has atrophied(shrunk) due to liver problems. It can also show if there are any bladder stones which are very common in dogs with liver problems. The type of stone that is consistent with liver problems is called ammonium urate and can ONLY be seen on ultrasound. They are NOT seen in x-rays.

If neither of these things are found, then an ultrasound could be inconclusive and further testing will be needed anyway. Ultrasounds do not typically show a liver shunt. The shunt could be positioned in an area that cannot be seen by ultrasound. Also, an ultrasound won't show if your dog has MVD.
__________________
Miko 's his Mommy
Yorkieluv is offline   Reply With Quote
Old 10-27-2008, 01:45 PM   #14
Senior Yorkie Talker
 
GucciBear's Avatar
 
Join Date: Aug 2008
Location: Montgomery, AL, USA
Posts: 98
Default

Okay, so this is the latest in Gucci's saga . . . After talking with the second vet, and explaining all I had learned from this site, he still felt it necessary to do an ultrasound. They also did another bile acid test, but just like my vet, the test is read in their facility and doesn't register over 30. It simply says it's above 30 - could be 32 or 102. Sooooo, we have to return to my vet for yet another bile acid test which they are sending out to an outside lab for reading - no cost. The ultrasound didn't show anything conclusive, right again, and fortunately they didn't charge me an arm and a leg for the tests. I asked about the protein C test, but didn't appear to understand what I was asking for. I was prepared for the worst, and when they asked for $100 I almost jumped the counter and kissed her! He's not showing any symtoms and even Scott agreed. We'll wait and see. I
Attached Images
File Type: jpg Gucci outside Halloween 2008.JPG (62.8 KB, 5 views)
GucciBear is offline   Reply With Quote
Old 10-27-2008, 05:49 PM   #15
Donating YT 2000 Club Member
 
Ladymom's Avatar
 
Join Date: Sep 2007
Location: North Carolina
Posts: 8,317
Default

Quote:
Originally Posted by GucciBear View Post
Okay, so this is the latest in Gucci's saga . . . After talking with the second vet, and explaining all I had learned from this site, he still felt it necessary to do an ultrasound. They also did another bile acid test, but just like my vet, the test is read in their facility and doesn't register over 30. It simply says it's above 30 - could be 32 or 102. Sooooo, we have to return to my vet for yet another bile acid test which they are sending out to an outside lab for reading - no cost. The ultrasound didn't show anything conclusive, right again, and fortunately they didn't charge me an arm and a leg for the tests. I asked about the protein C test, but didn't appear to understand what I was asking for. I was prepared for the worst, and when they asked for $100 I almost jumped the counter and kissed her! He's not showing any symtoms and even Scott agreed. We'll wait and see. I
All the information about the Protein C test is in the link I posted in my last post. You can print it out for your vet

Comparative Coagulation -- NYS Animal Health Diagnostic Center

If they are not collecting the sample for the bile acids test properly, the results will be skewed. It doesn't sound like either of your vets know much about current protocol for diagnosing liver disease. As I said before, you can waste a lot of time and money if you don't deal with a vet who is knowledgable.

This is from Dr. Center, the developer of the bile acids test:

The bile acid test is very reliable but the red blood cells MUST be separated from plasma (the clear part of blood) before they are sent to lab for analysis (centrifuged or spun to allow plasma separation from blood cells). Results can be falsely abnormal if the bile acid samples are lipemic (lots of fat IF the fat is not adequately removed by the laboratory analyzing the sample) or if hemolysis (burst red blood cells, makes the plasma red) occurs. The red color interferes with the color of the end point dye in the bile acid test. A clinician can tell if the sample is hemolyzed when they centrifuge the sample to separate the red blood cells from the plasma. If it is hemolyzed they should collect another sample. Drawing blood with a vacutainer needle into a vacutainer (suction of the tube facilitates the collection) may be too traumatic for some red blood cells augmenting hemolysis. Using a syringe and needle or syringe and butterfly needle appears to collect the best samples. After the blood is collected, the needle should be removed from the syringe and the top removed from the vacutainer so that the blood may be gently transferred to the vial. Results of the bile acid test should state if the samples were lipemic or if hemolysis occurred. In this case, the tests should be repeated.

PSVA and MVD Research Summary

Dr. Center also recommends that the vet collect the blood in a plain red-top tube versus a serum separator. After the blood clots, it should be spun down and the serum put in another plain red-top to go to the lab.
Ladymom is offline   Reply With Quote
Reply

Bookmarks



Thread Tools

Posting Rules
You may not post new threads
You may not post replies
You may not post attachments
You may not edit your posts

BB code is On
Smilies are On
[IMG] code is Off
HTML code is Off
Trackbacks are On
Pingbacks are On
Refbacks are Off




Google
 

SHOP NOW: Amazon :: eBay :: Buy.com :: Newegg :: PetStore :: Petco :: PetSmart


All times are GMT -8. The time now is 04:27 AM.


Powered by vBulletin® Version 3.8.9
Copyright ©2000 - 2024, vBulletin Solutions, Inc.
Copyright ©2003 - 2018 YorkieTalk.com
Privacy Policy - Terms of Use

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 100 101 102 103 104 105 106 107 108 109 110 111 112 113 114 115 116 117 118 119 120 121 122 123 124 125 126 127 128 129 130 131 132 133 134 135 136 137 138 139 140 141 142 143 144 145 146 147 148 149 150 151 152 153 154 155 156 157 158 159 160 161 162 163 164 165 166 167 168 169 170 171 172 173 174 175 176 177 178 179 180 181 182 183 184 185 186 187 188 189 190 191 192 193 194 195 196 197 198 199 200 201 202 203 204 205 206 207 208 209 210 211 212 213 214 215 216 217 218 219 220 221 222 223 224 225 226 227 228 229 230 231 232 233 234 235 236 237 238 239 240 241 242 243 244 245 246 247 248 249 250 251 252 253 254 255 256 257 258 259 260 261 262 263 264 265 266 267 268 269 270 271 272 273 274 275 276 277 278 279 280 281 282 283 284 285 286 287 288 289 290 291 292 293 294 295 296 297 298 299 300 301 302 303 304 305 306 307 308 309 310 311 312 313 314 315 316 317 318 319 320 321 322 323 324 325 326 327 328 329 330 331 332 333 334 335 336 337 338 339 340 341 342 343 344 345 346 347 348 349 350 351 352 353 354 355 356 357 358 359 360 361 362 363 364 365 366 367 368 369 370 371 372 373 374 375 376 377 378 379 380 381 382 383 384 385 386 387 388 389 390 391 392 393 394 395 396 397 398 399 400 401 402 403 404 405 406 407 408 409 410 411 412 413 414 415 416 417 418 419 420 421 422 423 424 425 426 427 428 429 430 431 432 433 434 435 436 437 438 439 440 441 442 443 444 445 446 447 448 449 450 451 452 453 454 455 456 457 458 459 460 461 462 463 464 465 466 467 468 469 470 471 472 473 474 475 476 477 478 479 480 481 482 483 484 485 486 487 488 489 490 491 492 493 494 495 496 497 498 499 500 501 502 503 504 505 506 507 508 509 510 511 512 513 514 515 516 517 518 519 520 521 522 523 524 525 526 527 528 529 530 531 532 533 534 535 536 537 538 539 540 541 542 543 544 545 546 547 548 549 550 551 552 553 554 555 556 557 558 559 560 561 562 563 564 565 566 567 568 569 570 571 572 573 574 575 576 577 578 579 580 581 582 583 584 585 586 587 588 589 590 591 592 593 594 595 596 597 598 599 600 601 602 603 604 605 606 607 608 609 610 611 612 613 614 615 616 617 618 619 620 621 622 623 624 625 626 627 628 629 630 631 632 633 634 635 636 637 638 639 640 641 642 643 644 645 646 647 648 649 650 651 652 653 654 655 656 657 658 659 660 661 662 663 664 665 666 667 668 669 670 671 672 673 674 675 676 677 678 679 680 681 682 683 684 685 686 687 688 689 690 691 692 693 694 695 696 697 698 699 700 701 702 703 704 705 706 707 708 709 710 711 712 713 714 715 716 717 718 719 720 721 722 723 724 725 726 727 728 729 730 731 732 733 734 735 736 737 738 739 740 741 742 743 744 745 746 747 748 749 750 751 752 753 754 755 756 757 758 759 760 761 762 763 764 765 766 767 768 769 770 771 772 773 774 775 776 777 778 779 780 781 782 783 784 785 786 787 788 789 790 791 792 793 794 795 796 797 798 799 800 801 802 803 804 805 806 807 808 809 810 811 812 813 814 815 816 817 818 819 820 821 822 823 824 825 826 827 828 829 830 831 832 833 834 835 836 837 838 839 840 841 842 843 844 845 846 847 848 849 850 851 852 853 854 855 856 857 858 859 860 861 862 863 864 865 866 867 868 869 870 871 872 873 874 875 876 877 878 879 880 881 882 883 884 885 886 887 888 889 890 891 892 893 894 895 896 897 898 899 900 901 902 903 904 905 906 907 908 909 910 911 912 913 914 915 916 917 918 919 920 921 922 923 924 925 926 927 928 929 930 931 932 933 934 935 936 937 938 939 940 941 942 943 944 945 946 947 948 949 950 951 952 953 954 955 956 957 958 959 960 961 962 963 964 965 966 967 968 969 970 971 972 973 974 975 976 977 978 979 980 981 982 983 984 985 986 987 988 989 990 991 992 993 994 995 996 997 998 999 1000 1001 1002 1003 1004 1005 1006 1007 1008 1009 1010 1011 1012 1013 1014 1015 1016 1017 1018 1019 1020 1021 1022 1023 1024 1025 1026 1027 1028 1029 1030 1031 1032 1033 1034 1035 1036 1037 1038 1039 1040 1041 1042 1043 1044 1045 1046 1047 1048 1049 1050 1051 1052 1053 1054 1055 1056 1057 1058 1059 1060 1061 1062 1063 1064 1065 1066 1067 1068 1069 1070 1071 1072 1073 1074 1075 1076 1077 1078 1079 1080 1081 1082 1083 1084 1085 1086 1087 1088 1089 1090 1091 1092 1093 1094 1095 1096 1097 1098 1099 1100 1101 1102 1103 1104 1105 1106 1107 1108 1109 1110 1111 1112 1113 1114 1115 1116 1117 1118 1119 1120 1121 1122 1123 1124 1125 1126 1127 1128 1129 1130 1131 1132 1133 1134 1135 1136 1137 1138 1139 1140 1141 1142 1143 1144 1145 1146 1147 1148 1149 1150 1151 1152 1153 1154 1155 1156 1157 1158 1159 1160 1161 1162 1163 1164 1165 1166 1167