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Old 08-02-2010, 12:49 PM   #1
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Question BAT results and chronic problems; not sure what to do next

I really need some advice and opinions from some of you who may have more knowledge or similar experiences as me.

My little buddy (approx. one-year-old, rescued stray) has had a lot of health problems, basically since April and we’ve only had him since February. He gets sick chronically, on and off, often gets a fever with these episodes, loose stools/diarrhea….sometimes they are normal, sometimes not, sometimes it’s a combination of both. occasionally vomiting. His stomach gurgles sometimes after eating. He has had some back pain a couple of times, which made him a bit wobbly…mostly after just waking up….not sure if the back pain is related to the other stuff at all, as that seemed to just start in June. It’s been a bit off and on since then too. He gets lethargic some days and irritable. Some days he seems fine and is his crazy puppy self.

He’s had bloodwork done multiple times. The first time he had full bloodwork done in April, everything came back normal, except his WBC count was very high: 24.49. We were in Canada with family during this time he got tested, but when we returned to TN. we had him re-tested again in June, everything was normal again. He’s been on about 4 rounds of antibiotics and sometimes gets a shot and couple days of prednisone to get rid of the fever. He responds fairly well to both, while he is on them.

He got sick again about 2 weeks ago, so I took him in and we decided to have his bile acids tested and do more blood work. He hasn’t shown a lot of the Liver Shunt symptoms, and previously, all his other blood work didn’t show anything weird with his liver. Here are his most results though:

BAT Pre-meal: 47
BAT Post-meal: 53

The other results that showed some abnormal results were:
BUN 35
AMYL 439
GLU 69
ALT <10 (were in the normal range, but just barely)

Previous blood test did not show anything out of the normal range, although AMYL was at 506, so it was on the lower side of normal.

His vet said that the BAT results weren’t high enough to make him believe it was a liver shunt, but they are higher than normal. Last week, said he would talk with a specialist and see what they thought and what their recommendation was for him to do next. So, I just got off the phone with my vet and he said that the specialist basically thought the same thing he did: that the results were inconclusive and wasn’t really sure what to make of it. He said that he could refer me to go see a specialist and that they would probably just want to do an ultrasound and then more tests, but in his opinion, the ultrasound might not tell them a whole lot. He did say that I could look at going to UT, which, if it is a liver thing, I would personally prefer to do, since we are only a few hours away and I would prefer to not waste money on another specialist if that’s the case. But given his history, past test results, etc., I don’t know what to think. We thought there could be a possibility of IBD and if so, would like to treat it with diet first as biopsy is the LAST thing I want to do if possible, but if it IS something that needs surgery, then I want to get it taken care of while he is young and before he has any more problems. My vet said it was up to me with what I wanted to do with him. He also feels like biopsy for IBD should be a last resort…Of course, I want to do any surgery as a last resort. Little dude is only 4 lbs, so I prefer to not have him put under if I can avoid it. It makes me nervous, which I know you all understand.

I’m also torn about what I should be feeding him right now. He was on Science Diet with the girl who rescued him and I had him mostly on Blue Buffalo and then Orijen. Right now, and for the past 5 weeks or so, I’ve been cooking him a bland diet. Did the chicken and brown rice thing, but now, my vet recommended that I feed him a mix of 25% chicken and 75% high fiber vegetables. He has been sick the least and recovered faster on the home-cooked food, but I know it is not balanced enough for long term. I feel like getting him the right diet plan could make a big difference in his symptoms, but if we don’t know what’s wrong with him, how can a nutritionist begin to formulate something for me?

I did take him to a holistic vet, (who is also practices traditional medicine too) a couple weeks ago too in hopes he could help me with nutrition and maybe add some thoughts on what was going on with him….I came out of there even more confused then when I went in. They did applied kinesiology….and it was all a little quacky. I was basically told my dog had Erhlichia (because they asked Snickers and he told them with Applied Kinesiology!) I did take him to my normal vet after that and the blood test confirmed that he did NOT have Erhlichia. (I guess the dog must have lied about that one).

Any thoughts? What should I do next? Wait for him to get sick again or take him somewhere now? I have no idea what the next step should be…I don’t want to waste any more money taking him to the wrong place that will run unnecessary tests (or diagnose my dog by asking him! Hahaha) I want to go the right type of specialist and be educated on what I need. Do you think it’s a liver thing and appropriate for UT?

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Old 08-02-2010, 01:17 PM   #2
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I would ask for a referral to U of Tennessee at this point. You will just waste money having more tests like ultrasounds done anywhere else. U of T will repeat all the tests anyway.
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Old 08-02-2010, 01:18 PM   #3
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This is all IMO.

Drop the kinesiology. Go with the good ol' western med for now.
Bile acids aren't terribly high, but they do indicate that the liver is having a hard time functioning for whatever reason. I wouldn't say it's a shunt, but it's worth checking into. Spiking fevers is definitely a problem and it's been going on for two long. I don't think you would have to see an expert in liver issues right now, but to make sure you aren't wasting money, I'd go ahead and go to UT> Their diagnostics department is probably the highest you can go to in TN and then you won't have to end up going there after spending thousands at another specialist's office. Whatever it is (kinda does sound intestinal), UT should be able to handle it. Ask them to start slow (one test at a time if possible) to hopefully lessen the bill. If you go to another specialist and then have to go to UT later, they will likely insist on running all of the tests over again. So I'd go right to the top and get it over with.
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Old 08-02-2010, 03:03 PM   #4
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Since you are so close, I'd be heading over to UT too. Nip it in the bud without seeing a dozen different internists, etc.

Bile Acids are not terribly high; and they probably could come down with the right diet. But your little one may have other issues going on with the fevers and all.

I probably would be looking into some low to medium protein foods in the meantime.

Really hope you can get to the bottom of this without too much effort and UT can probably do it from all I hear. I hope your little one gets on the right track. Poor baby.
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Old 08-02-2010, 10:14 PM   #5
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Thank you all for the replies.
I do agree that going the route of UT will probably be the best for both short and long term. My vet told me that if I did decide to do more tests locally and/or an ultrasound they would just want to re-do it anyway, wherever we end up at. (I do appreciate him being honest about these sorts of things and not pushing me to spend a bunch at his office if he knows I'll have to spend it again). As for the Kinesiology, that's one thing I know I don't need to invest in right now! The more I think about it, the more frusturated I get, because I went there wanting a nutrition consult (supposedly this guy is big on pushing nutrition for healing) and all I got was charged about 3 times more than expected for a bunch of crazy tests I didn't need! (So frustrating when you know that money is needed for your dogs future care....)

I've been making myself crazy trying to look at different food options. There is so many different opinions out there on what is right and best for dogs. Having a sick dog makes it much more to try to apply all the information to yourself.

Anyway, is there anyone you are aware of who may have been in a similar situation as me and would be willing to talk to me? Someone who went to UT with a dog that probably doesn't have a shunt, but went for further diagnostics? I'm just wondering what to expect as far as what kind of tests they would run and what kind of information I can expect to get out of it.

My vet had mentioned to me that he believed that as far as LS, UT did everything (all the tests and surgery) for somewhere just over $1000. So, I'm wondering how much it is just to do the testing and what they time frame is to get it done...for example, how many days/trips would we need to make. We are in the Nashville area, so it's about 2.5 hours, I believe. Not terribly far, comparatively speaking. But, I'm interested to know (or more accurately, my husband will want to know) will we make 1 or 2 trips or is it more of a 10 trip kind of thing?

I'm willing to do almost anything to ensure that Snickers lives the longest, happiest and healthiest life possible and would be devastated if anything happened to him...the thing that worries me and scares me the most is that I know, even for myself, I'm still in my 20's and have been just not feeling good myself for nearly 10 years. I've had every test and medicine my doctors think is necessary, but still feel like crap most days and often don't feel like I have an answer for me after all this time and having the ability to get great care. So, I'm terrified that it will be the same with my dog...as it has been this way so far. Like my vet and I talked about, you could keep doing tests forever, if you wanted to. Especially if there is possibly multiple conditions, chronically on and off, how do you know you have the answer? (Can you tell I'm a bit anxious at all?!)
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Old 08-02-2010, 10:47 PM   #6
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Quote:
Originally Posted by gaijingirl View Post
Thank you all for the replies.
I do agree that going the route of UT will probably be the best for both short and long term. My vet told me that if I did decide to do more tests locally and/or an ultrasound they would just want to re-do it anyway, wherever we end up at. (I do appreciate him being honest about these sorts of things and not pushing me to spend a bunch at his office if he knows I'll have to spend it again). As for the Kinesiology, that's one thing I know I don't need to invest in right now! The more I think about it, the more frusturated I get, because I went there wanting a nutrition consult (supposedly this guy is big on pushing nutrition for healing) and all I got was charged about 3 times more than expected for a bunch of crazy tests I didn't need! (So frustrating when you know that money is needed for your dogs future care....)

I've been making myself crazy trying to look at different food options. There is so many different opinions out there on what is right and best for dogs. Having a sick dog makes it much more to try to apply all the information to yourself.

Anyway, is there anyone you are aware of who may have been in a similar situation as me and would be willing to talk to me? Someone who went to UT with a dog that probably doesn't have a shunt, but went for further diagnostics? I'm just wondering what to expect as far as what kind of tests they would run and what kind of information I can expect to get out of it.

My vet had mentioned to me that he believed that as far as LS, UT did everything (all the tests and surgery) for somewhere just over $1000. So, I'm wondering how much it is just to do the testing and what they time frame is to get it done...for example, how many days/trips would we need to make. We are in the Nashville area, so it's about 2.5 hours, I believe. Not terribly far, comparatively speaking. But, I'm interested to know (or more accurately, my husband will want to know) will we make 1 or 2 trips or is it more of a 10 trip kind of thing?

I'm willing to do almost anything to ensure that Snickers lives the longest, happiest and healthiest life possible and would be devastated if anything happened to him...the thing that worries me and scares me the most is that I know, even for myself, I'm still in my 20's and have been just not feeling good myself for nearly 10 years. I've had every test and medicine my doctors think is necessary, but still feel like crap most days and often don't feel like I have an answer for me after all this time and having the ability to get great care. So, I'm terrified that it will be the same with my dog...as it has been this way so far. Like my vet and I talked about, you could keep doing tests forever, if you wanted to. Especially if there is possibly multiple conditions, chronically on and off, how do you know you have the answer? (Can you tell I'm a bit anxious at all?!)

Hello. My dog Daisy had many of the same symptoms. She has microvascular dysplasia (MVD or microscopic shunting of the liver) and she also has IBD, severe allergies and food intolerances. We have been able to see complete reversal of her poor outlook and physical appearance, along with major changes to her blood work, due to diet changes alone.

Did they rule out pancreatitis? the elevated WBC and elevated BATs and gurgling stomach sounds just like what Barney had a few months back when he was diagnosed with pancreatitis. The ALT reading is low, which is usually high in MVD or LS babies (at least my dog's reading was high).

The food does have a lot to do with it. 25% protein may be too high if the dog is liver compromised. In addition to % of protein, the TYPE of proteins are important in LS and MVD dogs. Many do poorly on meat (especially red meat) and some, like my dog, eat a total vegetarian diet.

My dog had post BAT over 100 and is now completely normal due to dietary changes alone- we feed a home cooked balanced meal.

Personally, I'd see how the blood work turned out after a diet change before I ran around doing all kinds of testing with those numbers, unless the dog continues to have symptoms.

We use board certified vet nutritionist Dr. Rebecca Remillard at the MSPCA-Angel Memorial Hospital in Boston - we do phone consults with her. IMO, there is no one on the planet more qualified. She saved my dog's life and I recommend her highly. She has many yorkie clients and is very well-experienced with excellent qualifications. So if you want a nutrition consult, she's awesome.
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Old 08-03-2010, 03:09 AM   #7
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My Lucy has mild MVD with BAT numbers that were initially similar to yours; but came down after a repeat test in 30 days on a lower protein diet. BUT, she did not have spiking fevers, etc.
She started having some tummy and what appeared to be neurological issues after I gave her some beef ALPO that a well meaning neighbor gave me. That's when we did her first BAT - which was still fairly low (like yours). But did show that her liver was NOT functioning 100%. Her vet really didn't want to lower her protein too much because she was less than one year old.

Then I switched her to a medium protein food - Wellness Limited Ingredient and started mixing with liver friendly foods such as cooked carrots; low fat cottage cheese and low fat plain yogurt. I cut down on the protein treats (like pupparoni); I continued to give her chicken because she seemed to do well with chicken ~ although some dogs with MVD do not.

She did well; but then had a couple of issues with her back legs going on which scared me further so then I switched her breakfast food to Natural Balance Vegetarian; which she eats well mixed with some cooked carrots. She still gets the medium protein food at dinner though - mixed usually with some canned chicken to get her to eat. The back leg thing seemed to resolve itself and it was determined that she has LP in both knees - unrelated to her liver.

Because her numbers were not indicative of a shunt (usually 100 or more); and she really has had no further symptoms and seems to be a happy, healthy pup - we have decided to treat her for mild MVD with a low to medium protein diet and supplements.

Nothing further needed for her at this time. Who knows what the future holds? But for now, so far so good.

I'm not sure that this will apply to your baby; but I just wanted to share my experiences.

I know it's scary when there is something wrong with your little one. If I were close to a great vet hospital; I would go there for answers. The may NOT want to do a bunch of tests on your baby but if there are continued symptoms - they may.
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