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09-09-2011, 06:25 PM | #1 |
Yorkie Yakker Join Date: Sep 2011 Location: VALLEY STREAM
Posts: 26
| Bile Acids Test My 6 month old Roxy recently had a bile acids test done. About a week ago she vomited twice and then looked dizzy (about to fall over). I took her to an emergency vet and only let them give fluids (they do not have a good reputation). I took Roxy to her regular vet the next day. They did blood work (CBC - normal except slightly off white blood cell counts, & pancreatitis - negative). I switched her food to Hill's Prescription Diet i/d. I noticed that she has not been drinking as much water and her bowel movements are much darker and smaller & not as frequent. She went in for the bile acids test yesterday and the results came back today. The dr said that her pre levels were normal (under 2) and her post levels were elevated (just over 37). He thinks it may be a small liver shunt, so he recommended I switch her food to Hill's Prescription Diet l/d. My question is, what else could these test results mean? She is a very active, happy puppy and does not appear to be sick at all. Prior to her vomiting twice, I was giving her Nutro Natural Choice dry & wet food, Old Mother Hubbard Chick N Apples mini biscuits, Bil-Jacs training treats, Pupperoni & Nutrical. I've been trying to read up on liver shunts, and a lot of what I read about doesn't seem to indicate that she has it. Her levels were normal before the meal (during the test). She did not seem to drink or urinate excessively and no other problems noticed. If anyone has any advice or has been through this, please write.
__________________ Love my little Roxy |
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09-09-2011, 06:35 PM | #2 |
Resident Yorkie Nut Donating YT 20K Club Member Join Date: Sep 2006 Location: Texas
Posts: 27,451
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09-09-2011, 07:12 PM | #3 |
Yorkie Yakker Join Date: Sep 2011 Location: VALLEY STREAM
Posts: 26
| That could possibly be it but is there a way to be sure what it is? From what I'm reading it pretty much just tells you if the liver is functioning properly or not...
__________________ Love my little Roxy |
09-09-2011, 07:31 PM | #4 |
Resident Yorkie Nut Donating YT 20K Club Member Join Date: Sep 2006 Location: Texas
Posts: 27,451
| Yes, there is a way to diagnose. Sometimes ultrasound is done but that does not always show a shunt. There is also the scintigraphy and also liver biopsies. I have seen varied opinions here on YT about this topic. Some people opt not to do invasive tests if they strongly believe it is MVD. If it were me, I would go to a board certified soft tissue surgeon (which your vet will probably refer you to at some point if the blood tests remain elevated) and I would ask him very detailed questions. I have no experience at all with liver shunts. There are many members here who do and I am sure they will be along to share their stories. I will keep Roxy in my thoughts and prayers. Take heart in knowing that these things are treatable and manageable.
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09-10-2011, 04:15 AM | #5 |
♥ Maximo and Teddy Donating Member Join Date: Jun 2009 Location: Northern Virginia
Posts: 25,041
| I don't have any experience with liver shunts or BATs, but I wanted to recommend ditching the Pupperoni and Bil Jac treats permanently, if you have not already done so. Hold the Nutrical for when Roxy is actually having a hypoglycemic episode. Sending positive thoughts for Roxy and you.
__________________ Kristin, Max and Teddy |
09-10-2011, 04:31 AM | #6 |
And Rylee Finnegan Donating Member Join Date: Apr 2007 Location: Metro Detroit, MI
Posts: 17,928
| That number isn't of major concern. Usually (there are exceptions) when there is an actual liver shunt, the post bile acid number is much higher. The pre number is also usually elevated. Microvascular dysplasia (the link that ladyjane posted) is more likely. It's inoperable and can be medically managed. A biopsy would show microvascular dysplasia, but not a larger shunt (although the surgeon would likely be able to see it when working with the liver). Ultrasound is fine, but not the most accurate for showing shunts even if one is present. They can show the size of the liver, condition of bladder and kidneys, etc. The more experienced the sonographer, the more likely they will locate a shunt if one is present. There is also the issue of intrahepatic (inside the liver) and extrahepatic (outside the liver) shunting. Extrahepatic are most common in Yorkies and are generally surgical. Intrahepatic are inside the liver and are medically managed. There is also the scintography that will show with fairly good accuracy if a shunt is present. The very best thing you can do is consult with a board certified internal medicine specialist with a lot of experience in this area. They will go over all of this with you and lead you to the best decision for your pup. All the above aside and even though the bile acids are not terrible elevated, this pup did have neuro symptoms and you should immediately go to a specialist.
__________________ Crystal, Ellie May (RIP), Rylee Finnegan, and Gracie Boo🐶 |
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