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Originally Posted by Ellie May  I would not open up a dog with suspected MVD for a biopsy alone.
It may be a good thing to do if the dog is being spayed (varying opinions).
Of course that isn't the case here.
Urinalysis is a good idea.
You could go to the Protein C test or ultrasound.
While Dr. Center's protocol is BAT, then Protein C then scintography if that is elevated, the assumption then is all Yorkies who have high bile acids and normal Protein C have MVD I guess. That obviously can't be right but I'm not sure how often that is the case and I'm not sure when she does recommend other testing. If you want to see the size of the liver and look at everything going on, the u/s is fine. If you are looking for a shunt diagnoses, it is as low as 60% accurate for that. We did a u/s and all we got out of it was a pancreatitis diagnosis. We did a biopsy and all we got out of that was mild bile stasis. 
Remember if you get everything under control and she is "completely" asymptomatic, you can start increasing her protein as long as that protein is the right type. There is really no reason to leave an asymptomatic dog on 20 or so % in my opinion. That doesn't mean you would go to 40-50% either though. Too little protein isn't a good thing. While she is having symptoms and since it may be her liver, I would drop the protein % and get her on a better type as soon as possible.
I typically look at the post number. Haven't read too much on the pre but 95% of dogs with shunts have elevated pre. Most shunt dogs have a post over 100 though. |
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Originally Posted by Ellie May And if you want to just get it over with and really rule out a shunt, consider doing scintography right away. |
I realized I didn't answer your question above about drugs. No, she hasn't been on any medication. She hasn't had topical flea treatment put on since September. She does take Heartguard once a month but it had been a month since her dose..she took one the day after her appointment on Feb. 1. Other than that...she eats her NV medallions, gets fish oil almost every day (Eicosaderm) and usually gets Juice Plus for Dogs (a supplement) once a day too...and she gets treats such as Wellness Pure Rewards, Ziwi Peak, dried liver, etc.
I seem to be getting a general consensus that a liver biopsy should only be done if she's open anyway...
I guess we'll either be doing a doppler ultrasound or a schintography...supposedly one of the clinicians at Texas A&M is supposed to be really good at finding shunts with ultrasound, and I've read that with ultrasound the accuracy really depends on how good the operator is. I've heard of the schintography of course, but I really don't know much about it...I'm not sure if they do that at A&M or not.
I think I've definitely decided to nix the x-rays..everyone seems to think it's a waste of money and won't tell me anything. So we'll do the urinalysis tomorrow and I guess I'll see about doing an ultrasound or schintography.
She's only showing mild symptoms and isn't really sick but I definitely don't want her to get sicker..so I really want a to have a better idea of a diagnosis.