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Originally Posted by MyFairLacy  with yorkies we always want to assume a shunt or mvd because in many cases it is. However bile acid results can be elevated with any type of liver disease. There are many other liver diseases too. When lacys bile acids were high (pre 44.5 and post 53.5) everyone assumed mvd but after her biopsy Tuesday the clinician I spoke with said she doubted lacy had mvd. I guess we will find out for sure when the results are in, but they are leaning toward some other cause of liver disease for her.
I've heard some good things about gulf coast but aren't that familiar with them. I'm right here at A&m and we were referred to dr Willard and dr cook, both internal medicine specialists. She had an xray and urinalysis done before we went to A&m and then did ultrasound and a blood ammonia test. With a shunt blood ammonia will be high and many times the liver will be smaller then normal. The person that did the ultrasound is supposed to be really good at finding shunts. Ultrasound is only as accurate as the person doing it. It was less invasive then jumping right to a scintigraphy. They would have done that next if a shunt wasn't found on ultrasound but blood ammonia was high. But with her results we were confident there was no shunt. They found abnormal areas on her liver so we then did a biopsy a d are now waiting results.
UT is supposed to be the best and cheapest for shunt repairs. I know a lot of people travel there. |
This is what I don't like about the current protocol (BAT, Protein C then Scint. if necessary). A normal Protein C and high bile acids is not always MVD and with no biopsy, we can't be sure. Then again, biopsy is kind of risky. I just don't get the high BAT, normal Protein C always meaning call it MVD in Yorkies. Then again, Dr. Center is really the expert.
And I really don't see how doing a BAT at 20 weeks then following the same protocol prevents overdiagnosis because a dog can have other types of liver disease at that age and high BA unless I'm missing something.
All I know is UT does more LS surgeries on Yorkies than anyone else could hope to it appears. They have a good anesthetic protocol and, in my opinion, they seem to have the best safety record and less complications.