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Originally Posted by 107barney  Did your vet do only a biopsy or did he do exploratory surgery? If doing a minimally invasive biopsy, it does not surprise me that he did not find a shunt because it was probably done either by ultrasound-guided needle biopsy or minimally invasive surgery (laparoscopy). Larger samples and such and more digging around would be done with full open exploratory surgery - a much more invasive procedure. It's been many years since I talked about these issues with Daisy's doctors but from what I recall, they were different surgical procedures depending on the goal.
I don't necessarily agree that there is a problem that your vet did not do BATs. Blood work and clinical findings are read as a whole in determination of the next steps. When Barney had a persistent elevation of a certain liver enzyme, the next step was a biopsy if the mild elevation of this certain liver enzyme continued. No one talked about BATs. This was a course of action recommended by my general vet. I got a second opinion from Daisy's internist and he said Barney's biopsy was not warranted just yet. They determined this based on Barney's blood work as a whole, his veterinary history, his clinical presentation upon physical examination, his current state of being, and other factors.
I see no reason why you could not ask your vet about some of the things other posters have suggested. Personally, I'd be making sure I consulted with a bd. cert. vet internist as you will cut to the chase faster and get the answers to all of it really quickly. I like to think of my general vet as Grand Central Station. Sometimes I get off the train there, and sometimes I need to change trains and go somewhere else. The thing is, my general vet has all the directions I need to choose the right train and to help me to get to my destination. Sometimes I know what to do based on my experience, but most of the time I don't. Corny analogy but true, I probably should not share that thought with my vet though.  |
Oh, its a great analogy - just like we now use general practitioner doctors that guide us to the specialists. I remember my vet saying he didn't feel he could get enough of the liver tissue samples with a needle biopsy and did something a bit more invasive - her scar was at least as long as when she had her hysterectomy. He said once he did open her up he noticed her gallbladder being full - I don't believe he saw a shunt - at least he didn't say so. I do also remember that we did bloodwork quite often and he would check her levels and since they were not coming down where he thought they should be, is when he decided on the biopsy. He was glad to know what the biopsy showed, (and at least it was not a cancer problem) but it really didn't change his course of treatment since he did like using the metro, but once that drug didn't work, we took her off that and just used the marin supplement and K/D.
I have my notes ready to speak with him next week. Thanks for your thoughts.