Quote:
Originally Posted by Ellie May  My dog had near normal enzymes when we realized she had a liver problem. Her bile acids (post) were high. She had no symptoms on a daily bases. Looked healthy.
Medical management was approved as appropriate for her by her IMS. She felt that Ellie was in no danger and that we should watch what drugs are given very carefully, give Denosyl if we felt like it, etc. Her regular vet agreed that she did not appear to be in danger. Her preprandial bile acids were only slightly elevated once. She had a liver biopsy. So while, yes, her bile acids were up and she appeared to be totally healthy, her IMS felt that she was okay. That can't be said for Lucy, unfortunately.
So if the bile acids go down in 6 weeks, are you supposed to assume that they are going to stay down or do you keep retesting? By the time put all that money into continuously testing bile acids, you could have a diagnosis... If they do come down some and it's decided to retest in 6 months, what happens if they went back up and were elevated all that time (all the while the IMS thinks more needs to be done).
L/D and Denamarin are not wrong, but they are probably wrong for Lucy if the IMS has recommended otherwise. They don't recommend invasive procedures for no reason. I'm confused why this protocol wasn't started last month. It also doesn't seem that the specialist has done anything more than a regular vet could have so far, so why dish out the money for a specialist and not do what they suggest? |
No offense but I think you all read what you wanted to read but skipped the part about what the IMS said:
Exploratory surgery/Biopsy (If there is a shunt they would repair it and if not they would just get the biopsy)
*Dr Myers feels this is the best route to go because if there is a bleed they can control it and if there is a shunt then she would only end up with one surgery. *****When I said Dr Myers feels this is the best route - I meant between any of the PROCEDURES not the best route to take all together
Laparoscopic biopsy
Ultrasound guided biopsy
OR
L/D Diet and Denemarin (sp?) and testing again in 6 weeks to see if her BAT's improve.
I am going to have a consult with my Vet today and then I am also going to ask to speak with Dr Myers myself later today after I talk to my Vet.
When I talked to him he didn't say "Dr Myers said you should do one of these procedures" he just told me what my options were just as they told me those options before and both times they said I can wait because of her specific case where the enzymes have gone down they don't think there is a rush to do any of the procedures.
Maybe I should have made that more clear when I wrote my first comment regarding this but I had just gotten off the phone with the Vet and was just trying to process the information again.
I also want to clear this up:
**When Lucy was first sick I went to the closest Emergency Vet I could find to help her which is the Vet that ended up doing the FIRST blood tests and BAT.
**Then I went to Blue Pearl to see Dr Myers who told me after examining her and doing a repeat blood test (NO BAT) which came out normal that if it was HER dog she would wait and repeat the tests in 4-6 weeks because she felt Lucy was in NO IMMEDIATE DANGER!
**During the waiting period I researched and found a different Vet that I was more comfortable with for Lucy because I felt the first place I went with her was not a good fit as I think they didn't deal with many small dogs. So, then I found my new Vet and after having a consultation with TWO Vets at the new clinic I felt much more comfortable with them and so I called BP and asked if it was a problem to have the BAT's repeated at the new Vets clinic and they said it was not a problem at all. So, I took Lucy there for the THIRD BT and SECOND BAT. The Vet also examined her and found her to be in very good shape - the physical exam came out perfect (and also when DR Myers saw her)!
**After getting the results my Vet called Dr Myers at BP and discussed it with her and that is now where we are at ABOVE........
I am not comparing my Lucy to anyone else and I want and will do what is best for her. The IMS has never to my knowledge said or recommended that I
should do one of the procedures so I think that is where we all got a little confused.
I am 100% comfortable with my new Vet and 100% comfortable with Dr Myers at Blue Pearl (which is a hospital that has BC surgeons). I will continue to consult with them and do what they think is best for Lucy and I will update you on how she is doing.
Again, I thank ALL of you for your support and I appreciate all of the input that I have gotten.
