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Originally Posted by katy-yorkie  I'm puzzled...all of Maggie's tests are normal. Ultrasound didn't detect anything, X-rays didn't detect anything, Ammonia was zero, liver profile was normal. Dr. Jones recommended that the BAT be repeated in a month. He recommended the Hill's l/d prescription kibble or canned, doesn't matter. He said there were no acceptable treats for this condition, only fresh vegetables. If everything is normal, how can she have a condition? Could my vet have somehow messed up when he did the original test? When her BAT is repeated in a month and if by chance it comes back normal, can she go back to what she was eating before? |
Did you read the material? It explains that there are varying degrees of liver pathology and conditions and that dogs suspected or diagnosed with MVD/PVD can be very sick to not so much. Most MVD dogs do well with diet and medical management. Medicine isn't always black and white and much of it is an art and requires a knowledgeable diagnostician to get to the bottom of a sick dog and get him to stay well. The lack of a shunt on a sono test means she probably doesn't have a liver shunt problem(though from what I've read abdominal sonograms are not always the best way to test for liver shunts on a small dog due to gas-filled intestines being hard to see through or overlying ribs or lungs making it easy to miss a small shunt here or there and possibly she could still have one or more shunts. I've read nuclear scintigraphy, tests using contrasts and Dopplers are often more sure testing methods in small dogs ) but due to high Bile Acids and whatever symptoms she has, they are making a probable differential diagnosis of MVD or PVH, which means her liver isn't properly cleaning her blood of toxins, most likely due her underdeveloped, hypoplastic portal vessels or atrophied blood vessels and other tissue or who knows what's going on in her liver.
The only true way to diagnose that condition as I understand it is a liver biopsy and maybe the vets either think she's too sick or either her symptoms are not severe enough to put her through that right now as it requires anesthesia and taking a portion of the liver to study. So they treat her with diet consisting of low, easily processed proteins and if she responds, then the vets came to the correct conclusion. If the diet doesn't work, more testing and possibly drugs will be required.
If the case of MVD/PVH isn't a severe one and the portal vessels are not all or too damaged or atrophied, hypoplastic and/or enough for her liver to function fairly well, she probably won't have a lot of liver damage to show up on blood tests. Someone correct me if I'm wrong but a high Bile Acids Test reading shows that she's not properly rapidly reabsorbing the most of her intestinal bile acids after a meal as she should and that's probably due to a liver condition and a reason to further test/continue to treat for liver problems.
Right now, you just want to keep her symptom-fee for a month at a time and then, in 6 months or so, whatever her vets say, stop and re-assess. You can make her treats as I do Tibbe's, soaking his kibble in water and keeping the pieces refrigerated or microwaving or baking the soaked, softened food. She can still have her treats. Tibbe cannot tolerate the green beans I've given him without getting nauseated and vomiting and being down for the day so your girl is blessed but he has a type of IBS in addition to his MVD.