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Originally Posted by katy-yorkie  Jeanie, the doctor in no way indicated that Maggie was too ill to have a biopsy performed right away. He didn't have an issue with recommending diet and the Denamarin and taking her back for a retesting in a month. The report does say that a biopsy will most likely be needed to determine the cause of her liver issues. Had he said that one needed to be done right away, I would have agreed. The report says that he is most suspicious of MVD or chronic inflammatory disease. If her bile acids are still high or her labwork isn't normal when he does her recheck I feel that he will recommend a biopsy and I will agree. I went with his recommendations. I hope that diet and the medications are all that she needs. |
He is correct that only a liver biopsy can determine a definitive diagnosis. You don't have to do one if and when he suggests it. The regular vet likely went over options and was leaving it to the internist to do the workup. Some people treat dogs for seizure without ever doing an MRI to determine the cause of seizures. They instead use anticonvulsants and say "it's probably epilepsy" -- the same is true here: Yorkie + high postprandial bile acids probably = MVD so just treat as if or if you must know then get a biopsy. I wouldn't and didn't. Even if it's not MVD, there's not really a problem with feeding a liver diet and denamarin in a dog with high BATs if that dog can tolerate the food and nutraceuticals.