bile acid testing

[belindaY]

I'm researching liver shunt, specifically how to spot and avoid it, and in need of clarification on the usefulness of bile acid testing puppies. At what age can this test be carried out, and how reliable is it? There seems to be a lot of controversy and confusion about liver shunt lately, including some incorrect diagnoses.

[bchgirl]

A bile acid test will only indicate a problem in liver function. To determine whether or not it was the result of a liver shunt or mvd...further testing would need to be completed. A protein c test would be in order to make that diagnosis.

[belindaY]

OK, but if bile acids are normal in a 12 week old puppy, can we safely assume it does not have congenital liver shunt of MVD?

[JaLaYorkieGirl]

Originally Posted by belindaY

OK, but if bile acids are normal in a 12 week old puppy, can we safely assume it does not have congenital liver shunt of MVD?

From what I have been told and from our vet speaking with Dr. Tobias...no this is not a safe assumption, the chances are obviously better but not guaranteed. Dr. Tobias even had an adult with normal BAs test positive for MVD via a liver biopsy.

It really depends on what vet you talk to as to what opinion you will get, there are several that do not think Bile Acid testing should be used as a screening tool, that they are just too unreliable. The last surgeon we talked to who does LS surgery, when asked his opinion he recommended starting with a full blood panel and then going from there if there is an indication of a problem.

[bjh]

Originally Posted by JaLaYorkieGirl

From what I have been told and from our vet speaking with Dr. Tobias...no this is not a safe assumption, the chances are obviously better but not guaranteed. Dr. Tobias even had an adult with normal BAs test positive for MVD via a liver biopsy.

It really depends on what vet you talk to as to what opinion you will get, there are several that do not think Bile Acid testing should be used as a screening tool, that they are just too unreliable. The last surgeon we talked to who does LS surgery, when asked his opinion he recommended starting with a full blood panel and then going from there if there is an indication of a problem.

At what age do they recommend the blood panel? I have heard that vaccinations can interfere with those results too.

[topknot]

I do both a full blood panel and the bile Acid test, but they are not guaranteed (not full proof). This is all we have a the time that is not invasive. Only a biopsy is accurate, but I am not going to have this done on a healthy, happy, bouncing puppy. Since the Bile Acid test and full blood panel is all we have at this time - I do screen, since it is all I can do at this time. I also screen parents before breeding.

My vet also stated that if you ever have a bad reading wait a few weeks and retest. He has seen a positive result go to a negative.

Dog food high in protein can also give a wrong reading too. You should stay in the range of about 20 precential of protein on your food. You should not go in the 40% range, via my vet and I agree.

They are hoping for a genetic code in only one year away from now. But they hope for this. I will be happy when we do eventually have it and know better.
T.

[my2boyz]

Stress and growth can also affect the bloodpanel results of puppies under a year. This is what the pamphlet from my vet says: "The ALK PHOS, if elevated, can indicate liver disease, cushing's disease, stress or bone activity."

My vet recommended that if that level is elevated the blood panel should be redone after the puppy is done growing.

[JaLaYorkieGirl]

Originally Posted by bjh

At what age do they recommend the blood panel? I have heard that vaccinations can interfere with those results too.

We try to do them at their 8 week checkups but if they are too small or too wiggly I will usually bring them back at 10 weeks just for the blood draw. So far we have not seen a bad result on the blood panels. If we ever would, we would just retest a few weeks after all vaccines are done and hang on to the puppy longer. We do not make our puppies available to be reserved until this test has come back normal.

Tina I agree with you on the food...which is one reason I just do not trust the test. We get several e-mails from people asking for advice and recently I talked to a lady whose yorkie was eating RC Yorkie food (28% protein), she had very high BA's post was over 100. The dog was clinically normal. She had a clear ultrasound and the vet knowing that they will not all show up recommended surgery to correct the suspected shunt and a biopsy. They went in for the surgery, found no shunt and did a biopsy of the liver...which came back normal. Oh yea and the dog which was to be shown was also spayed...

They switched her diet and re-tested 6 weeks after getting the results and wouldn't you know...her BA's were normal. How devastating. I think BA's are a good test but I also think they create a lot of unnecessary stressful panic. Our yorkies that are bred have a full blood panel done on a regular basis.

I really wish there was an easy answer and a full proof test.

I will say that Dr. Tobias recommended to our vet to have us do a liver biopsy at 2 years old, prior to breeding. I personally think this is too invasive.

[magicgenie]

Originally Posted by JaLaYorkieGirl

... recently I talked to a lady whose yorkie was eating RC Yorkie food (28% protein), she had very high BA's post was over 100. The dog was clinically normal. She had a clear ultrasound and the vet knowing that they will not all show up recommended surgery to correct the suspected shunt and a biopsy. They went in for the surgery, found no shunt and did a biopsy of the liver...which came back normal. Oh yea and the dog which was to be shown was also spayed...

They switched her diet and re-tested 6 weeks after getting the results and wouldn't you know...her BA's were normal. How devastating...

WOW, and the vet actually came back and admitted they ruined a show dog for nothing. SCARY. I would have done something very bad to him/her. So, basically this is saying there is no reliable way to rule out liver shunt without surgery. You can rule it in under certain conditions, but never out. Hmmmm. Got to think this over.