Bile Acid Test results--Liver shunt?

[TLC]

Originally Posted by Madisen55

thanks that was of much help! would you go ahead with neutering if levels were still a bit high or would you wait on it ?? any advice on that.. my dog is crypdorchid so i want to get him neutured before they turn cancerous!!

I would discuss that with a Specialist. Roxy had been spayed and had 2 Luxating Patella Surgeries, she also had her teeth cleaned - All the while, I had NO CLUE of her BAT levels - I am thankful she made it through the anithesia (sp?), but I don't know what I would have done 'if' I knew her BAT levels were that high.

[Madisen55]

thanks for the help!! ive been stressing over this for days!! im not sure i want to go see a specialist att his point (cost is too much) im going to speak to the new vet imwith and see if he will go ahead with surgery or if he wants to put him on a low protein diet and retest...i just keep thinking about the "what if" i go ahead with it and he doesnt wake up... i called a few vets offices and few said they dont do blood tests before nueturing so im sure many dogs go under with high BAT levels and come out ok.

[Ladymom]

Originally Posted by Ellie May

Normal is about 7 premeal and 15 post. Some vets say anything above 40 is concerning.

According to Dr. Center, anything over 25 is abnormal. Over 100 is indicative of a shunt.

Scintigraphy is considered more effective than ultrasound in diagnosing shunts. It runs around $400.

Dr. Center recommends getting a bile acids test done on all puppies before they go to their new homes with sixteen weeks being ideal. I belong to a Maltese forum where more and more educated puppy buyers are insisting that this be done beforehand or they have it done right after they get their puppy home. Since Dr. Center no longer recommends a 12 hour fast, it's perfectly safe for puppies now.

Do any of you get this done before buying your puppy? Yorkies are 36 times more likely to have a liver shunt than all the other breeds combined according to the study done by Dr. Tobias at UT.

http://www.vet.utk.edu/clinical/sacs/shunt/faq.shtml

[sadiesamie]

Originally Posted by Madisen55

thanks for the help!! ive been stressing over this for days!! im not sure i want to go see a specialist att his point (cost is too much) im going to speak to the new vet imwith and see if he will go ahead with surgery or if he wants to put him on a low protein diet and retest...i just keep thinking about the "what if" i go ahead with it and he doesnt wake up... i called a few vets offices and few said they dont do blood tests before nueturing so im sure many dogs go under with high BAT levels and come out ok.

I would ALWAYS have pre surgery work done before ANY surgery. the extra 150.00 you pay can save your pups life. In fact our vet does highly recommends it. At first i always saw it as a way for them to make more money. but not any more. No way... The blood work and pre surgery work will red flag any potential problems that you were not aware of.

For us- going forward, I would highly recommend this to anyone who owns a yorkie. IMy two will have blood work done every 6 mos- regardless. A full blood panel. It's the only way to make sure all of there organs are working properly. In the past- i would have thought differently- but with what we have been through this past year. No more annual exam and that's it.... fronline/heartguard and shots. I want a full blood panel done on both. And ALSO you should do a urinalysis too. At least once a year if not every 6 mos these little dogs are prone to so many things and catching things before it's too late WILL make a HUGE difference. I cannot stress that enough.
We had NO idea my Sadie was producing large amounts of protein in her urine. I decided to tell the vet that i wanted a urinalysis done on her and that is when it showed up. I even started the whole process with the crystal situation that my other yorkie was dealing with. Had i not done that who knows where we would be with this all. Let me tell you- WHAt a shocker! when I suggested that since my other yorkie Samie was having crystal issues i wanted to have my other dog Sadie checked too. Only because they are two different litters but have the same mother-different father. Eventually Sadie would have shown symptoms of muscle weakness and lost a lot of weight (muscle mass) her kidneys could have started going into kidney failure. But thank GOD we caught this all in time with me suggesting a urinalysis. Now she is on meds and her prot/creat ratio has improved. I, on the other hand may be developing "ulcers" from all of the worrying i have done with both of my girls. :-) these little girls really have made me so worried it's crazy. I am better but with them going on 10 yrs old this is when things start to go wrong.

I would get an opinion from your vet in regards to delaying the surgery or not. It's always scary when they are put under. But anestestic has come a long way and my vet reasurred me by telling me that my dog (when she had her teeth cleaned last June) would be wearing an anesthia mask and they would be monitoring her vitals the whole time she was under.
She said if any of her vitals started doing anything what so ever...The mask would come off immediately and she would wake up super quick. almost immediately. That made me feel better. apparently it is inhaled and that is how the vet put her under. Plus......... the vet called me every 30 minutes to reassure me that every thing was going perfect. She also encountered additional dental work that needed to be done (1 tooth that was infected and another that needed to be pulled out) so she kept me informed the whole entire time. Yes- i won't lie- I was on pins and needles the whole time but the constant phone calls made the WORLD to me. I had no idea this was how surgery day was going to be when the day finally got here. I was very worried as well. It's completely normal. If you have a Great vet you will be more at ease. :-)

[Ellie May]

I would not neuter yet. I would wait and see if the vet/specialist wants a liver biopsy. They can be done at the same time (saving money and only once under anesthesia). A coagulation profile (correct me if I"m wrong?) should be done before a biopsy.

Ladymom, I agree. Anything above 25 is abnormal. Some just write it off up until about 40 and just watch. Anything above about 30 or 40 (for Yorkies) really HAS to be checked out in my opinion. I would check out anything above 25 though.

Ultrasounds can be a waste of money. They are often inconclusive and you may want to go with scintography instead. Even if it is MVD, your dog needs to be on supplements to support his liver and low protein food. It is best for him.

Of course you could just wait a month and retest if you feel that is what you should do. I just wouldn't be comfortable with it.

[sallen15]

Originally Posted by Madisen55

i've called a few places and they gave me lower quotes on the nutering and they do it without blood work is that unsafe? i have a gut feeling nothing is wrong with riley and i dont want to pay for an ultrasound if not needed...but again im concernedd of going else where and something happens... maybe i should request to do another test in 30 days

I just went through the exact same thing with my Lucy. She had elevated Bile Acids and some low readings on some other blood work. So I waited a month and had the Acid Bile and blood work re-drawn and it her acid bile was still elevated but the other levels were stable.

I contemplated what to do because the cost of an ultrasound was pricey. So I switched Lucy to Wellness Puppy food because the protein is a single source Chicken and also started using Missing Link. She wasn't having any symptoms related to liver disorders.

After talking with the vet extensively. I decided to have an x-ray done at the vet's office to see if her liver was normal sized. The vet did the x-ray and said her liver looked completely normal and that she could go ahead and be spayed.

I was nervous, but the vet didn't have me fast her as long the day before and she also administered glucose in her IV fluids during the surgery to prevent any hypoglycemic attacks. She came out fine and was happy as a clam when I picked her up from the vet that day. She had to wear a onesie for about a week and a half while her incision healed and now she is the happy vibrant puppy she's always been.

[Ellie May]

How are things coming?

Ellie's bile acids were up (just checked as a precaution) a few months back. Her post meal was 47. The vet gave me two choices after consulting an internist. I could either have an ultrasound done by a specialist or supplement and wait a month. I decided to supplement for the month and her numbers went down. The deal during that month though was if Ellie get sick she goes straight to the specialist. And Ellie's numbers weren't nearly as high as your dogs. Had your Yorkie had heartworm preventative within about a week of the test or flea med? The vaccines were too far back to affect it.

[Ladymom]

Originally Posted by Ellie May

I would not neuter yet. I would wait and see if the vet/specialist wants a liver biopsy. They can be done at the same time (saving money and only once under anesthesia). A coagulation profile (correct me if I"m wrong?) should be done before a biopsy.

Ladymom, I agree. Anything above 25 is abnormal. Some just write it off up until about 40 and just watch. Anything above about 30 or 40 (for Yorkies) really HAS to be checked out in my opinion. I would check out anything above 25 though.

Ultrasounds can be a waste of money. They are often inconclusive and you may want to go with scintography instead. Even if it is MVD, your dog needs to be on supplements to support his liver and low protein food. It is best for him.

Of course you could just wait a month and retest if you feel that is what you should do. I just wouldn't be comfortable with it.

You are so knowledgable on this subject. I'm sorry you had to learn by firsthand experience.

Have you seen this from Dr. Center? If not, I think you'll find it very informative:

http://www.vin.com/proceedings/Proce...2675&O=Generic

[Madisen55]

i just went to pick up all of his results from the vets office just so i can have a look and i also booke dna appt for another vet to get a second opinion...i have a feeling he is ok and with just maintaining a low protein diet and restesting with help.. it's comforting to hear that other people with dogs and high test results have come abck ok after surgery,, but he did have a few vaccinces a couple weeks before hte first blood test,, is alt was at 211 and so we tested again a few weeks after that and it was wat 190? still high but much lower...everything checked out to be normal other then the alts i will update once i hear back from the new vet on monday morning!!

[Ellie May]

I thought the vaccines were a few months before the blood test... A few weeks before might affect the results.

The ALT is too high. The highest it should be is 100 or maybe 118. I don't know how high the ALT has to be for this to apply but experts say if the ALT is high, the liver is 70% damaged. They probably mean elevated to 500-700 though. Maybe check with a vet?

[Ellie May]

Originally Posted by Ladymom

You are so knowledgable on this subject. I'm sorry you had to learn by firsthand experience.

Have you seen this from Dr. Center? If not, I think you'll find it very informative:

http://www.vin.com/proceedings/Proce...2675&O=Generic

I don't think I had seen this. I will read it.

Atleast there probably isn't anything wrong with Ellie after all. I studied all of it for nothing.

[Ladymom]

Originally Posted by Ellie May

I don't think I had seen this. I will read it.

Atleast there probably isn't anything wrong with Ellie after all. I studied all of it for nothing.

Not for nothing. You are doing a wonderful job of educating people here on YT.

[Madisen55]

i thought it was a few months but i got the records from the vet and it was only a few weeks... i know his alt was quite high im getting a second opinion to see if a new vet will put him on a new diet some meds before we go through with the ultrasound and biopsy.. as well im going to ask him about the protein c test!!! thanks everyone for all the great tips!! ive already started riley on new food by Hills that is 16% protein and no more human food!?? any ideas as to what i can give him as treats?

[Ellie May]

Originally Posted by Madisen55

i thought it was a few months but i got the records from the vet and it was only a few weeks... i know his alt was quite high im getting a second opinion to see if a new vet will put him on a new diet some meds before we go through with the ultrasound and biopsy.. as well im going to ask him about the protein c test!!! thanks everyone for all the great tips!! ive already started riley on new food by Hills that is 16% protein and no more human food!?? any ideas as to what i can give him as treats?

small bits of apple peeled, watermelon, green beans

[sadiesamie]

Originally Posted by Ellie May

How are things coming?

Ellie's bile acids were up (just checked as a precaution) a few months back. Her post meal was 47. The vet gave me two choices after consulting an internist. I could either have an ultrasound done by a specialist or supplement and wait a month. I decided to supplement for the month and her numbers went down. The deal during that month though was if Ellie get sick she goes straight to the specialist. And Ellie's numbers weren't nearly as high as your dogs. Had your Yorkie had heartworm preventative within about a week of the test or flea med? The vaccines were too far back to affect it.

My Samie had heart guard on 12/9 and blood work done and the bile acid test done on 12/15. She also had blood work done on 12/11 b/c that was the day she fainted and we wanted to figure out what happened. Apparently she saw something with her liver count and wanted us to do the bile acid test. (It was later determined that my other dog and her got into it over their food and my other yorkie put her down on her back. Vet says her trachea collapsed and she fainted) We still decided to have some blood work done. I asked the vet and she said that the heart guard would not make her results different? do you think otherwise? It makes sense to me.