Acid bile test? Help
 

Manolo is having an Acid Bile Test done right now as we speak. I pulled his food and water last night and they will draw blood then feed him a high protein diet then draw blood again. I should have him home by 1pm. Can anyone give me some advice on his levels. I like to be educated before I speak with his Vet. Manolo has had 3 Seizure type behavior in the past 2 years. Its very scary. He falls on his side and cant get up and his head seems tillted back almost like he is paralized. I pick him up and hold him and it seems to be over in 5 min. I do give him neutrical. Im not sure if this is the signs of a shunt or Hypoglasimic. Thats why Im having him tested. He is only 2.9 lbs and its so hard when they are this small because you have to act fast or they can go down quickly. My vet said that sometimes they dont come out of that seisure state. This is scary. Can someone give me some advise..Thanks.

If your vet is sending the blood to Idexx, the reference range is 7 or lower preprandial (pre meal) and 15 or lower postprandial (post meal). The postprandial can be normal up til 25 according to Dr. Center (developer of the bile acids test).

Seizures could be a symptoms of liver issues, hypoglycemia or a whole lot of other things. How many times a day is he fed?

I free feed him so he nibbles all day long. Do they send off the blood work and how long before I hear anything. They did a pre blood work then they fed him high protein diet then drew more blood. What is a normal level.

When they are Hypoglasemic do they have seizures. I know they get lathargic but this is way more than lathargic. He gets stiff and cant move. no shaking at all. He has only had 3 in my presence and that scared the h... out of me. I had to rub nutrical on his gums but he snapped out of it in 5 min. Did you go thru this with yours.

Try not to panic *until* you get the results - should be the next day. You should also have a complete blood panel and urinanlysis done too - this will show if there's anything else "off" that could indicate liver issues.

Roxy's first BAT was Pre 43 and Post 100.9 = VERY HIGH :(

Try reading up on Liver Shunt and MVD so you have a better idea of what they are.

Roxy most likely has MVD.

When you get the results, come back to us and let us know what they are and what the Vet suggests, we can help guide you from our experiences ;)

The normal level is in post number 2 of this thread.
Yes, hypoglycemia can cause seizures as can epilepsy, thyroid problems, hydrocephalus (doubtful in this case), etc.
No, Ellie doesn't get seizures but her postprandial bile acids were 106 on last check.

I don't know the answer, but will be praying for you. I'm sorry you have to go through this. I'd be a nervous wreck too.

Thanks All I just brought him home and we will find out tommorow. I will let you know. He is fiesty as ever. Yes I did have a full blood panel done not too long ago and everything was normal. Thanks for your support. Lissette

Bile Acid test
 

I just took in rescue a tiny 2 lb female Yorkie. Her bile acid test was off the chart and then found out the owner had been feeding her nothing but steak, chicken, pork to make her gain weight.
I'm not sure if now that I have her on a low protein diet should I have the bile acid test redone?

Dr Tobias is the leading vet for liver shunt issues and once my vet sees this little one I'll have him contact her to discuss all the issues.
You might want to "google" Dr. Tobias and IF your little one has high bile acid results Dr. Tobias will discuss a plan of care and procedures with your vet for free.

My prayers are with you and your little one.

I'm here for you...Winston is almost 5 years old and has been having episodes very similar to your baby, for nearly 2 years. The vets and specialist say Winston's "seizures" are from low blood sugar and not epilepsy. I was able to rush him to the vet, so she witnessed the seizure and his glucose was dangerously low...I believe it was 25...the normal is 60-132. Does Manolo lose control of his bladder? Winston does not. Winston's bile acid test was near normal...no shunt.
NutriCal always brings Winston out of it. It was advised to feed him 6 small meals daily. I also have to check his blood glucose at the first sign of a seizure...it's always very low. He is also on diazepam (Valium) to keep him somewhat calm, to conserve his energy/sugar. Nothing I do really seems to help. I'm very curious what your vet finds with your little boy. How old is he? My thoughts and prayers are with you, I hope they guide your vet to an answer...

I have not heard back from the doctor yet. I will update everyone on this condition. Dumb me, I thought he was fainting. But the last time I knew it was something else. Manolo is 3 years old and I have had him since he was a baby. He is my daughters dog but he stays with us. I free feed him Canadae and distilled water sometimes chicken but thats it. Im glad someone else has seen this type of seisure. Its very scary the way their body just gets stiff and head tilted back. Im thinking its low blood sugar also but I wanted to be sure. How do you check his sugar level? Do you do this yourself? I will keep you guys informed on what this is.

I do use an at home blood glucose meter, I prick the pad of his foot for a drop of blood. The vet had said, to use his ear, I had no luck with that or his tail. I do believe you could poke his gum/lip area too, but I have not been able to do that during a seizure...he's totally helpless, stiff, panting, tongue hanging out, his eyes seem to be wide open but not focused. He's either on his side with his legs straight out, or on his belly, spread eagle. The gums and inside of his ears turn a very strange bluish/purple color almost gray, as if he's getting no oxygenated blood. I rub NuriCal on the roof of his mouth, this seems to work the best...although he does usually vomit afterwards. I've had some luck, not using quite as much and this helps with the vomiting. I'd say it takes about 20 minutes, for him to be able to stand up again and walk, but he starts coming around within 10 minutes, I just hold him, talk to him, comfort him and wait. I don't know, I worry that I'm missing something...a reason for this...a way to prevent it. Of course I don't want to overlook something that may be fatal, if it can at all be treated, you know?
Please do let us know how your little one is doing and what your vets take is on it, thoughts and prayers go out to you and your Manolo.

OK, His results are in from his acid bile test. pre food 18, post food 60. They think he has Micro vascular shunt. My vet spoke with a Dr Radash of the Dallas Vet Surgury Center and our next step would be a Transplentic Scintophry or an Imaging when they insert dye. Help Give me more advise. Manolo was a normal size pup not the smallest or the largest. But after a year he seemed not to grow. Drinks more water than the rest. Now this. He is running around like nothing but those 3 times he has had seisure scared me. Dr Radash does not think its a full blown shunt but a mild Vasqular shunt, by his blood work. What do you guys think....Im sorry I have repeated myself but Im stressed about this little guy.

Well, at least you have an answer and a starting place.
You don't need to go to scintography quite yet if you don't want do.
How about a Protein C test? This is just a blood test. Normal levels indicate MVD and abnormal indicate a full shunt. There are exceptions though. Then if the number is in shunt range, a scintography would be next. However, you might want to go with scintography even if the Protein C test is normal. Personal preference...

Because he is symptomatic, he will need to be on a specific diet. Has your vet talked to you about that? He will also need supplements.

You are a God sent. Thank you. I called my vet and he said that he will do this on Monday with the Urine test to see if their are any crystals. He is quite new to this but what I like is he is receptive and gets information from other doctors. He is a 2006 graduate from A&M . S o when I asked him what you said he that makes great sence and he was going to do this Monday. He did mention the diet because he thinks it a Vascular Shunt and he said that Manolo would be on supplements and a special diet. Please keep me informed on any more info and support. Thank you...Lissette

Supplements:

Denosyl or Vetri DMG
Milk Thistle (Hepatosupport is okay)
Vitamin E
Possibly fish oil/omegas
Lactulose if symptomatic

If he is seizing, I'd go with a prescription diet. Those would be Royal Canin LS 14 kibble (makes some Yorkies itchy but is a fair food and very palatable) or Science Diet L/D canned. The L/D kibble wouldn't be my first choice. If he isn't seizing, you may be able to add some high quality vegetarian protein to these foods or possibly give a vegetarian kibble like Natural Balance. Homecooking is also an option. In my opinion, no red meat ever. It produces the most ammonia (toxins) and that builds up and can cause neurologic symptoms (hepatic encephalopathy). Extremely restricted protein isn't really a good idea, so if he can handle more than what is in those prescription diets, I would personally add it. Vegetarian protein is best followed by fish and chicken. Even chicken is questionable. It really depends on the dog. You may want to watch purines and give low purine foods only (I don't, but it is a good idea) and this is a must if there are bladder issues (UTIs, stones). Your vet will give you the dosing on the meds.

Did that answer your questions?

Yes Thanks so much. Please keep the info coming as you know more than me. Dr Darrel has called his Profesors at A&M for more advise and all the local specialist...Thank you for being there....

Well this seems to be a case of good news/bad news, huh Lissette. I'm so happy you decided to follow you gut instincts and get Manolo tested and I know Dr D. will figure it out and help you find the best possible solution for Manolo. Dr D is the BEST! Continuing prayers that everything works out for you. :)

You are getting some answers at least...hope it all works out for the best. There are some very knowledgeable people here regarding liver shunt/MVD...you'll get wonderful advice and support.
I was so certain that Manolo's seizures sounded so much like Winston's, but liver shunt has been ruled out in our case.
Question, if a dog's bile acid test comes back negative, is there any reason to have them rechecked, years later...or further liver testing done?
Best wishes for you and Manolo...I'll keep him in my thoughts and prayers...

No, they don't have to be rechecked unless they were checked before 20 weeks or there is new concern about liver function. If they were the slightest bit elevated and the dog is seizing, I personally would probably recheck.

Thanks!

Im so sick about this. I have not put him down all day today. Just cuddle with him. I looked at Dr Tobias website trying to get more info. Im so sick and sad

Ahhh...Hun, try to remain calm. LS or MVD is NOT a death sentence. You are doing everything to help your baby. He can live a happy a nd long life. You've got a great Vet and a great support group here for you....

There is a Liver Disease group at Yahoo. They have a lot of members just like You and Me (LS and MVD parents ;))

They can help guide you even further:
DogLiverDisease : Dog Liver Disease

Liver disease is a scary diagnosis but with the correct protocol, he should do very well. :) I heard of one small dog who lived to be 17 with MVD. Try not to worry too much.:)

I have been doing a lot of reading too...mostly about diets...it's very interesting. I think your boy is in very good hands, find the problem so that you are better able to treat the problem. It's going to work out...he'll be fine.

Try not to panic. His bile acids are high, but under 100 which is a good sign.

The next step would be a Protein C test. Here is all the information you need about the test to show to your vet:

Comparative Coagulation -- NYS Animal Health Diagnostic Center

Great information everyone. I am ready and armed to tackle this situation. God Bless all of you for the great advise. I fowarded all these notes to my vet. My vet Dr Darrell loves YT because everyone educates themselves and helps find solutions. I am going to change his diet today and try and get a presciption for the food you suggested Ellie Mae. I spoke with his breeder who is a friend of ours and his dogs have been tested and nothing has ever shown up in any of them. He even gave us a lifetime guarantee on any hereditary diseases. YOU GUY HAVE GIVEN ME GREAT ADVISE and all of you have made me strong. Thank you

Hang in there Lissette, it's going to all work out just fine. :hug: I know it will. You've caught this early and you've got the best doctor on your side. :)

Oh Teresa, I had the worst night last night thinking what have I done to make him sick. Then I just got home from work and saw all these wonderful responses and I feel so strong. Manolo will live to be 20 years with my fight behind him. Non of Pats dogs have ever had this problem. I think it must be burried in his line somewhere. Manolo quit growing around 6months and has stayed the same size. Thats a sign. I love it when someone told me that all Yorkies should have an acid bile test. I should have also seen the sign when he spins. It seems like he only spins when he want to go outside. Never any other time. Oh WELL when David takes out Papi he spins wanting a piece of my Bird. This has made me more aware and I hope you guys will soon get an acid bile test done. I dont think Yogi will ever need one since he is soooo hardy but I would have Gracie and Boo checked to make sure you are right on track of things...

Just wanted to pass this on - they were a huge help.
DogLiverDisease : Dog Liver Disease