Vet wants a scintigraphy done? Hello all- I recently posted about my 2.5 pound Willow who had elevated bile acids discovered in April. She showed a pre-19 and post-45 (or so, I can't remember the exact #). She had no crystals in her urine. So we got referred to a specialist but in the meantime I put her on Royal Canin LS14 and waited a month to have her bile acids tested again. Some quick background-She had one seizure episode over a year ago, but there were other factors (comfortis, possible trauma) involved so they weren't sure why and she has had none since. She has no other real symptoms, she circles when excited, but the specialits didn't seem concerend, said she appeared very healthy. She eats well and despite being so small, has good body composition. This time she was pre-1.3 and post-31. Because the vet still can't be sure, she suggested a scint, because if we tested the bile acids again in 6 weeks, it could still be inconvlusive. She said she may have a shunt, or these levels just may be normal for her, the only way to be sure of no shunt is with the scintigraphy. Should I go ahead and do the scint even with the risk of the anesthesia? She needs LP surgery soon so we need to know for sure if something major is going on. Should I get a protein C done first? Or should I just go ahead with the scint to rule out a shunt for sure? I went ahead and scheduled her, but I am getting nervous!!! |
Yes - get a Protein C test done first. Those BAT results do not point towards a shunt, rather I would say MVD. :( |
It is a personal choice between you and your vet. I can tell you that I (and this is just me) would not. I'd do the Protein C test and slowly proceed while putting the LP surgery in the back of your mind until this is figured out. Those numbers could mean a shunt but it is more likely MVD or something altogether different. Ellie's bile acids were 106 post last January and we did an ultrasound (not recommending it because of their accuracy). It showed nothing major with her liver and because of her age and lack of symptoms, we are going no further right now. If I had to do it over again, I would have done the Protein C test first. Ellie's liver biopsy showed no MVD (only had it done because she was getting spayed anyway), so we don't know what it is but I would be putting her through a scint at this time. In my opinion (and I am not a vet), those numbers are too low for that test unless the Protein C test indicates a shunt. |
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AVMI- Portal Scintigraphy is your dog head pressing on walls, acting spaced out after eating, vomitting, picky eater, seizing as these are all signs of liver shunt if not no way would i do testing like this Now LP surgery should only be done if dog is in pain and lifting leg up constantly otherwise they will do fine with LP ok going to read whole thread just panicked when i saw this so wanted to respond immediately |
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Totally agree with you 100%. I'm not a vet but with the low levels, I'd really wait to have your pup retested. LP seems to be the buzz word for vets. It can be wieght managed as well as a bit controlled with glucosamine. Seek a 2nd opinion from an orthopedic surgeon. What grade level is the LP. |
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And yes, an Orthopedic that is also at my regular vet's office has seen her and is the one who recommended the LP surgery. Given the choice between getting her knees fixed so she can live a pain free normal life and waiting until it could possibly be too late and she go lame later, I think I'll choose the former. As for the internal specialist, she conferred with many of the other specialists in the same office, and they aren't pushing anything on me, they just gave me their opinion if I wanted to know for usre she did or did not have a shunt before we proceed with the LP. I am completely comfortable requesting not to have the scint, just wanted some input. I am thinking of doing the Protein C, and then deciding from there. |
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I would not imagine she has a shunt with those numbers but could be wrong - shunts usually throw bile acids over 100 post. Also the dog would be having alot of symptoms. Also numbers can be off due to gall bladder contraction during blood draws and why more than one pre and post bile acid are done along with protein C. Alot of vets are real quick to do a ton of testing when not really necessary. Treat the dog not the blood work so if the dog is not having symptoms running a bunch of unnecessary tests is not right as it puts alot of stress on the dog. |
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