My baby is sick :-( - Page 2 - YorkieTalk.com Forums

TheresaG · 08-31-2009, 05:14 PM

Just an update, Corky has been acting like normal. Tomorrow morning he has an appointment with the internal medicine specialist. Hopefully all goes well, and it is something that can be controlled with low protein diet.

TheresaG · 09-01-2009, 05:20 AM

We went to see the internal medicine specilaist today and he looked over his lab restults and didn't seem too concerned. He said he doesn't see anything that would require harsh exploratory surgery, or even an ultrasound at this point. We decided that I will take Corky in for repeat labs next week and if things are at a high level then we will explore further. He has not had any symptoms since Saturday so he said that if he shows symptoms again to bring him back in right away and not wait till next week. But hopefully all is going to be well. Maybe he was just got into something.

harleyyorkie · 09-01-2009, 05:38 AM

First, I hope Corky gets better, good wishes going out to you.

Second, I don't know if your baby ate a mushroom or not but, my Scooter ate a mushroom from outside. He had the runs and vomiting really bad for like 3 days. The vet gave him something for nausea & the runs. He came out of it fine, but I am now on constant mushroom patrol! I have a can of coins that I shake so it makes a loud noise anytime any of them go near a plant or put anything in their mouths other than food/water or a toy. They are just like babies, everything goes in the mouth!

dwerten · 09-01-2009, 07:08 AM

Quote:

Originally Posted by TheresaG

We went to see the internal medicine specilaist today and he looked over his lab restults and didn't seem too concerned. He said he doesn't see anything that would require harsh exploratory surgery, or even an ultrasound at this point. We decided that I will take Corky in for repeat labs next week and if things are at a high level then we will explore further. He has not had any symptoms since Saturday so he said that if he shows symptoms again to bring him back in right away and not wait till next week. But hopefully all is going to be well. Maybe he was just got into something.

well i hope he is ok but personally i would want to know what the correct bats numbers are and if over 100 but if he has any more episodes i would get him in right away

TLC · 09-01-2009, 07:21 AM

I agree that the Vet did an inhouse BAT and they are really no good.

When you repeat the Bile Acid test, please insist that they are sent out to a Lab for the results. You need to know the exact pre and post numbers, as this will explain better than just those stupid in house ones that say >30 (ridiculous that they do that

)

TheresaG · 09-01-2009, 08:16 AM

History: His owner reports that for about three days last week, Corky
did not seem to be feeling well. He was shaking, lethargic, and not
eating. Lab work submitted at the end of last week showed a slightly
eleated ALT liver enzyme concentration and pre- and post-prandial bile
acids concentrations that were listed as greater than 30. Shortly after
his visit to the doctor Corky seemed to start feeling better, and he now
seems back to normal. No treatment was undertaken, so his issues seemed
to resolve without any intervention

Physical Examination findings: His general exam today was
unremarkable.

Weight: 4.05 lbs 1.840 kgs

Procedures: physical exam and consultation

Results as of 9/1/2009: We reviewed his history. We do not know
what caused his signs last week, but it is nice to see they have
resolved. Hopefully they will not come back.

There is no way to know if the lab work findings have anything to do
with why he did not feel well last week. It is possible that liver
disease is/was present, but it is also possible that his signs had
nothing to do with the changes found on lab work. Those changes raise
questions about the status of his liver, and given his breed, about the
status of the blood supply to his liver (ie the possibility of
abnormalities in the blood supply to the liver, commonly referred to as
shunts).

Options for dealing with the information gathered so far include
repeating lab work to see if the abnormalities noted last week prove to
be repeatable findings or not, or digging for more information by doing
tests like ultrasound or MRI. Ultimately, if the goal is to be as
certain as possible about his liver and its blood supply, the most
direct way to do this would be through exploratory abdominal surgery,
liver biopsy, and assessment of the blood supply to his liver with a dye
study called a portogram. Even though this is the most complete way to
proceed, I think it may be too aggressive as a next step at this point
in Corky's case.

My recommendation, as long as he seems to be doing well, is to repeat
his lab work (chemistry profile, bile acids profile that gives actual
numbers rather than a range like greater than 30) in 7-14 days. If that
lab work is normal, I'd check it a third time in a month or two to get a
third set of values for review. If it is abnormal, then decisions can be
made about which steps to take next to gather additional information

If Corky does not seem to be doing well, then he should be re-assessed
sooner, and the above plan can be modified to fit his changing
circumstances.

dwerten · 09-01-2009, 08:30 AM

what concerns me is they say exploratory surgery and you do not need this to determine liver shunt - the three best test are all non surgery based - the only way i would do liver biopsy for mvd is if the dog was being spayed then they have the dog open to do this otherwise i would not as the other tests are real good indicators of mvd and mvd can be treated with low protein only and does not require surgery only liver shunt does so at this point you need to know what the true bile acids are as what you have is just a waste of your money quite honestly and I would tell the vet to throw out the snap tests and not use them and send to labs as she is wasting peoples money by doing a test that is inconclusive. If she did the lab bile acids you would know where you are but because they did not do this they wasted your time, money, and stressed out the dog for an inaccurate assessment in my opinion as no vet should ever use a snap bile acid as it is not conclusive and why run a test that is inconclusive when you can run real easy a conclusive one for a pet owner

sorry this just makes me mad when vets waste peoples money with diagnostics as this happened to me and i was 20k plus in vet bills for tests that were a waste so this really burns me - I believe in doing the most accurate test for the problem and doing it right the first time

TheresaG · 09-01-2009, 08:43 AM

Quote:

Originally Posted by dwerten

sorry this just makes me mad when vets waste peoples money with diagnostics as this happened to me and i was 20k plus in vet bills for tests that were a waste so this really burns me - I believe in doing the most accurate test for the problem and doing it right the first time

The doctor said that any invasive proceedures would be if they are absolutely necessary. He does not want to nor does he advise that be done at this point. He said that I should not even change his diet right now, because the SNAP bile acid test is very inclusive. He said you can't tell if it is 30.2 or if it is 100, and there obviously is a big difference there. That is why next week he wants to do a bile acid test in which he gets specific numbers. It was my choice to do it next week. Just because he did only have his last blood taken on Saturday. I totally agree with you that the other vet should not be wasting people's money like that. I have both of my pets on the wellness plan at Banfield and it does not cover the tests they had to do on Saturday, so I had to spend $300 to have inclusive tests done. That kind of bothers me a little. Because now i'm going to have to pay all over again to have the same tests done.

TLC · 09-01-2009, 09:14 AM

I do not care for Banfield

A serum Bile Acid Test (sent out to the Lab) from a Private Vet, costs about $60 to $100 depending on the area.

dwerten · 09-01-2009, 10:37 AM

Quote:

Originally Posted by TheresaG

The doctor said that any invasive proceedures would be if they are absolutely necessary. He does not want to nor does he advise that be done at this point. He said that I should not even change his diet right now, because the SNAP bile acid test is very inclusive. He said you can't tell if it is 30.2 or if it is 100, and there obviously is a big difference there. That is why next week he wants to do a bile acid test in which he gets specific numbers. It was my choice to do it next week. Just because he did only have his last blood taken on Saturday. I totally agree with you that the other vet should not be wasting people's money like that. I have both of my pets on the wellness plan at Banfield and it does not cover the tests they had to do on Saturday, so I had to spend $300 to have inclusive tests done. That kind of bothers me a little. Because now i'm going to have to pay all over again to have the same tests done.

tell the vet you want to be refunded for the $300 for tests that were not conclusive as that was a waste -- I only paid $75 for pre and post bile acids and a full cbc is about $120 so what was the $300 for ? Ultrasounds are like $400 here and that was what upset me as it was a total waste of my money. If your dog is over 25 on bile acids low protein is important 22% with no symptoms 18% if having symptoms -- you do not need to switch until you have the tests run properly then you can go from there unless the dog is acting sick

09-01-2009, 05:38 AM	#18
harleyyorkie Donating Senior Yorkie Talker Join Date: May 2009 Location: Sunny South Posts: 470	mushroom eating First, I hope Corky gets better, good wishes going out to you. Second, I don't know if your baby ate a mushroom or not but, my Scooter ate a mushroom from outside. He had the runs and vomiting really bad for like 3 days. The vet gave him something for nausea & the runs. He came out of it fine, but I am now on constant mushroom patrol! I have a can of coins that I shake so it makes a loud noise anytime any of them go near a plant or put anything in their mouths other than food/water or a toy. They are just like babies, everything goes in the mouth! __________________ Elizabeth Harley Rita Scooter Bandit Peanut

09-01-2009, 07:21 AM	#20
TLC Slave to My Rug-Rats Donating Member Join Date: Jun 2005 Location: Long Island Posts: 7,247	I agree that the Vet did an inhouse BAT and they are really no good. When you repeat the Bile Acid test, please insist that they are sent out to a Lab for the results. You need to know the exact pre and post numbers, as this will explain better than just those stupid in house ones that say >30 (ridiculous that they do that ) __________________ Adopt Donate Foster www.yorkie911rescue.com

09-01-2009, 08:16 AM	#21
TheresaG Yorkie Talker Join Date: Jan 2009 Location: Odenton, MD Posts: 20	The emailed response from the doctor. History: His owner reports that for about three days last week, Corky did not seem to be feeling well. He was shaking, lethargic, and not eating. Lab work submitted at the end of last week showed a slightly eleated ALT liver enzyme concentration and pre- and post-prandial bile acids concentrations that were listed as greater than 30. Shortly after his visit to the doctor Corky seemed to start feeling better, and he now seems back to normal. No treatment was undertaken, so his issues seemed to resolve without any intervention Physical Examination findings: His general exam today was unremarkable. Weight: 4.05 lbs 1.840 kgs Procedures: physical exam and consultation Results as of 9/1/2009: We reviewed his history. We do not know what caused his signs last week, but it is nice to see they have resolved. Hopefully they will not come back. There is no way to know if the lab work findings have anything to do with why he did not feel well last week. It is possible that liver disease is/was present, but it is also possible that his signs had nothing to do with the changes found on lab work. Those changes raise questions about the status of his liver, and given his breed, about the status of the blood supply to his liver (ie the possibility of abnormalities in the blood supply to the liver, commonly referred to as shunts). Options for dealing with the information gathered so far include repeating lab work to see if the abnormalities noted last week prove to be repeatable findings or not, or digging for more information by doing tests like ultrasound or MRI. Ultimately, if the goal is to be as certain as possible about his liver and its blood supply, the most direct way to do this would be through exploratory abdominal surgery, liver biopsy, and assessment of the blood supply to his liver with a dye study called a portogram. Even though this is the most complete way to proceed, I think it may be too aggressive as a next step at this point in Corky's case. My recommendation, as long as he seems to be doing well, is to repeat his lab work (chemistry profile, bile acids profile that gives actual numbers rather than a range like greater than 30) in 7-14 days. If that lab work is normal, I'd check it a third time in a month or two to get a third set of values for review. If it is abnormal, then decisions can be made about which steps to take next to gather additional information If Corky does not seem to be doing well, then he should be re-assessed sooner, and the above plan can be modified to fit his changing circumstances.

09-01-2009, 09:14 AM	#24
TLC Slave to My Rug-Rats Donating Member Join Date: Jun 2005 Location: Long Island Posts: 7,247	I do not care for Banfield A serum Bile Acid Test (sent out to the Lab) from a Private Vet, costs about $60 to $100 depending on the area. __________________ Adopt Donate Foster www.yorkie911rescue.com

08-31-2009, 05:14 PM	#16
TheresaG Yorkie Talker Join Date: Jan 2009 Location: Odenton, MD Posts: 20	Just an update, Corky has been acting like normal. Tomorrow morning he has an appointment with the internal medicine specialist. Hopefully all goes well, and it is something that can be controlled with low protein diet.

09-01-2009, 05:20 AM	#17
TheresaG Yorkie Talker Join Date: Jan 2009 Location: Odenton, MD Posts: 20	We went to see the internal medicine specilaist today and he looked over his lab restults and didn't seem too concerned. He said he doesn't see anything that would require harsh exploratory surgery, or even an ultrasound at this point. We decided that I will take Corky in for repeat labs next week and if things are at a high level then we will explore further. He has not had any symptoms since Saturday so he said that if he shows symptoms again to bring him back in right away and not wait till next week. But hopefully all is going to be well. Maybe he was just got into something.

09-01-2009, 08:30 AM	#22
dwerten BANNED! Join Date: May 2007 Location: USA Posts: 11,073	what concerns me is they say exploratory surgery and you do not need this to determine liver shunt - the three best test are all non surgery based - the only way i would do liver biopsy for mvd is if the dog was being spayed then they have the dog open to do this otherwise i would not as the other tests are real good indicators of mvd and mvd can be treated with low protein only and does not require surgery only liver shunt does so at this point you need to know what the true bile acids are as what you have is just a waste of your money quite honestly and I would tell the vet to throw out the snap tests and not use them and send to labs as she is wasting peoples money by doing a test that is inconclusive. If she did the lab bile acids you would know where you are but because they did not do this they wasted your time, money, and stressed out the dog for an inaccurate assessment in my opinion as no vet should ever use a snap bile acid as it is not conclusive and why run a test that is inconclusive when you can run real easy a conclusive one for a pet owner sorry this just makes me mad when vets waste peoples money with diagnostics as this happened to me and i was 20k plus in vet bills for tests that were a waste so this really burns me - I believe in doing the most accurate test for the problem and doing it right the first time