Lucy's Bile Acid Test Results
 

Lucy got her bile acid test results yesterday and they were slightly elevated. 51 before feeding and 41 after feeding. (That sounds backward). I guess 20 is normal and anything over 100 is considered definitive for a shunt.

Her vet was really not sure. With her issues this week-end, he thinks it is a possibility and next step would be a scintography; I would have to travel to Ohio State.

However, he said he wouldn't be in a great rush to do this unless she has another episode like she had this week-end.

He did not recommend to change her food at this time. Our tentative plan is to keep an eye on her and redo bile acid tests in 30 days and go from there.

She is fine at the moment. I'm very confused as to the right thing to do.

Put her through the test? Or wait the 30 days and re-test. Do her numbers 'jump out' at anyone?

Appreciate any advice. Meanwhile, I'm going to search the boards for all the information I can find . . and give Lucy a hug. She's so sweet; I don't like the thought of her suffering OR that the food I'm feeding her is making her suffer. OR putting her through needless invasive testing. OR waiting too long . . . but maybe her numbers are low enough to not worry.

I just don't know.

I don't know, but I'm going to bump your post so someone with the necessary knowledge perhaps can help you. Good luck to you.

My suggestion is to contact Dr Centers at Cornell University. She developed the BAT tests and familiar with everything LS. She's very helpful and answers phone calls very quickly.....I'm sure she'd want to see the results and would definately help you in making the right decisions......

i would do a phone consult as well with dr centers as the pre is high as my girl had a post first time it was 73 then had pre and post and pre was 3 and post was 54. Then i fed a low protein diet which i recommend you do 18% since your dog had symptoms it sounds like if no symptoms then 22% protein. I feed a 18% protein diet to mine and had her bile acids redone 6 mos later by dr dodds and it was pre 3 and post 26 and 25 and below is normal so the low protein diet helped so i would at least recommend this for now. I opted not to do the scintigraphy with mine only because she had no symptoms. There is another blood test protein c test but have found that not to be very accurate as a dog tested negative with that and had 4 shunts so after that i felt it was not accurate. The scintigraphy is pretty accurate but again there was a yorkie on here Ginger that had scintigraphy done by dr tobias and her bats were high and scintigraphy showed shunt and they opened her up and spay her at same time and no shunt so it can be tricky so I would consult with centers for sure and pay a phone consult fee and have her review the testing.

Keep in mind if the gall bladder contracts at time of blood draws it can throw the test off and why i opted for the second one and then the third 6 mos later

also join this group asap Liver_Shunt_And_MVD_Support@yahoogroups.com as they are very sharp about this disease and i believe tobias' assistant is on the group as well so they will advise as well based on blood work

This is per Dr Center's lastest seminar:

Disregard the normal fasting ranges provided by laboratories: This value is not useful and will only confuse you. Approximately 15% to 20% of dogs have a higher fasting than post-prandial (after meal) bile acid value due to individual differences in the rate of stomach emptying and intestinal motility.

good to know my girl had exact same pre on the two with pre it was 3

Do you think she will do a phone consult with me even though I probably will not be taking Lucy there? Mainly because she is so far away.

If so, I will ask the Vet for a copy of her results.

Also, wonder why the Vet did not recommend diet changes? I specifically asked him about it and he said that she was little and needed protein as a growing puppy. This confuses me as everyone else seems to be on low protein . . maybe I would be trading one problem for another?

I will join the group and call the doctor if she will consult with me.

Thank you for your knowledge. On the one hand my Vet said - no need to rush into anything unless she has another 'episode' - on the other hand, he is now reluctant to spay her in February as we planned - so makes it a bit confusing for the owner - who does not know what they are doing!

In the meantime, is there something I can give her as a treat? I was giving her bits of cooked chicken but maybe there is a better treat I could give her . . . while we are deciding what to do? I think her favorite, pupparoni, might not be too good right now either.

So very sorry to hear about your puppy, I bet it is confusing for you. Have you tried to give her cherrios? My puppy loves cherrios I have to keep a low fat diet for her even tho my vet has NOT recommended it. She had one episode of pancreatitis and I never want it to happen again so I just give her a low fat diet..

Cheerios sounds like a good idea. Thanks!

Absolutely,

There is another member that contacted Dr Centers just last week. She responded within minutes...

At the very least she can assist you by reading your pups results and guide you to your best option......

I don't know how old your pup is. However, Dr. Center recommends that an initial test should be done at 16 weeks and another at 6 months of age......

I have no further advice but will hold Lucy and you in our thoughts and prayers.

Huggs

I would hold off on the spay until she is diagnosed because she may (but very unlkely) need shunt surgery and there is really no reason to go in twice...

What happened this weekend?

Treats anything low fat and low protien.

Green beans, peeled apple bits, and watermelon are good for liver compromised dogs. Cooked carrots, sweet potato, and zucchini would also be okay.

no pupperonis those are not good for yorkies anyway as they are too high in fat those things are greasy and vet told me when dex got pancreatitis those are the worst treats too high in fat

i would hold off on spay and if this were my dog when they spay i would have them do liver biopsy to give a firm diagnosis of mvd as that really is the only firm diagnosis for mvd so you will know for sure

Yes centers should do phone consult just like dr dodds consults on blood work over the phone - some charge and usually the charge of an office visit which it is worth it since they specialize in these things and always good to have a second opinion from a specialist when things are more involved

Just wanted to say that Lucy is in my thoughts and prayers.

Thanks to everyone for their replies. Lucy loved the cheerios!

To address some of the questions - Lucy has been fine up until this week-end when she started having spastic type movements and could not get comfortable. Then began with lethargy and hiding under furniture. She was taken twice to her Vet who could find nothing wrong. We determined gas and tummy issues because I had put some Alpo on top of her kibble - which I had never done. (And will never do again)

Because her littermate (different mother/same father) ended up having a LS, our vet decided to go ahead and to the bile acid testing. Had she not had that episode - we would not have done it because she was eating, playing, and growing normally AND her liver enzymes were tested when I first brought her home and they were fine.

I think I will obtain a copy of the test results and schedule telephone consult just to be sure that I am doing all the right things between now and next month - when we have scheduled another bile acid test. Her results were only midly elevated and she only had the one incident - so we really don't know. She will be 6 months old for that test - so I think we have a good plan and on target. My vet won't spay her until we have alittle more information and I think he is wise for that.

Everyone here has great advice. I will try the different treats for her - no point in fueling the fire with chicken and pupparoni.

I will let you know what I learn in my consult.

i would definitely stick to low protein or a highly digestible protein like fish - you could treat with cod and you can get it from sam's club in freezer section and cook it up and keep in baggy and give small pieces like you were doing the chicken

My Cali had a bile acid test with results the first time 92/0 or close to that and on repeat was like 49/0. An ultrasound showed no external shunt so when she was spayed they did a liver biopsy which showed a very mild MVD (internal shunt) which required no tretament. I do keep her on a lower protein diet and have had no problems 4 years later. The specialist that was treating her said in her experience BA results under 100 were usually indicative of MVD and higher than 100 an external shunt. I hope Lucy's next test will be normal.

Thank you for sharing that. I love to hear positive outcomes or whenever a problem can be managed with diet. Did your regular vet do the spay?

I love my Vet but I'm getting the impression he is not anxious to do the spay.

So I might end up going to Ohio State for that and maybe they'll do the same thing that Cali had.

Gosh. These little ones are a BIG responsibility! We also have a Westie and, other than skin issues, he is very independent compared to Lucy. But I'm probably a little more attached to Lucy and my son to Ringo.

the mvd just to be clear is not an internal shunt that is usually found in big dogs - the mvd is tiny shunts in liver

Hi. Preprandial (before meal) test results will be high if the dog releases bile in the middle of the night. Many dogs do this. The postprandial (after meal) results if >100 indicate shunting, <100 indicate HMD (MVD) Vegetable proteins better than meat, can give egg white (no Yolks), pasta, low sodium, low fat cottage cheese, Plain low fat yogurt.
Seizures can happen within 30 minutes of a meal, watch during that time. If that happens, get back to the vet for medications, or if walking as if drunk, lethargic, UTI, drinking more water, staring/blank look...
Good Luck,
Kathy

yeah my girl is on soy diet as soy is a low protein - her diet is 18% protein

This is a page from my most favorite site:

Portosystemic Shunts FAQ

Best place for info on liver disorders on the web!

Thank you for that! Right now my vet is not recommending a change in diet but I think I'm going to do the telephone consult once I get a copy of her test results. Hopefully, that will not offend my Vet. After all, he has hundreds of pets to worry about and I have only 2!

But I am not going to feed her the high protein diet (yikes) that I feed my Westie due to his allergies.

And I am going to offer her treats that are low in protein and maybe give her a little plain, low-fat yogurt.

And maybe then her next test will be normal! I know. I won't get my hopes TOO high.

Gosh. It's amazing how much time I have spent in this forum. I've been spending time on YT for a while - but I never thought I would be in the sick and injured forum!

I'm glad it's here. And I feel so bad that there seem to be so many of us in here . . . . . why is that I wonder?

good post

some dogs are lactose intolerant so be careful with yogurt as it can give them diarhea and it has to be lowfat and stoneyfield is what many use if you want to try it