Tibbe's BAT Test Abnormal and Levels High!!!

[TxVicki]

[QUOTE=TxVicki;4207508]I know you mentioned that Tibbe was having test's at the specialist today and hope it all goes well. I do hope you are still having it done, since I saw that you had fed him this morning????[/QUOTE]
OPPS my mistake on this. That was yesterday morning. I guess I didn't read the date corect. SORRY ABOUT THAT.

I pray that all goes well with his test.

[rubymoon2072]

glad to read tibbe is feeling more like himself. still sending many prayers.

[Maximo]

Happy to read that Tibbe is doing better and better. Praying for both of you today.

[yorkietalkjilly]

Please excuse any typos/misspellings - am shaking so hard and trying to copy this report from today's tests.

Reason for Visit:
Tibbe is presented for transplenic portal scintigraphy.

(His history typed in here briefly - and most know that so I'll omit it here.)

Assessment:

Findings: The patient was placed under general anesthesia with Sevoflurane for the procedure. Approximately 2 mCi technetium pertechnetate was injected into the splenic parenchyma under ultrasound guidance and a dynamic acquisition of radiopharmaceutical distribution was obtained. Following the acquisition, the dynamic sequence was visually reviewed to identify the pattern of radiopharmaceutical uptake. There is radiopharmaceutical uptake within the liver prior to uptake within the heart, which is a normal expectation.

Following the nuclear medicine study, an abdominal ultrasound was performed. The liver is a normal size, shape and echogenicity with good visualization of the portal vessel markings. The portal vein is well-visualized at the porta hepatis and is considered a normal size. No nodules or masses are identified within the liver. The gallbladder is normal. The spleen has a homogeneous echogenicity with smooth and well-defined margins. The right limb of the pancreas is normal. The kidneys are a normal size and shape bilaterally with adequate corticomedullary distinction. Multiple, small, hyperechoic foci consistent with small nephroliths are observed in the renal diverticulae bilaterally. There is no evidence of renal pelvic dilation. The adrenal glands are bilaterally normal for size and shape. The urinary bladder is moderately distended. No calculi are observed in its lumen and there is no evidence of urinary bladder wall thickening. The prostate is normal. The stomach, duodenum, and visualized loops of jejunum have a normal wall thickness and wall layering architecture. The thickness of the wall of the colon is normal. There is no peritoneal effusion or abdominal lymphadenopathy.

Conclusions:
1. The nuclear scintigraphy study is normal. There is no evidence of congenital or acquired portosystemic shunts.
2. Small nephroliths are identified within the kidneys bilaterally.
3. The remainder of the abdomen is ultrasonographically normal. A definitive cause of this patient's elevated bile acids is not identified. Mild microvascular dysplasia is not excluded and may require a liver biopsy for definitive diagnosis. In the absence of clinical signs of hepatic insufficiency or abnormal biochemical markers for liver function, I am uncertain if a liver biopsy is necessary in this patient at this time.

Plan:

As per Dr. Sayers.

Debra S. Gibbons, DVM, MS, DACVR
Animal Imaging
6112 Riverside Drive
Irving, Texas 75039 (972)869-2180

Discharge Instructions:

Verbal - withhold food another two hours or so, water and medicine may be resumed and let him sleep it off. No need to see the internist, Dr. Woolley unless I just want to do so and Dr. Gibbons and Dr. Dave (forgot his last name already) a visiting vet from Texas A&M College of Veterinary Medicine, neither see a reason to get the liver biopsy any time soon unless he takes a dramatic turn for the worst. She said no need to put him through that until and if there is more trouble. Dr. Gibbons said the small kidney stones are in a good place in the kidneys, not blocking anything and are a fairly frequent find in Yorkies in abdominal ultrasound studies and not to sweat them. She said some dogs just form small stones like some people do. Dr. Gibbons says there is a GI panel of some kind that the vet can do and send off to Texas A&M that might be helpful but doesn't see the need at present. Any ideas what this all means?

[MandiesMom]

I don't have any advice or anything to add to what you posted.

I just wanted to say..Yay!

[dottiesyrky]

WOW! That is what I make of the results!!!! Great news for Tibbe and you. He sure had a good work up and exam of all his organs. Hopefully he will recover from the exam and be fine from now on. So be joyful and get some sleep knowing Tibbe is OK.

[yorkietalkjilly]

Oddly his BAT levels were: pre - 103; post - 60. Dr. Gibbons thinks maybe the tubes could have been switched by the vet tech or lab tech.

[MauiGirl]

Yay, no liver shunt, and everything appears to be normal!

So he "might" have MVD, and the only way to know is do a biopsy. I personally would not at this point (just my opinion), as doing so involves surgery and related risks of infection, and complications. And, they can't fix MVD, you would only treat it with "medical management".... meaning lower protein & fat diet, and maybe including some supplements.

When my Tiki was suspected of having MVD, I realized that her liver does not filter toxins out of the blood properly. So, I do everything possible to reduce her exposure to toxins, plus feed lower protein food (absolutely no people food especially fatty meats), and my vet is very conservative with her vaccinations. My vet does not repeat BATS anymore, as he said they will probably always be a little off.

Good news is that she is now 5 and seems healthier and happier than ever. But, if someone comes along and shares their bacon with her, or a chunk of cheeseburger, she will get sick, be withdrawn and have jelly diarrhea for a week, and will stop eating.

Good luck with Tibbe. So happy he doesn't have a shunt. Hugs to you both.

[Ellie May]

It means he likely has MVD. Drugs given should be carefully thought out forever. Low protein diet may be indicated. He has GI troubles which can go along with MVD. So he will be dietarily tricky but doable.

Bile acids can go up for so janyreasons. Because pre and post were both high it is likely he as an unappy liver. BUT it sounds like he will be fine.

Ellie's pre was worse than that and she is 11. Deep breaths.

I would not open my dog up just for a biopsy in this case.

[sandy simpson]

I would rejoice over those results and not put Tibbe through any more trauma. If he is eating a high quality food, pooping and peeing regularly, and sleeping I would let him just recover. Prayer over him will continue and I just know he is going to be fine. You are such a Yorkie lover! Bless you for taking such good care of this precious dog!

[yorkietalkjilly]

Originally Posted by Ellie May

It means he likely has MVD. Drugs given should be carefully thought out forever. Low protein diet may be indicated. He has GI troubles which can go along with MVD. So he will be dietarily tricky but doable.

Bile acids can go up for so janyreasons. Because pre and post were both high it is likely he as an unappy liver. BUT it sounds like he will be fine.

Ellie's pre was worse than that and she is 11. Deep breaths.

I would not open my dog up just for a biopsy in this case.

I'm thinking MVD too and low protein diet. Going to see the vet Friday for f/u and see if we should segue to it slowly and pray he doesn't start itching madly.

Meds always do seem to have a prolonged effect on him - sleeps a lot after most of them.

Crystal, course I'll be asking the vet but want your input, too. Would you keep on with Heartgard or change before his next dose at the end of the month? Or could I give his Heartguard in 2 pieces - one in A.M. and one in the P.M.?

[Ellie May]

Originally Posted by yorkietalkjilly

I'm thinking MVD too and low protein diet. Going to see the vet Friday for f/u and see if we should segue to it slowly and pray he doesn't start itching madly.

Meds always do seem to have a prolonged effect on him - sleeps a lot after most of them.

Crystal, course I'll be asking the vet but want your input, too. Would you keep on with Heartgard or change before his next dose at the end of the month? Or could I give his Heartguard in 2 pieces - one in A.M. and one in the P.M.?

Some can't handle it. Sounds like Tibbe is one. I woud not een consider giving it again.

As for itching, don't settle for a food he is miserable on. You have options.

[lisaly]

I have thought of you and Tibbe all day and a good part of yesterday, too. Without a liver biopsy, there is no definitive answer about MVD. but I wouldn't put Tibbe through that. I'm sure you'll find a healthy diet for Tibbe. and he will do great. I home cook for Katie and use BalanceIt as a supplement, but Katie has no health issues. A vet nutritionist might be able to help you find the best diet for him. It was very inexpensive to get a diet for Katie, but even for a special needs dog, it's not too expensive. You might want to check out Dr. Remillard's site. The findings today are really positive I think, particularly since Tibbe has had so many abdominal problems and those results were also positive. I think you are on your way to a healthier Tibbe. I have learned so much from reading on YT, and as a huge bonus, I have grown to care about so many people and pups. I am so happy you found your way to YT, and I am so thrilled that our lives have touched. The love you and Tibbe share is so palpable. I pray for much love, laughter, and health for you and your precious Tibbe.


PetDiets - VNC putting pets' health first!

[jadabug]

Jeanie I don't know how in the world I missed this thread!! Poor tibbe I'm sorry he has been so sick and I know how stressed you must be. I'm glad it wasn't a shunt and hopefully with the right diet he will get right back on track.
I'm glad you kept insisting you knew something wasn't right. What a good mommy you are

[yorkietalkjilly]

Originally Posted by lisaly

I have thought of you and Tibbe all day and a good part of yesterday, too. Without a liver biopsy, there is no definitive answer about MVD. but I wouldn't put Tibbe through that. I'm sure you'll find a healthy diet for Tibbe. and he will do great. I home cook for Katie and use BalanceIt as a supplement, but Katie has no health issues. A vet nutritionist might be able to help you find the best diet for him. It was very inexpensive to get a diet for Katie, but even for a special needs dog, it's not too expensive. You might want to check out Dr. Remillard's site. The findings today are really positive I think, particularly since Tibbe has had so many abdominal problems and those results were also positive. I think you are on your way to a healthier Tibbe. I have learned so much from reading on YT, and as a huge bonus, I have grown to care about so many people and pups. I am so happy you found your way to YT, and I am so thrilled that our lives have touched. The love you and Tibbe share is so palpable. I pray for much love, laughter, and health for you and your precious Tibbe.


PetDiets - VNC putting pets' health first!

Thank you for another great link. I'll be reading that tomorrow. I was so thrilled to hear he didn't have a big old terrible shunt and have to have that surgery, I'm still weak. But happy weak. MVD is no picnic but at least it is something that ls usually treatable with diet and careful observation of his intake of things. And, the radiologist said that his liver was a normal size and quality. I was so glad toxins aren't flooding first to his heart and into his brain, body rather than his liver for a good "washing" first.

Wonder why his liver isn't shrunken from the likely MVD? Will it in time, do you think, even on a low-protein diet? Wonder if he'll need that lactulose, too, or it that is only used for classic liver shunt?