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

Tibbe is back at the vet getting an IV, a shot for his nausea and vomiting and something for diarrhea and observed today. His BAT showed high levels and the vet said that he'd just glanced at them before going into surgery today but that he thought one level was around 60 and the other slightly over 100, and I'm a little unsure which was which, pre- or post-prandial, etc. Short-term memory shot from no sleep for so long and I'm just so tired I could barely follow him. He said we'll talk more when I pick Tibbe up.

He's saying he did speak to Carmenn Woolley, DVM, and a Diplomate of American College of Veterinary Internal Medicine at the Lake Ray Hubbard Referral Clinic and Emergency Pet Care Center and that she suggested today's treatment at this current clinic, then some type of contrast imaging test at yet another facility and then she will see Tibbe at the LRH ER Center. She treated him early last year for his pneumonia but IDK if she is best for his liver issues. She seems very sharp and informed, takes her time with the dog and the owner. She has seen him for other tummy upsets and recommended his CPL test last year.

And thanks to Ellie May/Crystal, we are this far along as his female vet last week after all his tests and exam said his regular liver studies WNL and he should be okay. Then Crystal said in a post he could still have issues even with normal testing liver enzyme levels, etc. So we got the BAT. I'm so grateful to her for telling me that or we'd be a few days late in getting that.

What do you all think? How high are these bile acids levels and how do they compare with any dogs you have had and what did you dog have to have done. Is an internist okay for these levels? I'm in a quandary what to do and sick with fear.

Tink's BAT results were over 300, pre and post prandial. Tink had surgery, bc she also had bladder stones... but she ended up not having a portosystemic shunt. She had tiny, inoperable shunts from the Bile Duct being blocked, causing very high pressure in her liver. A pill fixed that. Tibbe's results are not outrageous, but indicate he does have one or more issues. Could be LS, Gall Bladder (blocked bile duct) or a number of other things can cause BATs to be off. Normal range is generally <10 or 20 pre and post prandial, depending on what lab is used.

The test sounds like a scintigraphy, a nuclear imaging test (a dye is injected) (runs around $3-400) or if not that, a doppler ultrasound. I think the scintigraphy is the better test. Both cost close to the same.

I don't know anything about this but I'm going to continue to pray for Tibbe and for you!!

Jeanie, I'm sorry to hear Tibbe's BAT results were not normal, but I'm glad you are now on the road to figuring out what is wrong. Keeping Tibbe in my prayers.

I'm so sorry Tibbe is having problems. I have to go back and read other threads to catch up on what all Tibbe is dealing with, but just wanted you to know he's in my prayers.

Toki's post value was in the low 60s, I believe. Her liver enzymes (ALT) were around 300 (but they fluctuate). We had a blood sample sent to Cornell for their Protein C assay (not a required test but just something my vet offered and that I wanted to do). An ultrasound was done which showed that Toki didn't have a large external liver shunt (not 100% reliable though...they did however find bladder stones) and that her liver was otherwise normal looking.

Based on the bloodwork, BAT, ultrasound, and Protein C results, my general vet suspected MVD over shunt but sent us to NCSU to have the scintigraphy done (which ended up ruling out shunt). They diagnosed Toki with nonencephalopathic MVD. If I could go back in time, I think that I would have just done the blood work, BAT, urianalysis, and scintigraphy.

Is the rest of Tibbe's bloodwork normal?

I've been thinking a lot about Tibbe and following your other thread. Sending positive thoughts your way...we are all here for you!

So sorry about Tibbe. Keeping Tibbe in my thought and prayers

So sorry to hear about Tibbe's test results...hope it's nothing serious, will keep praying for you & Tibbe.

I am so sad reading about Tibbe. He is a precious dog and I pray that all you are doing for him will point to the problem and he will be well. Keep believing in the power of our Lord to lead and guide you and the vets to do what is right for Tibbe. God has opened some amazing doors for me because I sought His help. I will definitely be praying hard for this to be resolved and Tibbe to come home well and happy again. Hugs to you, Jeanie.

I will be praying for you and Tibbe!!

As will I, (((((Jeanie and Tibbe)))))))

I am so sorry for all you and your baby are going through. I wish there was something I could offer in advice but I have no experience with this. So I'll leave it to those on here that do.

What I'll do is continue to offer love support and prayers.

Bless sweet Tibbe and you. Sending prayers :hands: I am so thankful Tibbe has Ellie May/Crystal and so many other knowledgeable supporters here. Jeanine you and Tibbe are so special. May all the love and compassion you have shown to others be returned threefold to you and Tibbe. Hugs and prayers

Jeanie i am so sorry for what you and Tibbe are going through, Micah's BAT test were about the same as Tibbe's, he had all the test mentioned here at UT in Knoxville,Tn he was diagnosed with MVD and he is doing really good almost 5yrs old now

I am sorry to hear about Tibbe's BAT results. Hopefully, at worse it is a mild case of MVD. Cali has that and her BAT were 0/47 and 0/78 i believe. A liver biopsy confirmed mild MVD
and she has done well on a lower protein diet only. Keeping Tibbe's in my prayers.

Sending prayers for your Tibbie, I know how stressful it is to have a sick baby:(

I am sorry his tests are abnormal, but at least now you can get to the bottom of his issue. I will keep you and him in my thoughts and prayers.

Yes, his blood tests,, including liver studies, were normal pre-dental cleaning and again last week when a comprehensive exam/tests were done. Once when he had pneumonia Feb/2012, his amylase was 200 or 400(forget which) at the ER vet but the vet there said he wasn't that concerned about that one level since all his other tests then were WNL and they did full but not special testing(no BAT or CPL or whatever that pancreatitis test is called). He did finally have that pancreatitis CPL Snap test last June/July and it was normal.

Thank you for the information and thoughts. We need all we can get.

Thanks for the information, Patti. I'm just so worried his diet will make him itch! What he's gone through with that itching until it finally calmed down was just awful. He literally could not be still and his tail was clamped down the whole time since he came home from the vet yesterday until we went back today. He was nauseated too, vomiting/spitting up, refusing food and having diarrhea - not too bad but since he NEVER has had diarrhea but one other time in his life - it was bad. I'm hoping he can hold his own overnight once I pick him up tonight. I sure appreciate your information and prayers.

I think you know already....my Teddy Bear had 7 years of totally normal lab studies!

He suddenly developed bladder stones and a liver shunt was found at that time. The only symptoms he had in looking back was some occasional vomiting...hind sight is 20/20 but I have to say if I ever had a pup doing that for no reason again, I would do BATs. I suggested this recently to another member but I think she thought I was off base. Now, this is two pups who had normal labs and elevated BATs (although Teddy only had them after surgery since his was found without the benefit of BATs) ....so I think the message being sent to us is very clear.

Here is Teddy Bear's thread:

http://www.yorkietalk.com/forums/sic...ver-shunt.html

I cannot speak about results on BATs because Teddy did not have them prior to surgery.

Oh and as for MVD, the nutritionist I use said that moderate protein is what is given to pups ... Teddy Bear is on moderate protein diet.

I highly recommend a consult with a vet nutritionist once you find out exactly what is going on...for now is your vet recommending a RX diet for Tibbe?

What is considered moderate protein? I am assuming that low protein is around 14% or so since that is what the Rx hepatic kibbles are around but I'm not sure what a moderate protein diet would be. What is Teddy Bear eating now?

Keeping you and your sweet Tibbe in my thoughts and prayers. Sending hugs.

Tibbe
 

Praying for your Tibbe and hoping the liver issues are not major and can be managed with diet. At least you now know why your poor baby has been so sick.
I do so feel for you and Tibbe with the sleepless nights and discomfort you both have been feeling. Hope when you pick him up he will be feeling a little better and that you will soon get some much needed rest.
I know that intense itching has been a concern for Tibbe, and I may have missed it in your posts, but could the itching be due to the liver/bile issues and not allergies? Please forgive me if this has been dealt with before.
Get well soon dear Tibbe, we are all praying for you and wishing you well.

I don't know what they will put him on now that we have his BAT levels. He was on Hill's I/D GI until last Friday and then on the Hill's I/D Low Fat and that seems to be what started his itching after I was done segueing to it Monday. He started scratching like crazy Monday night, the night before his BAT. Neither of us slept that night and then he did the same thing when we got home from the vet yesterday. I picked him up just before they closed so by the time he started in scratching again, they were closed. Neither of us slept much last night, though Tibbe did finally mostly settled around 11:00 p.m. but still awakened frequently during the night spitting up or a spot or two of diarrhea and then had a large diarrhea stool early morning and into the vet we went again. That's when the vet hit me with the BAT levels.

I do now remember Teddy's thread! My brain is such much I haven't remembered much since Tibbe got sick. I just can't sleep when he's sick and he's been sick since Friday. Now, I'm sneezing on top of the many visits to the RR lately so I've got a touch of something mean, too. Haven't washed my hair for 3 days - just showered and back out as fast as possible in case Tibbe should seize or something - don't know what to expect from minute to minute so I just sit and watch him as matter-of-factly as I can so he doesn't get completely neurotic from constant observation. I put this stupid smile on my face so maybe he can't tell so much how scared and worried I am. He probably knows my every worry though and wonders why I have this furrowed brow, haggard face and fake smile on my face when I do look at him. But I try not to let him see I watch his every single move since he's been sick and not acting "right".

I'm going to re-read Teddy's entire thread soon as my eyes aren't so yuck. Lack of sleep has them dry and some double vision. Tibbe and I are both wrecks, it seems! I swear I used to be tougher than this.

TKPK, I wondered that, too. Low 20's?????

I'll always get a BAT as a matter of course on any Yorkie/dog w/repeating tummy issues from now on. If I'd just known this last year and gotten one then, we might have saved him some liver or other damage and a whole lot of misery! I feel guilty as all get out even though his vets never ever suggested it once and they seemed to some extent think I was an overworrier - at least I got that feeling - might have been just me but I think I'm right about that.

Jeanie, I've been following your thread and was on pins & needles waiting for Tibbe's BAT results. I'm so sorry they came back abnormal. Hopefully it's a mild problem that can be managed with diet and/or meds. You are both in my thoughts & prayers.

He is on canned Hill's Ideal Balance, Mature Adult Gourmet Turkey or Chicken (not the savory stew as it has higher protein). It has undergone feeding trials for adult maintenance and has lower fat which was what Teddy needs....it has some protein restriction but she said that it meets the NRC recommended allowance for protein for adult maintenance.

My vet was shocked. Now, I will say that Teddy was not as bad as Tibbe in that he was not at the vet with constant issues. I do think that general vets often miss these things.

One of the specialists told me that finding shunts like this is very common. I always thought their liver enzymes would show something, but not so.