High ALT & High BAT
 

Last month I took my puppy Choco (8 months old/5 pounds) to the vet to get his blood work done before his neuter. A couple days later, I received an email from my doctor with the results showing his ALT level was high- 169. Then my doctor suggested a bile acids test to check for liver function. I decided to do the test after researching, which cost $187! Then my doctor emailed me back saying the results were high- (Pre meal: 16 / Post meal: 58.4). So now he suggests testing for possible shunt with portal scintigraphy- a noninvasive technique for diagnosing shunts that doesn't require anesthesia or sedation.

About 2-3 months ago, Choco suddenly refused to eat dry food & barely ate. However, after we switched to wet food & changed the dry food to Wellness brand, he started eating again. Now he eats, sleeps, & plays well. No seizures, vomiting, or walking in circles. He alway drops his toys in front of me to play with him & gets excited to go outside. He does tremble once in awhile but not for too long. I bought the milk thistle & he just started taking it 2 weeks ago.

So now I'm confused and worried about the high test results. Is the portal scintigraphy test ($500) necessary? Choco is my first pet so I'm not sure what to do :(

Sorry....just seeing this post. Hopefully, my bumping it will make it more visible to others and you will get more responses.

I would hate to say you don't need a test that your vet is suggesting. I probably would do it just so that I would know for sure; but I know other people who have opted not to do it and treat as if it is mvd. Usually shunts have higher BATs. It could be microvascular dysplasia. I think I would at least for now, speak with the vet about putting him on a prescription liver diet. One of my pups who had high BATs and a negative scintigraphy is on Royal Canin liver diet and doing very well. She has MVD.

Here is a link that might be helpful to you:

http://www.vet.utk.edu/clinical/sacs...2013-04-10.pdf

Can you put a pattern to or link the trembling to other things happening concurrently? Or does he just spontaneously start trembling out of the blue? Yorkies are emotional, passionate dogs that can tremble or shake from excitement, fear, wanting something or anxiety but it can also be from pain. If the trembling just starts out of the blue and is pretty consistent, I believe I might want to go ahead and find out if there is a shunt present via the scintigraphy.

Unless the trembling is out-of-the blue and not brought on by anything you can recognize and/or your dog is not head-rubbing, lethargic, vomiting or spitting up bile or having other symptoms to indicate he's uncomfortable to miserable, he maybe does just have MVD that is responsive to the new diet. Maybe you could try another BAT to check what bile acid levels are now to try to see where he is.

Tibbe's BAT test done two years ago was $78.00. He then had an abdominal sonogram and a scintigraphy which ruled-out liver shunt, showed some small kidney stones in the sono but the vets decided he wasn't then a candidate for liver biopsy to give him a differential diagnosis of MVD with concurrent IBS and start him on a hepatic diet. His IBS won't allow a full hepatic diet yet so now we're at almost half hepatic and half Hill's I/D GI and he's doing very well at age 7 1/2.

Oops....reread this.... The food my foster pup is on is Hills LD .. not RC.

Any updates on how your little guy is doing?