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Old 10-25-2006, 02:03 PM   #16
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Default UBAT vs Serum Bile Acid Test

The Urine Bile Acid Test does give an indication that an abnormality can exist in the liver however like the IDEXX SNAP test it only show an elevated Bile Acids and doesn't give a number that's indicative of a Liver Shunt as compared to MVD/HMD (Microvascular Dysplasia / Hepatic Microvascular Dysplasia). Generally a Serum Bile Acid level in the range between 30 to 80 is more indicative of MVD/HMD and is treated with a proper low protein diet along with Lactalose and possibly Milk Thistle whereas a Post Prandial number above 100 is more indicative of a Liver Shunt and requires corrective surgery. The Urine Bile Acid test and IDEXX SNAP Bile Acid Test does not quantify those numbers to as accurate a degree as the Serum Bile Acid Test.

The Urine Bile Acid Test also doesn't show reversed Bile Acid numbers that can happen from a dream/nightmare where the dog is excited and that excitement results in increased Gastric activity and elevated Bile Acid numbers.

Dr. Karen Tobias of the University of Tennessee in Knoxville, a foremost authority on liver disease in dogs and specifically Yorkshire Terriers, does not recommend the UBAT or the IDEXX SNAP Bile Acid Test because their results are not definitive. Since the cost of a Serum Bile Acid Test is about the same as either of the other tests mentioned and is considered the standard protocol for diagnosis of Liver disease, I can not see any reason to use a test that requires further testing to know what's going on. Ultimately it's up to the dog's owner and that of their vet as to what test should be done.

Advise given here is only to meant to provide information that can aid in acting as an advocate for your Yorkie and should not be taken as definitive.
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Old 10-25-2006, 02:30 PM   #17
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In 2001 a study was done showing that less than 2% of Yorkies were diagnosed with a liver shunt. Of course, 2% is too high, but we have to remember that leaves 98% unaffected.

There is NO test that is 100% reliable in showing a liver shunt, except:

Liver Imaging Radiography - Invasive - A dye is injected into the spleen and the dye is tracked through Radiograph through the blood vessels. A blood vessel bypassing the liver can easily be seen on the image. This is the only universally accepted method of confirming a shunt, short of major surgery, it however is extremely invasive.

Tests, blood or urine, only indicate how the liver is functioning at best.

Other Liver Dysfunctions that could mimic Liver Shunt:
Acute Hepatic Failure - Rapid loss of liver function due to death of liver cells caused by drugs, toxins, infectious diseases and lack of oxygen. Mimics Liver Shunt signs and symptoms.

Hepatic Lipidosis - The accumulation of fatty tissue within the liver caused by appetite loss which promotes the accumulation of lipid in the liver. Mimics Liver Shunt signs and symptoms.

Hepatitis Chronic Active - Inflammation of the liver causing the accumulation of inflammatory cells and scarring. Mimics Liver Shunt signs and symptoms.

Copper Storage Disease - Genetic disease caused by excessive accumulation of copper in the liver. Mimics Liver Shunt signs and symptoms.

Infectious Hepatitis: Viral disease that targets the liver, kidneys, eyes and blood stream. Mimics Liver Shunt signs and symptoms.

Benign Tumors: Abnormal cell accumulation that affects the livers ability to filter and process properly. Mimics Liver Shunt signs and symptoms.

Cancer: Abnormal cell accumulation that affects the livers ability to filter and process properly. Mimics Liver Shunt signs and symptoms.

Toxins: Excessive overload of impurities in the blood stream that overloads the livers ability to filter and process properly due to illness or disease. Mimics Liver Shunt signs and symptoms.

Parasites: Such as liver flukes or HEARTWORMS which invade the liver causing the livers inability to filter and process properly. Mimics Liver Shunt signs and symptoms.

Liver Abscess: Lesions that cause the livers inability to filter and process properly. Mimics Liver Shunt signs and symptoms.

Cirrhosis - One form of the end stage of liver disease causing the liver to be unable to filter and process properly. Mimics Liver Shunt signs and symptoms.

Trauma - Severe or blunt blow to the liver region causing contusions. Mimics Liver Shunt signs and symptoms.

Pancreatitis - A severe inflammatory process that occurs with digestive enzymes that can spill over into the liver and cause severe disease. Mimics Liver Shunt signs and symptoms.

ADVENOVIRUS - Viral disease of canines. Mimics Liver Shunt signs and symptoms.

POISONS: Toxic substances ingested by mouth or absorbed through the skin into the blood stream that can have deadly consequences to your animal such as Oleander, Azalea, Rhododendrons, Poinsettias and Japanese yews to name a few. Causes liver malfunction and can mimic Liver Shunt signs and symptoms.

MEDICINES: There are several chemicals that could be toxic to the liver including medicine given daily to many animals such as Rimadyl (arthritis treatment), Thiacetarsamide (heartworm treatment), Ketaconazole (fungal treatment), Tylenol (acetaminophen), Glucocorticoids (cortisone), Anthelmintics (wormer), Parasiticides, Phenobarbital (epilepsy meds).
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Old 10-25-2006, 06:00 PM   #18
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Default 2% Liver Shunt is Inaccurate

The 2% Liver Shunt victims you quoted were statistics compiled in 2001 but were accumulated in the five previous years and they didn't take in account the dogs with MVD/HMD. This percentage has increased drastically in the last several years as the popularity of the Yorkie increased and climbed to the #3 AKC registered dog.

Yorkies have a 36% greater instance of Liver Shunt than all other breeds combined. While you quote all other maladies that could be connected with Liver Disease you seem to set aside the importance and incidence of Liver Shunt in this breed.

I don't have a Liver Shunt dog nor have I ever had one because the breeders I got my Yorkies from make every effort to make sure they don't breed carriers that would produce Liver compromised dogs. They don't allow a puppy to leave their kennel until it's at lease 16 weeks old and they also Bile Acid test each of the puppies before they leave for their forever homes.

I help moderate a Yahoo group that deals with Liver Shunt and MVD/HMD and I've done this for over 10 years. I was also on the board of a group that funded Liver Shunt surgery for those that didn't have the funds to do it themselves. Until you've walked in their shoes you'll never know the grief and heartache they experience. I've sat in the vets office with some of them, having made the trip to U/T myself, and watched them cry their eyes out when they had one of the 5% that don't make it after the surgery. After seeing that I'm not so quick to dismiss the cavalier attitude that most of the disreputable breeders have towards Liver Shunt and related diseases.

I receive hundreds of emails a year from people with Liver Shunt and MVD/HMD dogs. They are looking for answers on how to care for their dogs and ways to fund the necessary surgery if that's required. It's sad, oh so very sad, when they have to put the dog to sleep because the breeder won't assist in the financial burden that's brought to bear on the dog's owner and they can't afford to pay for the surgery themselves. They didn't bargain for a very sick dog when they spend their hard earned money for what was represented to them as a healthy dog. Most breeders just bury their heads in the sand and say it's not their responsibility.

Over the years I've sent over 150 Yorkies to U/T for Liver Shunt surgery since that facility will perform the test and surgery for less than half the cost of other well known veterinary teaching facilities or private veterinary practices.

All the other liver maladies you quoted are but a small percentage of liver disease and don't come anywhere near the incidence of Liver Shunt or MVD/HMD. To give the impression they they account for more than they do is a disservice to the readers of this forum.

To argue back and forth is pointless and doesn't help those that are looking for answers so I'll refrain from continuing this thread. Anyone that wants to contact me for more information can do so privately by emailing me at: satman@inbox.com
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Old 10-25-2006, 06:56 PM   #19
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I really appreciate everyone's help. Brucey is running around like nothing ever happened. He does still have a open fontanel so I'm starting to think the seizures came from a head injury like the vet suggested as one possibility. He is still going to get some blood work done the next time he is at the vet so I will keep everyone posted!

Again thanks to everyone!
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Old 10-26-2006, 11:17 AM   #20
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Quote from satman:
you seem to set aside the importance and incidence of Liver Shunt in this breed.

I don't know how saying the the only definitive test for liver shunt is a radiography dye test is negating the importance of liver shunts. I simply disagreed with your findings that there was a blood test that could do this.

I have never purchased, sold, or bred a victim of liver shunt and hope I can continue to claim that in the future.

I just don't see any reason to yell FIRE!!!!!! until you at least see smoke!
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Old 10-27-2006, 09:58 AM   #21
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Quote:
Originally Posted by Lacy's Mom
Quote from satman:
you seem to set aside the importance and incidence of Liver Shunt in this breed.

I don't know how saying the the only definitive test for liver shunt is a radiography dye test is negating the importance of liver shunts. I simply disagreed with your findings that there was a blood test that could do this.

I have never purchased, sold, or bred a victim of liver shunt and hope I can continue to claim that in the future.

I just don't see any reason to yell FIRE!!!!!! until you at least see smoke!
That is because you have never experienced a dog with Liver Shunt, or had to hear about people that are devistated because they can not afford the surgery to correct the problem, of have heard them cry because their baby died becauswe they did not know that it was a shunt that their precious pup had. Liver Shunt is far more prevalent than what you would like to believe. Breeders have kept silent much too long on this subject, and it is just now coming to light.

Yes, I have experienced a dog with Liver Shunt, and when I had her surgery done, there were others at the Purdue University having the same surgery. Now that is just from a small area of my state, so what would it be nation wide. If breeders had been open before instead of covering it up, there would not be so many today.

Also, many dogs have died because the problem goes undetected, because vets and people did not know to check for this. People are being educated now becaue of all the lists that talk about it.

Last edited by mmyorkies; 10-27-2006 at 10:01 AM.
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Old 10-27-2006, 02:11 PM   #22
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Quote:
Originally Posted by Lacy's Mom
I just don't see any reason to yell FIRE!!!!!! until you at least see smoke!

But in yorkies you need you yell FIRE and hope its not the real thing!
Livershunt is so common in yorkies
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Old 10-29-2006, 07:07 PM   #23
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Here is the website of Dr. Kaen Tobais, the leading livershunt research veternarian. When I had a question about one of my kids, I sent her an email and she responded within 24 hours. http://www.yorkielane.com/LiverShunt/

Liver shunt can be very difficult to diagnose -- many different illnesses share the same type symptoms. A full fasting blood profile will give your vet a starting point to decide on what other tests might be necessary.
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Old 10-29-2006, 07:08 PM   #24
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I forgot to say that I am sending get well hugs :ghugs: and sending prayers that you do not have a LS problem.
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Old 10-29-2006, 07:35 PM   #25
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Quote:
Originally Posted by chattiesmom
Here is the website of Dr. Kaen Tobais, the leading livershunt research veternarian. When I had a question about one of my kids, I sent her an email and she responded within 24 hours. http://www.yorkielane.com/LiverShunt/

Liver shunt can be very difficult to diagnose -- many different illnesses share the same type symptoms. A full fasting blood profile will give your vet a starting point to decide on what other tests might be necessary.
I have heard that from others here on YT, as well. That Dr. Karen Tobias, returns e-mail right away.
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Old 10-29-2006, 10:46 PM   #26
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First I am glad to see the baby is somewhat better. If he has an open font you'll want to keep a good eye on him.

A few of my thoughts on LS testing and then I will leave it alone. Since this really doesn't help the OP who is worried about her baby. We all hope everything works out the best for him.


As far as the livershunt info. I have supported Terri and the group as best I could since its inception. Its a good cause and has helped many Yorkies to live who otherwise may have had no hope.

My point was that both SBAT and UBAT are only screening tools and not diagnostic tools, further testing would be required if either were abnormal.

SBAT can be elevated by other things such as lipemia and hemolysis.
UBAT are not effected by these. It is sensitive to the liver function itself. It's supposed to have 100% sensitivity.
I hope this could possibly help in reducing unnecessary invasive tests that could be done in false positives from the SBAT.

While I respect Dr. Tobias, I asked her opinion prior to my using the UBAT she told me she could not comment on it due to not having used it.
I also respect Dr. Dodds who is a leader in the field of Vet. medicine as well.

I think more people would screen their dogs if it was an easier procedure than fasting and drawing blood twice from a squirming pup. I think this type of screening is key to slowing down the instances of Yorkies bred and born with liver shunt/mvd.
I know vets who won't do the SBAT on an asymptomatic pup but have no problem with the UBAT. This I would think is the goal. Get as many dogs screened as possible.


It is up to each person and their Vet to make the choice, which is why I didn't think UBAT should be discarded so easily. I am not concerned with the cost. I would pay a higher price for the UBAT because the stress on the pup is my first concern.
I believe all options available to us should be able to be considered.

A dog with symptoms needs all the care we can give no matter what the tests involve.

This is JMO (I am not a Vet) and we all do what we think is best for our dogs.
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Old 10-30-2006, 03:49 PM   #27
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Just wanted to update everyone. Brucey is doing great! He has not had a seizure in a week and a half. He has shown no signs of a livershunt or no gastrointestinal problems at all! He was very tired for 3 days or so after the seizures but I expect that to be normal in dogs, as it is in people. My vet thinks that it is a waste of time and money to do the tests at this point. He did advise me to let him know if any of the symptoms return.

It was a very scary week. My heart goes out to anyone who has a livershunt baby! I just knew(or so I thought!) that he had a liver shunt. I was trying to decide what I was going to do. I would do everything in my power to save him but my checkbook does not have endless funds(as I am sure many others don't as well). I was thinking well I could try to control it by diet( if that's would have even been an option). But that would probably mean cutting his life short or him living a sickly life.

The other option I thought of was giving him up to a rescue organization. That way they could get him the surgery he needed and then adopt him out to a new family. Of course that to me seems to only be punishing the original owner. It's not like you choose for your puppy to have such a serious health problem. I think there should be more programs( or a program) to help people get their dogs the help they need and let the dog stay with its owner. Of course I may be speaking of something I don't know anything about. With rescuses maybe the person adopting the dog takes on the vet bills.

Thanks to everyone for all the responses and helpful information. I will continue to keep you posted!

p.s. Sorry for the rambling!
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