Ellie's Bile Acid Results are in
 

Preprandial: I don't know
Postprandial: 47

Vet consulted an internist and they said you can send her to us now or supplement for a month and retest. We are choosing option B since she doesn't really have symptoms. I am quite worried......................
Yorkieluv, where are you????????? Are we doing the right thing?

Kiwi's bile acid results just came back elevated as well. Hers were a little higher than yours, in the 65 range after eating. We are driving down to Orange County to get a scan done with a nuclear isotope thing to see if she has a shunt or hepatic microvascular dysplasia. The vet and I are pretty sure she doesn't have shunt since she has no symptoms. But we both want to get the scan to be sure.

It sounds as though your vet is giving you a good option of retesting since she doesn't have any active symptoms and her bile acid test is in the lower range.

Now I am debating if we should just do the scan but I really don't want to. She has had a vaccine reaction and has trouble gaining weight. Those are really her only signs. Do you know if they anesthnetize for the ultrasound type tests?

I am pretty sure they don't use anesthesia for either the ultrasound or the nuclear isotope scan. I think that they might give the dog a sedative if it moves enough that they can't take pictures.

Does your vet think they can get a good picture of the shunt with ultrasound? My vet said that the ultrasound would be inconclusive because it is almost impossible to get a good picture of the shunt with ultrasound. That is why she is sending us to Orange County to get the nuclear isotope scan.

No, the vet didn't say ultrasound (my mistake). She said imaging techniques.

That is close to the number we had...ours was 50-something. We didn't even get the lactulose. Chloe has no symptoms, and wouldn't eat any of the special food, so we're just feeding her regular. I'm going to do a retest probably around the end of this month.

Hmmm, Mistyinca, aren't you worried that there may be a shunt without further tests? I am not saying I think there is or that you are doing the wrong thing because I think it is probably fine, but without tests I will worry about it. I just don't want to go through all the testing if it isn't necessary. You know?

Hi Ellie May!! Okay, this is just my opinion, but I would put her on "lower" chicken based or vegetarian based food for 1 month and give her supplements like milk thistle...Retest in 30 days. Don't give any vaccines or flea meds or anything like that within 2 weeks of her retest....If her levels are still off, then she probably has something going on, possibly MVD. Then you might want to do further testing...Either scintigraphy, portography, or liver biopsy...
Don't waste your money on an ultrasound...it's inconclusive many times.

When you say lower protein how much would that be. The RC LS 14 is 14% which seems a little low without symptoms. Avodern is 7-8%. I will not feed Natural Balance because of the recalls and I will not feed Science Diet because, well, I am one of those that thinks it's Science Death. Any ideas? Even with diet, if it is MVD the levels will stay up that high? What if the levels go down? Does that mean it is not MVD? The vet was also told by the specialist to deworm her just in case. She got her heartworm med 6 days before last test which I thought would be long enough to wait but maybe not...

The RC Hepatic is actually 15.6% once you convert it to a dry matter basis, but you don't have to feed this if you don't want to.
Avoderm Vegetarian canned is 7%, but again, it's tricky...It's not actually 7%...it's actually 26.9% once you convert it to a dry matter basis...The canned is NOT recommended....It was too much protein. Only the dry is recommended, which is 22% once you convert to a dry matter basis...
I would NEVER recommend any Hill's products...
6 days was probably long enough to wait to do the test, but if you suspect that the higher levels were due to the heartworm meds, then make sure you wait longer...

When I say lower protein, I mean under 22%...and not from any red meat sources like venison, lamb, or beef...Also, no turkey or duck because of the tryptophan.

Here are the links to the info on Avoderm:
http://www.breeders-choice.com/dog_p...og-dry-veg.htm
http://www.breeders-choice.com/dog_p...ermdog_veg.htm

No, because she has no symptoms except that she doesn't eat well, and since I switched her food, she's eating way way better and has put on lots of weight! :thumbup: From what I learned, the ultrasound that they wanted to do has a low probability that it would find anything unless it was a single shunt, and since her number is still in the fairly low range, it does not indicate a single shunt but probably mvd (I was told the way they treat that is with diet and lactulose anyway). I was also on another list where there was discussion of a high incidence of high tests (such as the range yours and mine are in) associated with people feeding Royal Canin. So for now, since Chloe is happy, healthy, energetic, and now eating regularly, I'm going to see how she does on this and re-test and see if there's a change. If she shows any negative health symptoms, then I will do further tests. But she is the picture of health, and that is good.

Also,
I have the Royal Canin Hepatic LS 14. Chloe won't eat it. If you want to try it, I'd be happy to fill a ziploc and send you some to try before investing $30 in a bag. Just let me know! :)

I think you are doing the right thing.

Roxy's numbers were pre 43 and post 100.9
TJ's numbers were pre 5 and post 43

Roxy had a u/s and a full blood panel done yesterday with the Specialist.
The u/s showed no shunt and her liver was of normal size and normal shape. Roxy's Doctor just called (Dr. Deborah Trainer, DVM, DACVIM at the Center for Specialized Vet Care, Westbury NY)

We got the results back from these tests: Superchem/CBC - Urinalysis - Crystocentesis - Coagulation Prof 3 PT/PTT/PL

She said her clotting times are normal. Her urine is normal, no signs of any crystals. No increase in liver values. Her CBC was normal (except 2 types of white blood cells or counts - can't remember exactly - something like: Monosite and Basofils - were slightly increased which says something about cronic inflammation) . I asked if her skin infection (since March) could have something to do with it and she said that's a possibility. But she isn't all to concerned about it. All in all she said that there's no indication in these results to lean towards a shunt, although, she could still have a shunt or she could just have a mild case of MVD.

She wants me to bring Roxy back in next week to redo ALL the above tests and redo the BAT. Once we get those results, we can discuss whether it makes sense to do any further testing or just monitor with diet and supplements and maybe continue the meds (or not).

In the meantime, she said to continue with the Metronidadole and Lactulose for Roxy. But to watch her this week to see if I can tell any change in her behavior, like is she more active and/or upbeat. Which she said would help decide 'if' she suggests continuing them or not.

** Now TJ - She considers #'s over 40 to be questionable. So she recommends we get the Superchem/CBC - Urinalysis - Crystocentesis - Coagulation Prof 3 PT/PTT/PL - and to do the BAT again.

So, I think you should take Yorkieluv advice and go with a high quality low protein diet and add supplements and then re-test in a month.

Keep us posted!

Holy Moly, if Ellie's numbers were over 100 (over about 60 for that matter) I would be freaked. I think 47 is just too high for it to be "nothing" so I am really concerned.

I cant help ya on what to do, but wanted to say Bella and Diggy send much love and kisses!

Awww, thanks Diggy4.

Mistyinca, thanks for the wonderful offer. I will let you know if we decide to go with RC but right now it looks like Dr. Dodds or Avoderm. Ellie has actually never turned her nose up at any kibble. She loves to eat (which is sort of weird for high bile acids).

Roxy who has high #'s is the Piggy of the family. She can eat and eat and eat. She eats her food and then waits for TJ to be done and she runs to his dish and finishes what he can't eat, then she runs back to her plate to continue licking (nothing, b/c nothing is left). Sometimes I wonder if I put this huge meal down, would she stop ever (hahaha).

Ellie had her blood panel done tonight. Her ALT is up (118).
Her preprandial result was 4.1.
The vet wants us to use Panacur (I am not thrilled) just to make sure she doesn't have worms (internist she consulted asked about it).
She is on Denosyl once daily for 30 days.
Vitamin E (400 something or others) daily.
Antibiotics for two weeks.
Lower protein diet.
Does this seem acceptable?
Her ALT was 45 in January so I am a bit concerned about the jump.
Sorry for sentence fragments....it has been a long day.

I am not sure what ALT is?

Take a look at this site, someone had just sent it to me and there seems to be some good information.

http://www.dogaware.com/specific.html#liver

Thanks TLC. I will look at that site in a minute. I am not sure what ALT is either except that it is a liver value. 118 is not that high but it is far from what I want. Anyway, Ellie isn't feeling well today. She was fine before we started antibiotics, panacur, and denosyl. I think there are just too many substances going into her body too fast. She threw up a little bit this morning (uncharacteristic of her lately) and has been laying around (normal for morning so we will see later). I feel like by trying to help we are hurting her.:( I am not doing really well right now.

Denosyl makes them nauseated...That's probably why she threw up. You can try giving her some Nux Vomica for the nausea which you can get at the health food store. Drop a couple of beads straight into her mouth, but don't touch them as the lose potency...

Thanks Yorkieluv. She was her active self today and hasn't thrown up anymore. I just don't like having to give her all of this stuff.

Oh, also make sure that you don't give her the antibiotic on an empty stomach because that can cause nausea also. But do give the Denosyl on an empty stomach. Milk thistle/Marin doesn't cause nausea, have you thought about giving this?

Yes, I have thought about it but the vet didn't say anything. I don't think the internist she talked to said anything either.

Yep, that has happened with Miko before. That's why we usually give the antibiotic with food. Actually, same goes for me!! LOL :) I have to have food in me when I take one.

Maybe I should have worded that different. Antibiotics always taken with food. Vet didn't say anything about milk thistle. Is it necessary?

Oh, oops! As far as milk thistle, it is usually recommended. Giving it to her won't cause any harm to her. It will be helpful because it protects the liver from damage and helps repair/regenerate the parts that are damaged...You could call your vet and ask what he/she thinks, but there's no reason not to give it if you want. They might be more familiar with the name "Marin."