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10-30-2008, 11:00 PM | #1 |
Donating YT 1000 Club Member Join Date: May 2008 Location: Maui, Hawaii
Posts: 7,740
| Liver disease My vet left a message on my answer machine that Tiki's pre-op blood work came back with abnormalities, bile acids are high, so they have cancelled her Nov. 5th spay surgery. They are closed now, so I have to wait until Friday morning to call for more details, and as she said "discuss liver disease". OMG, I almost fainted, and have cried for 2 hours. I don't know the numbers, or any of the tests etc. that will be coming, but from reading on YT over the last 6 months, I know that this is every Yorkie owner's nightmare. I'm just sick over this and don't even think I can sleep tonight. Thank God for YT, and all I have learned here. When I made the appointment to have Tiki spayed, I asked about the pre-op blood work. They said it was optional, and usually only recommended for older dogs to check organ function; they don't push it so much for puppies, as they are usually healthy. Well, after reading about it here so much, I said I wanted it done anyway, and opted for the more extensive/expensive version which had to be sent to an outside lab a week before surgery, rather than the more common in-house one on the day of surgery. At least now we can try to diagnose and treat whatever it is. So, I'll be researching like crazy, and checking back here often for help from all of you who know about liver disease/liver shunt, MVD,etc. Tiki is only 7 months old, and 7 lbs.; is there a chance that high bile acids can be from anything other than liver disease..... like poison, or diet? I'm just praying this isn't true.
__________________ SANDY, MOM TO TIKI , KAYLA , KARLEE , R.I.P. MEIKA |
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10-31-2008, 05:20 AM | #3 |
And Rylee Finnegan Donating Member Join Date: Apr 2007 Location: Metro Detroit, MI
Posts: 17,928
| Bile acids can be up if the liver is not functioning properly. She could've gotten into something very toxic but I think you would've known about it. Had she had any meds or vaccines in the last week or two? The next step does depend on the numbers but most likely it will be a Protein C test or scintography or the vet will try to talk you into an ultrasound. Is she having any symptoms? Lethargy, depression, inappetance, gastrointestinal issues, drooling, circling, head pressing, seizures? Liver disease is scary but it isn't a death sentence. And after all of this is figured out, she can still be spayed.
__________________ Crystal, Ellie May (RIP), Rylee Finnegan, and Gracie Boo🐶 |
10-31-2008, 05:27 AM | #4 |
Senior Yorkie Talker Join Date: Mar 2008 Location: justin tx
Posts: 130
| I am so sorry you are going through this. This is what happened to us. I would suggest to not jump ahead of yourself and take things one step at a time. First speak to your vet and get the actually numbers of the bile acid test and their recommendations. Paisley had her bile acid test done after her pre spay blood work was done and came back "abnormal". Her spay was canceled and we waited for the bile acid results. Her post number was 227 and if I remember correctly the post normal range is 15-25. After a scintigrapy it was concluded that she had a liver shunt.
__________________ Christina |
10-31-2008, 06:39 AM | #5 |
Donating YT 2000 Club Member Join Date: Sep 2007 Location: North Carolina
Posts: 8,317
| Try not to panic. She could have asymptomatic MVD which many dogs live with with no problems. Here are a couple of good links for you: Hepatic Vascular Disorders - WSAVA 2006 Congress Portosystemic Shunts FAQ To determine if you are dealing with a possible shunt or MVD, the next step is a Protein C test. Here is all the information you need to show your vet if he is unfamiliar with it. Many vets are and will just waste your money on an ultra sound which can be as low as 60% unreliable: Comparative Coagulation -- NYS Animal Health Diagnostic Center |
10-31-2008, 09:22 AM | #6 |
Donating YT 1000 Club Member Join Date: May 2008 Location: Maui, Hawaii
Posts: 7,740
| Thank you all for you kind and helpful replies. I knew I could count on you to help me find the right information quicky, and I am grateful that you continue to respond to each new person who posts with these problems. Tiki has not had any symptoms that have been noted. She eats well, is very smart, alert and active, plays a lot with her younger Morkie "sister". Her last puppy shot was in July, and since then nothing but monthly heart worm prevention. I try to watch her when I take her out in the yard, and have to constantly pull leaves and things out of her mouth, and she tries to eat grass sometimes. The only other concern I had and mentioned to the vet is her posture. She eats well, and even gained a pound in the last month, but she has grown long and thin, and seems to have a slight hump/hunch toward her rear. Her tail (which was docked too short) is always tucked down. Her vet is a young female, at a clinic with several more experienced vet/surgeons. I'm sure they all will be involved in her case. I will be doing all the research I can to stay on top of things. I live on Maui, so have a limited number of choices. I still have to wait another hour for the vet to get in, so I'll be reading. I can't thank you enough for your help and encouragement.
__________________ SANDY, MOM TO TIKI , KAYLA , KARLEE , R.I.P. MEIKA |
10-31-2008, 11:48 AM | #7 |
Donating YT 1000 Club Member Join Date: May 2008 Location: Maui, Hawaii
Posts: 7,740
| Going nuts, waiting The vet has been tied up with an emergency, so I haven't been able to talk to her yet. I asked them to fax me the blood results, and hope they will. In the meantime, I'm thinking I need to prepare to shift Tiki's diet toward low protein/low fat. She currently eats a combo of dry :Innova Puppy & Eukanuba Puppy & Science Diet, and I've been giving all 3 dogs about 2 tablespoons of diced chicken, or home cooked chicken/rice/veggies sprinkled over dry in the morning and evening. Any advice as I wait for vet consultation?
__________________ SANDY, MOM TO TIKI , KAYLA , KARLEE , R.I.P. MEIKA Last edited by MauiGirl; 10-31-2008 at 11:50 AM. |
10-31-2008, 12:02 PM | #8 | |
And Rylee Finnegan Donating Member Join Date: Apr 2007 Location: Metro Detroit, MI
Posts: 17,928
| Quote:
__________________ Crystal, Ellie May (RIP), Rylee Finnegan, and Gracie Boo🐶 | |
10-31-2008, 04:48 PM | #9 |
Donating YT 1000 Club Member Join Date: May 2008 Location: Maui, Hawaii
Posts: 7,740
| bile acids Finally got a copy of the report and talked to the vet. Bile Acids are 39.2, and they should be under 15 (does that sound right). That was just a pre-spay blood workup and was about 3-4 hours after eating. A couple other liver enzymes were a little off but not really bad. Tomorrow I'm taking her in "fasting" to do the next series of tests SBA and PSBA. I mentioned Protein C test, and she seemed not to know what I was talking about, so I'll go into that further with her tomorrow. I'll be shopping for a new brand of food too, and welcome any suggestions. Many thanks for the help.
__________________ SANDY, MOM TO TIKI , KAYLA , KARLEE , R.I.P. MEIKA |
10-31-2008, 05:02 PM | #10 |
Donating YT 2000 Club Member Join Date: Sep 2007 Location: North Carolina
Posts: 8,317
| Dr. Center, the developer of the bile acids test, has set the cut off at 25, not 15. It doesn't sound like your vet did the test properly. You need paired samples around a meal. Serum bile acids should be collected Before and 2-hours After a meal (this serves as a provocative challenge initiating bile acid release from the gallbladder, intestinal reabsorption, passage into the portal vein to the liver, and rapid liver extraction from the portal blood). The term Postprandial refers to the after meal sample. Dogs DO NOT eed to be fasted for 12-hours to conduct this test. The important issue is to test BEFORE and 2-Hrs after FEEDING to fully evaluate the dogs ability to extract bile acids from the portal circulation. Spilling of portal blood contents into the systemic blood is reflected by finding high Serum Bile Acid values > 25 umol/L in a sample collected from a leg vein or jugular vein. The sample also needs to be collected properly or the results will be skewed: The bile acid test is very reliable but the red blood cells MUST be separated from plasma (the clear part of blood) before they are sent to lab for analysis (centrifuged or spun to allow plasma separation from blood cells). Results can be falsely abnormal if the bile acid samples are lipemic (lots of fat IF the fat is not adequately removed by the laboratory analyzing the sample) or if hemolysis (burst red blood cells, makes the plasma red) occurs. The red color interferes with the color of the end point dye in the bile acid test. A clinician can tell if the sample is hemolyzed when they centrifuge the sample to separate the red blood cells from the plasma. If it is hemolyzed they should collect another sample. Drawing blood with a vacutainer needle into a vacutainer (suction of the tube facilitates the collection) may be too traumatic for some red blood cells augmenting hemolysis. Using a syringe and needle or syringe and butterfly needle appears to collect the best samples. After the blood is collected, the needle should be removed from the syringe and the top removed from the vacutainer so that the blood may be gently transferred to the vial. Results of the bile acid test should state if the samples were lipemic or if hemolysis occurred. In this case, the tests should be repeated PSVA and MVD Research Summary |
10-31-2008, 05:18 PM | #11 |
Donating YT 1000 Club Member Join Date: May 2008 Location: Maui, Hawaii
Posts: 7,740
| Thanks LadyMom, I'm printing that report to take with me tomorrow too. Tomorrow will be the paired SBA, they asked me to bring her in fasting and they will draw, then give her food and wait 2 hrs. for second draw. It's a little over an hour drive, so I'll be there when they open at 9:00. I really appreciate having access to the most current information, as I don't have many choices in Maui, and will have to work with the vet.
__________________ SANDY, MOM TO TIKI , KAYLA , KARLEE , R.I.P. MEIKA |
10-31-2008, 05:25 PM | #12 | |
Donating YT 2000 Club Member Join Date: Sep 2007 Location: North Carolina
Posts: 8,317
| Quote:
Here's another one to print out and show your vet. This one is about the Protein C test: Comparative Coagulation -- NYS Animal Health Diagnostic Center | |
10-31-2008, 05:30 PM | #13 | |
Donating YT 1000 Club Member Join Date: May 2008 Location: Maui, Hawaii
Posts: 7,740
| Quote:
__________________ SANDY, MOM TO TIKI , KAYLA , KARLEE , R.I.P. MEIKA | |
10-31-2008, 07:24 PM | #14 | |
And Rylee Finnegan Donating Member Join Date: Apr 2007 Location: Metro Detroit, MI
Posts: 17,928
| Quote:
Was this a Snap test ran in the office? It should be sent out to the lab. If the liver enzymes are off at all and she has high bile acids, I would really think there is an issue here but maybe it is just mild MVD.
__________________ Crystal, Ellie May (RIP), Rylee Finnegan, and Gracie Boo🐶 | |
10-31-2008, 10:54 PM | #15 | |
Donating YT 1000 Club Member Join Date: May 2008 Location: Maui, Hawaii
Posts: 7,740
| Quote:
Thanks for your input.
__________________ SANDY, MOM TO TIKI , KAYLA , KARLEE , R.I.P. MEIKA | |
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