Results of Bella's CBC and Bile Acid test
 

Bella is scheduled for her spay the 27th of this month and also is having 8 remaining baby teeth removed. Had her CBC, Bile Acid test and Liver Chemistry. I don't understand a bit of it except, on her pre meal it was 8.6 and post meal 36.1 with (High) next to it. I'm just sick and although the vet said they would do her spay as a liver compromised dog. Should I go ahead and spay?!? Do I need to take Bella to a specialist at this point. She acts fine but I don't want anything to happen to her. :(

Liver Chemistry
Total Protein 6.2 5.0-7.4
Albumin 3.8 2.7-4.4
Globulin 2.4 2.6-3.6
A/G Ratio 1.6 0.8-2.0
AST (SGOT) 38 15-66
ALT (SGPT) 90 12-118
Alkaline Phosphatase 80 5-131
GGT 10 1-12
Total Bilirubin 0.1 0.1-0.3
BUN 15 6-25
Glucose 86 70-138

Complete Blood Count
WBC 10.4 4.0-15.5
RBC 7.7 4.8-9.3
HGB 17.4 12.1-20.3
HCT 49 36-60
MCV 65 58-79
MCH 22.6 19-28
MCHC 35 30-38
Comment
RBC Morphology Normal


Differential Absolute %
Neutrophils 6760 65 2060-10600
Lymphocytes 2912 28 690-4500
Monocytes 520 5 0-840
Eosinophils 208 2 0-1200
Basophils 0 0 0-150
Platelet Eatimate Adequate
Platelet Count 395 170-400

Bile Acid
Bile Acids, Pre Meal 8.6 < 13
Bile Acids, Post Meal 36.1 (High) < 25

How old is she?

That isn't terribly high and because her enzymes are normal, there may have been something else going on like the gallbladder contracting. I would probably retest in a month. You could go ahead with the spay now because it probably isn't serious, but on the off chance that it is a shunt (very unlikely), the spay could be done at the time of shunt surgery. So you may want a diagnosis first.

Is she having any symptoms?

It is great that you did the bloodwork before surgery. I am going to email this thread to some folks that know more about this than me. Hang in there.

she is fine it is mvd as my dog had post biles of 54, 73 and now 27 on low protein diet. Put her on low protein diet and it will go down - also gall bladder can contract throwing off the test so re-do it in 6 mos after lower protein diet. What is protein count on food now? If not having any signs of liver issue i would go to 22% protein and she will be fine with spay - you can have them biopsy liver to confirm mvd while doing spay if you trust this vet real well as that will confirm mvd or not but i do not think it is anything serious and not liver shunt with those low of numbers and normal ALT. She is just like mine as mine has normal ALT as well. Mine just went under for dental yesterday and did perfect - he said she did great - we went to a board certified dentist to have it done- she is 5 and she was spay with 8 months with no full panel as i did not know any better back then

why did they opt for bile acids since alt was normal? that was smart of your vet since a yorkie as most do not do this so they are being extra cautious which is great - you have a good vet it sounds like

Thank you Ellie May, Zander's mom and dwerten. You have been my shoulder to cry on right now. :ghug:It just hit me like a ton of bricks is all and the fact I love my baby.

Bella is 8 mos. old on the 8th of Aug. Right now she is on NV medallions twice a day and The Honest Kitchen she get's once a day. I will have her retested and will go along with the spay. She has a mouth full of teeth and know I would have to deal with that issue down the road. The Vets office said there will be 3 in the room with Bella's surgery. The vet, someone watching her vitals and can't remember what the other person would be doing, sorry my heads in a fog from crying. Will be looking for lower protein food and hopefully I can get her to eat, she's so picky.

The vet wanted the test and said "I wish more people would have it done, but do to cost most opt out". I knew from what I've read here it's a good thing to have done. Bella weighs 3 lbs. 8 oz.

I thank you all so much for being here!

Hugs,
Lori

Cali had on first test 0 pre and 90 post on retest 0 pre and 46ish post, she had a liver biopsy when she was spayed and was diagnosed with very mild MVD, no treatment needed, but I do watch her protein intake. The specialist said that in most cases if the BIle Acid score is under 100 it is MVD. It sounds like Bella's is either off for some other reason or she would have a very mild MVD. Try not to worry as she should do fine with surgery as all her other results look fine. Hugs

Hi, I wonder if your Bella would do good on the honest kitchen preference, then you can add some fish as the protein which may be good for a while. I have my 2 older yorkies on Wellness simple solutions 21% protein, 12% fat. I want to switch to the Honest Kitchen preference pretty soon.

Good luck.

I would think this is gallbladder instead of liver. One of mine tested like this by a medical school, very accurate. They suspected gallbladder, retested later, results were normal. I would not be too concerned at this point. Was your vet concerned? Bile acids would be completely off the chart if there was a shunt, VERY high.

Also just noticed her liver profile is NORMAL. If she had a shunt or even MVD her protein, BUN, etc would be off as well.

WHOAAAAAAA two medallions a day and honest kitchen - hold the phone that is too much food gf -- my 6lb got two medallions a day with no honest kitchen -- this is probably the problem

as if they do propofol, isoflurine, iv fluids and catheterization - also if the teeth need to come out get them out now as that way you will not have to put under again

yeah they diagnosed mvd and dd bun, creatinine and alt was normal as well - she was high on 3 bile acids so still could be mvd. A shunt is over 100 post bile below 100 is usually mvd

yes i agree 100% - get cod and add to that diet as fish is a highly digestible protein. I am considering the preference for my malt and have really looked into it alot. This is my favorite of honest kitchen recipes. I really am leaning towards gall bladder contraction with her or very mild mvd like mine

yep 100% agree with this

I'm going to talk to my vet about the possibility of a liver biopsy when she's spayed. Am also going to watch her protein. Thanks so much for sharing your info and encouragement..

Hmmm, just a suggestion, something to think over.... I would put her on a lower protein diet, this could just be due to the amounts of medallions and Honest Kitchen she is eating at this time. Then I would her retested in a few months before doing the biopsy. If the values are elevated then yes go with the biopsy. Just food for thought. :thumbup:

I will get some cod (yum) and give to her with her HK and "cut out" the NV medallions. I do love the medallions but we have to pick out the bones for her anyway (she spits them out). Bella likes the HK and try mixing cod along, geen bean and Preference. I am fortunate that I can buy HK where I live. Thank you for the ideas and support!

Thank you, I'm going to start the lower protein diet tomorrow and cut out the medallions and buy some cod to fix and mix with HK. I am going to her retested in a few months. Thank you and any suggestions are so much appreciated.

The vet didn't seem to concerned but did mention they would spay her as a liver compromised dog (not sure what the difference is). I'm sighing a huge sigh relief after reading all the posts. Thank you and I'm so thankful to all of you.

I'm going to write down the propofol, isoflurine, iv fluids and catheterization and find out what the vet has in mind. Thank you for all the ideas, they have been helpful. I was a wreck earlier and really feel allot more at ease with everyones knowledge.

IMO, it is too early for a liver biopsy.
That procedure is not without risks and her post is a bit low for me to consider it.

Yes, shunts usually cause a much higher post but it is still a very slight possibility and the bile acids could go up (or down) next time. Ellie had three bile acids tests. Her post results 1) 47, 2) 15 and 3) 106 and her liver enzymes were only (slightly) elevated once. Bile acids are a funny thing...

IMO, if you want to do the spay now, it would probably be just fine. By the way, not all vets use propofol even for liver compromised dogs.

Thank you Ellie May. I'll hold off from asking for a biopsy. How long did you wait in between getting Ellie's bile acid tests?

I'm going to go ahead and have her spayed. Her teeth are a mess with needing 8 baby teeth removed. I already had held off on the spay hoping she'd lose a few more teeth, but since that isn't happening and none seem lose.

1) Septemberish, 2) October and 3) January

She did have a liver biopsy because she was being spayed and her vet thought while she was in there, why not do it. Her bile acids were low at the time. It really depends on your vet, if you trust them and if you just want a diagnosis quickly.

By the way, in Ellie's case it didn't show much of anything and neither did an ultrasound, so she still has no diagnosis...

yeah get the spay done as 8 mos you are getting close to first heat as did my dd at 8 mos and almost waited too long :( she only lost one tooth but my boy yorkie who was neutered at 6 most lost 10 teeth but you want them out of there as this breed has horrible teeth issues so you do not want tartar build up at that young of an age to start problems with gum disease.

the thing with doing that is you have to put the dog under again and they are already in there doing the spay and she is such a small dog putting her under again so soon i would not recommend. and they have to open her up again:( Honestly if it were my dog I would not do the biopsy with those low of numbers as it is most likely just mild mvd and the lower protein diet will drop the numbers.

it just means they will use propofol instead of ket-val which i prefer propofol instead anyway as ket-val can trigger seizures in dogs prone to seizures and liver compromised dogs are prone to seizures. this is why pre- blood work is so important as propofol is more expensive than ket-val and some vets still use ket-val. They call it special K so make sure your vets use propofol or i would switch vets as small dogs should not get ket-val in my opinion

i agree i would not do liver biopsy with those low of numbers and normal alt -- i do not believe in doing testing further unless a dog is having issues and/or real high numbers. The gall bladder can contract and throw off test as well so i agree just do spay and get the teeth out of there as i believe dogs who are not being bred should be spay before first heat as i have seen dogs die at age 2 of pyometra as it comes on so fast and within 48 hrs the dog is dead :(

I'm going to have to find out for sure since the vet did say they would treat her as liver compromised. Am willing to pay more to know my baby will be ok. I'm going to have to call the Vet's office and find out, Thank you!

I'm sure hoping she doesn't come into heat before then, that has also been on my mind. The Vet only does spay's and neuter twice a month and guess that is what she (the vet) does the entire day. Her teeth have to be removed and am surprised there is one lose one left, so don't think there going to come out on their own.

Cali has so many health issues as a puppy, hypoglycemia, stomach problems, not eating so with her Bile Acids we decided to do the liver biopsy after the ultrasound showed no visable shunt. Since she was so sick as a puppy she was under the care of a specialist and then we thought she had an intestinal blockage while she was in heat so she had to be spayed during heat and they did a liver and intestinal biopsies at the same time by a board certified surgeon. After the biopsies came back the internest and surgeon felt that her case was so mild that all her illnesses were not due to her MVD, she was just a sick puppy. Cali's vet does take into consideration any meds she puts her on and prefers to avoid future surgery's unless absolutely necessary because of her MVD. She does yearly blood work and all of her liver values have been great. I had Cali's Bile Acid's done about 2 weeks apart because the first one was done right after a hypoglycemic episode and I wanted her retested before doing the liver biopsy. Maybe you could retest soon and if it is normal you won't have to go any further. Hope that is the case.

Oh Patti, It sounds like you went through allot with little Cali. She sure is a cutie and looks like a real sweetheart. They sure can make us worry. I want to have Bella tested again in the near future, I want to know so I can do everything humanly possible for her. Thanks so much and I so appreciate you all. Hugs, Lori