Bile Acid Test
 

So, I'm confused...the dog behaviorist that I have been taking Maggie to see suggested that she have a couple of tests run due to some side effects that Maggie had when she was given a certain medication. She recommended that I have a T4, Free T4 by ED, TSH and autoantibodies - all of these together, and the Bile Acid Test. To my shock the Thyroid was normal but the BAT wasn't normal. The Pre was 2.0 and the Post was 120.0. Her food in between the test was her normal kibble and not very much of that. Maggie will be six in September and has been very healthy. I somehow thought at her age the chance of the BAT being off was not even an issue. When the vet called to explain it, he was busy (story of my life these days) and is ready to send me Texas A&M for a biopsy. I don't know if I should get the liver biopsy done, of course this would be the call of the vets at TAMU or just change her kibble and have the test run again in a few months. Whatever she eats needs to be a kibble that Buster can also eat. They are currently eating Fromm's adult, small breed. Any suggestions?

Jeanie, make an appointment at Gulf Coast with Dr. Jones. I would not jump to a biopsy just yet. Call me if you have any questions.

Do I need a referral for Dr. Jones?

Yes. Let the vet refer and then you call and make the appointment. Make sure it is with him! Tell him I sent you.

Keeping Maggie in my thoughts and prayers that a biopsy will not be necessary.

Sending prayers for Sweet Maggie.

Keeping Maggie in my prayers. You've been through the ringer lately and need a break!

Thanks! Just when I think I have one of them up and going .... Maggie has always been my healthy one ... but hopefully Buster is on his way to recovery and after him, Maggie's issue won't be anything I can't handle.


I'm going to get me a t-shirt that reads: I work for my dogs......


We know they aren't dogs but it's a Yorkie thing and some people don't get it.

Looking at GCVS website, there are several doctors in the Internal Medicine Dept, is Dr. Jones going to be the best one? Nothing but the best for John's little girl....

So sorry to read this, it's one thing after another for you and your pups.

Did you read this: http://www.yorkietalk.com/forums/yor...tobias-ut.html

They estimate that perhaps as many as 50% of Yorkies have MVD, but most are asymptomatic.

Jeanie that is pretty high postprandial BAT so I agree with Linda that internal med is a place to start. I'm not sure I would jump to a biopsy. What are her symptoms?

Cathy, that's the weird part, I didn't think she had any symptoms. The reason I had the testing done is because the behaviorist put her on two different medications and she couldn't tolerate either...generic Prozac and generic Paxil. She totally quit eating and acted like walking across the room was a struggle, all she did was sleep, on both medications. The behaviorist thought she needed her thyroid and BAT checked. I thought she probably had thyroid issues but not BAT. She is a little plump, she sheds and is a little sluggish, breathes very heavily at times. I've asked the vet about all of the symptoms and he wasn't concerned (she has had all of these symptoms for a few years). She had blood work done at the end of February for her dental, didn't see anything unusual. She won't be taking any of the meds from the behaviorist either. The behaviorist is supposed to be an excellent one but she believes in medication, I don't think mine need it. I was taking them to the behaviorist as Maggie sometimes attacks Buster and it had become more frequent and I was worried for Buster especially with his leg issues.


I won't have a biopsy done, she will see the internist first and we will go from there. (I've written another small book).

Yes, and I forgot to say Dr. Chris Jones. They have two Dr. Jones. He is awesome Jeanie. He took care of Teddy Bear last year when he was diagnosed with a shunt. Remember, he had no symptoms either. The only thing that we might have missed was years earlier when he had had a problem after a surgery on his legs with his pain meds and the anesthesia. He had to stay in the hospital an extra day because he was out of it.

Dr. Jones also is Cookie's specialist.

You will love him. He is very nice and very, very knowledgeable. He also has weighed in on Olivia's case. He was the one who prescribed an antibiotic that finally got her liver to do better.

Feel free to call me and I can rave about him! :) :p

Thanks Linda! I'm going to call GCVS tomorrow. I feel bad, I hope I haven't over looked Maggie's issues while focusing too much on Buster. I'll be taking her in as soon as I can get an appointment. Maggie just had her dental in February and had no side effects other than it usually takes her longer to come out of the anesthesia. Anyway, she will get in to see Dr. Chris Jones as soon as I can get her in. I have so many questions, I hope he doesn't mind.

He is awesome, Jeanie, and very very thorough. Be sure to be very clear when you call there that you want to see HIM.
He is patient and will answer all of your questions.

Update on Maggie
 

Dr. Jones just came out to talk to me. The ultrasound and the X-rays didn't reveal any liver issues. Her ammonia level is zero. The liver profile won't be back until tomorrow. So far, so good. He's recommending an LD diet and Denamarin. He wants to check her BAT again in another month. He's going to email me his summary later today. He is not wanting to do a biopsy at this time. He wants to see if the diet and the meds are effective.

Sounds promising so far. I wonder if this might have anything to do with her behavioral issues. I know when I don't feel well, I can be pretty cranky.

I didn't know an abdominal sono would always show a liver shunt in a toy dog. That's good that hers didn't show one and her ammonia is 0. Hoping for good liver studies results tomorrow. If those come back okay and she stops having the symptoms with the diet change, I know you'll be thrilled. Prayers are still going up for Maggie.

My daisy did very well on the Hills LD canned diet (she did lousy on kibble). Due to her allergies we couldn't use it after the first couple of years. However, like Dr Jones, our internist tried this med management first with her and she went from 107 post down to 33 very quickly on that diet and marin (which is now discontinued and people use denamarin). I hope that Maggie will do well too!

What does the L/D stand for? Was trying to see if it might be something I could try for Tibbe and I can't find it?

It's Hill's Prescription Diet l/d Hepatic Health. Probably what they give all dogs that present with liver issues. I asked if Buster could it, he said no...guess who wants it? I'm now eagerly waiting for his report.

This is the food and it is a Hill's prescription food.
l/d® Canine Hepatic Health - Canned

I'm thinking about calling them to see if I can get a few cans of the canned food. I don't see why not...so she doesn't get bored. She ate a little, drank a little water, pottied and she's asleep. She was up all night with the bad weather we had.

Great news!! Keeping Maggie and you in my prayers that the diet and Denamarin will be all that is needed.

Sorry to hear the weather did not cooperate last night.

Dr. Jones thought it might have something to do with her behavior issues. Is that too much to ask/hope for? That her health and behavior issues can be resolved with diet and meds? She was so good making the drive in this morning with the rain, empty tummy, etc. She barely pottied before we left, she hates going outside in the rain. We got there at 8:30 this morning and got back home around 2:30. Complete angel...the time she was with me.

Tibbe had panic attacks when I first got him at 9 mos. of age, having spent his whole life alone in a crate outdoors in a shed, and then we worked him through those and he was fine. But once he got sick from MVD and the symptoms began to show, sometime after he was 4 years old, his panic attacks resumed and really got bad last year when he was his worst and was finally diagnosed. Once he was diagnosed as having MVD and went on his hepatic diet, no more panic attacks.

Thanks Kristin!

More questions
 

I'm puzzled...all of Maggie's tests are normal. Ultrasound didn't detect anything, X-rays didn't detect anything, Ammonia was zero, liver profile was normal. Dr. Jones recommended that the BAT be repeated in a month. He recommended the Hill's l/d prescription kibble or canned, doesn't matter. He said there were no acceptable treats for this condition, only fresh vegetables. If everything is normal, how can she have a condition? Could my vet have somehow messed up when he did the original test? When her BAT is repeated in a month and if by chance it comes back normal, can she go back to what she was eating before?

Bile acids of 120 are not normal. The bile acids test is nonspecific for any illness but it does mean that there is a liver problem of some sort. Dr Jones plan seems reasonable to me. I'm sure there are some treats you could use, but for now, you might want to just follow the advice entirely and see if her value improves. You might find this link helpful: https://ahdc.vet.cornell.edu/sects/c...m/bileacid.htm

Jeanie, just follow what Dr. Jones said. As to what she will eat later on, I would not worry right now.

When you have time, read about Teddy Bear....he never had abnormal labs...EVER and he had a shunt. I am quite sure he would have had elevated BATs but they were never done, so I dont know. You just never know! Keep in mind, that I am NOT saying she has a shunt....she may not even have MVD but you need to just follow the plan.

http://www.yorkietalk.com/forums/sic...ver-shunt.html