The Liver Shunt - Bile Acid Test Thread

[k/c mom]

Originally Posted by MTC

I know this thread is old, but I wanted to thank everyone for posting this information. We just got our wonderful Maltese, Chloe, about 4 weeks ago when she was just 12 weeks. Our breeder gave us the results of a BAT that was done around 11 weeks and the results were 1 pre /30 post. We took Chloe to our vet the first week we had her and he thought she should be retested at 16 weeks because he thought 30 was high. The retest was this past Tuesday. We got the results tonight and they were 1.2 pre and 70.9 post. He had indicated that it was probably a shunt and that we need to immediately go to Hills LD food to try to manage the shunt. He was concerned about putting her under for her spay surgery in a few months and wanted to make sure she gets on the Hills LD immediately.

Now, I am glad that I found this site because it has absolutely helped to calm our nerves and educate us on the shunt and MVD topic. However, it is still alarming to us that she went from a 30 to 70.9 in just over 4 weeks. I know that 70.9 isn’t too alarming in and of itself, but is the increase in just 4 weeks an area of concern?

Unfortunately, the breeder did not explain shunts or MVD to us in detail as Mary H would have , she just said that levels >100 are an area for concern, but since she was 30 she was fine. So naturally we didn’t think anything of the BAT results. When we bought her we went with a reputable breeder that had Champion lines to try to minimize some of the predisposed health risks. You can only imagine my disappointment when the vet said that it is a shunt and we need to be prepared for her to be sick. It’s all a little shocking since we have only had her for four weeks. She doesn’t display any symptoms that I can tell so it makes it even harder to understand.

I mentioned MVD to the vet and he kind of blew it off… I am not sold that he knew what it was. What I do know is that I am close enough to UPenn should I need a second opinion. Any thoughts or opinions on her levels would be appreciated.
Thanks in advance!

Oh, gosh, I can imagine your panic based on what your vet is telling you but don't panic yet!!! You may want to start a new thread if you don't get responses in this one. I would absolutely take her to U of Penn, especially since you say it is close to where you live. It seems to me that your vet is jumping the gun in saying she has a shunt, but I'll let the experts give their thoughts. I assume you told the breeder all this ? If not, I surely would.

Did you read what MaryH said in an earlier post? (See quote below and you can click on the arrow by her name to get to the entire post.) She mentions "moderately high" ... your Malt's results were 70, which would fall in this range.

Originally Posted by MaryH

At whatever age, if a puppy has extremely high bile acid values (greater than 100) I personally would do a Protein C test next. If a puppy has moderately high bile acid values (50-99) I would think about doing a Protein C test after taking into consideration other factors ... weight, activity level, occurrences of diahrrea and/or vomiting, behavior after meals, neurological symptoms, etc.

[MTC]

Thanks Sher for the quick reply! I did see Mary's post and trust me the "moderately high" comment is what I am hanging all of my sanity on right now.

I do plan on contacting UPenn for an appointment since I believe it may be difficult to convince my current vet of the intricacies of the Maltese breed. I feel like even if I continue to see him he is going to make all of his decisions (some more expensive than others) based on his belief that she definitely has a shunt.

[Humbug]

Anyone have an opinion on whether it would be beneficial to periodically re-test BA? I have always had the impression that if MVD is diagnosed, then the BAT will always come back in the abnormal ranges (my baby's numbers have always been quite abnormal). My vet however wants to continue rechecking every 6 months to a year. I would prefer to continue running a CBC and monitoring her ALT values which came back well within the normal range the one and only time we have done this.

[MaryH]

Repeat bile acid tests are going to tell you one thing and one thing only .... that your dog does not have a perfectly functioning liver. Running an annual CBC is far more beneficial. ALT/AST levels will tell you if the less than perfectly functioning liver is causing problems (which a bile acid test won't).

[Humbug]

Originally Posted by MaryH

Repeat bile acid tests are going to tell you one thing and one thing only .... that your dog does not have a perfectly functioning liver. Running an annual CBC is far more beneficial. ALT/AST levels will tell you if the less than perfectly functioning liver is causing problems (which a bile acid test won't).

Thanks! That's what I thought too.

[Sammie]

moving to another

[cometgrrl]

Indy's bile acid test results were 60 pre and 4 post. The test was done at 17 weeks by Stacy's vet.

Indy is healthy, happy, active, and has NO symptoms. However, I am pretty sure my vet is going to recommend a follow-up BA test, but after reading up, I don't think that is needed. My question is what *should* my vet be doing to follow-up? Should we do ALT/AST testing, protein C test? We are going in for Rabies vaccination @ 5 months and to schedule neutering, so I want to be prepared and not bullied by the vets into any testing that we don't need. I do want to make sure though, that we are doing everything necessary to make sure he continues to be healthy and happy!

Thanks so much in advance! There is a lot of great information here on SM, and I am happy to be here and able to ask you all for advice.

[jmm]

There is no reason to repeat the test unless it was done incorrectly. I highly doubt it since I've spoken with Stacy about the test protocol. Your dog is probably absolutely fine. If you are extra paranoid, you can always have the Protein C done. Routine labwork prior to the neuter should be standard (that should include an ALT and ALKP).

[cometgrrl]

JMM - thanks, that's exactly what I was looking for. I wasn't sure what tests are included in the pre-neuter blood work, so I just wanted to check and be sure.

Just want to make sure we are doing everything we can to ensure Indy has a long, healthy, happy life.

I lost my first maltese last year... in the end, he had acute renal failure caused by medications (diuretics) for his congestive heart failure. The only silver lining was that we caught the heart failure early, and with proper treatment, he lived a whole YEAR longer than all the vets (even our cardio specialist) thought possible. I am so happy that we had that extra time with him, so I am keeping my eye on Indy already (hopefully without being too paranoid!!).

[myfairlacy]

Originally Posted by cometgrrl

Indy's bile acid test results were 60 pre and 4 post. The test was done at 17 weeks by Stacy's vet.

It was higher PRE and normal POST?

My London had a bile acid test at 17 weeks too...pre 2.1 and post 12.1