Bile Acid Test

[MaryH]

For any of you who may be thinking of running a bile acid test on your dog(s), there is a new test out, the IDEXX SNAP test for bile acids. Don't waste your money!! While you will get both pre- and postprandial values, the values are given in ranges -- <12; 12-25; >25. You might get a postprandial value of >25 but the test does not tell you how much greater than 25. And there's a huge difference between 26 and 200 but because all you get is >25, you've just spent good money for a worthless result and now you've got to spend more money to have a traditional bile acid test run to get a meaningful value. This may well be a worthwhile test for breeds that do not have liver issues but it is NOT a good test for Maltese.

Mary

[Missy&Maggie]

This maybe a dumb question, but I am going to ask anyways. Can a Maltese develop liver issues over time like a shunt or MVD or is it something that is noticed by a certain age or something that they are born with? How often should a dog be bile acid tested? I am starting to get worried because it seems like liver issues are becoming more prevalent. Thanks!

[MaryH]

This maybe a dumb question, but I am going to ask anyways. Can a Maltese develop liver issues over time like a shunt or MVD or is it something that is noticed by a certain age or something that they are born with? How often should a dog be bile acid tested? I am starting to get worried because it seems like liver issues are becoming more prevalent. Thanks![/B]

I'm not positive but I think the consensus is that dogs are born with PSVA/MVD. Dr. Center recommends testing puppies before they're sold (I think her preferred age would be 16 wks.) and the only time that I've read that it's worthwhile to retest is if you have a dog whose shunt was ligated, then retest to insure that the ligation worked. As with any other chronic conditions (cancer comes to mind), whether in humans or animals, I do wonder if there is a higher occurrence or if we have better, more sophisticated means with which to diagnose?

Mary

[MickeysMom]

I think that most of the time it is congenital, but they can develop shunts over time due to liver disease.

[Malteseluv]

Yes, thank you for posting this information. Do not waste your money on idexx snap...Get a regular serum bile acid test (pre-prandial and post-prandial). The dog is fasted overnight for 12 hours, taken in for a blood draw. They feed the dog, then 2 hrs later take another blood draw.
As far as liver shunts and MVD goes. Most dogs who have liver shunt are diagnosed by the age of 1, but I have seen dogs much older than that be diagnosed, from 3-7 yrs old.
When they have MVD, many times, symptoms go unnoticed, so the dog may not be diagnosed until 2,3, or even much older than that...
Numbers above normal range but below 100, typically point more towards liver shunt.
Numbers above 100, typically point more towards MVD.
There are always exceptions to these "generalizations." I know of a yorkie whose numbers were under 100 and had a liver shunt, and I know several dogs, including my own, who have had number beyond 300 that have MVD.
MVD and liver shunts are usually congenital, but it is possible for a dog to have an "acquired" shunt later in life also.
About 15% of dogs who have liver shunt ligation surgery develop acquired shunts as well...

[jmm]

Can dogs develop high bile acids later in life but were normal as a puppy? Yes: there are MANY types of liver disease out there that develop later in life. Anything from infection to chronic phenobarbital use to a toxin exposure. And yes, dogs with severe liver disease can develop acquired shunts. This is NOT the same thing as the PVSA/MVD that is talked about so frequently with Maltese. This is why when you test an adult Maltese, you raise a question - is this something to worry about or not. Knowing their numbers as pups can help clear that up.

As many times as you measure the bile acids, you will get a different result. Dr. Center emphasized that abnormal is abnormal. If you get 4/40 and then 5/70 the dog is still abnormal. Bile acids is not a good monitoring test for that reason (unless post-shunt ligation based on the vet's recommendations). When we consulted with Dr. Center on a pair of dogs a number of years back, she recommended appropriate intervals to monitor ALT(SGPT) and full chem panels on those dogs. My "reg vet" (who is a boarded internist and did her residency at Cornell with Dr. Center) has us do a chem panel and check up every 6 months on my current MVD confirmed case and suspects.

[Malteseluv]

The thing about regular "routine" bloodwork is that abnormalities in the liver (elevated numbers) won't show up until the liver is 70% damaged. That's why it's important to bile acid test. It's much more sensitive to liver function.

[Missy&Maggie]

This is great information! I'm so happy that I asked! I want to give Maggie time to recovery from her spay and whatnot, but next on my list of things to do is a full blood work-up and bile acid test. I learn so much from this forum!!! Y'all are a wealth of knowledge!!!!

[jmm]

The thing about regular "routine" bloodwork is that abnormalities in the liver (elevated numbers) won't show up until the liver is 70% damaged. That's why it's important to bile acid test. It's much more sensitive to liver function.[/B]

My point was agreeding with Mary that bile acids are not a good monitoring test. It has been recommended to monitor liver enzymes (ALT) at intervals instead of doing repeated bile acids which give you no information. This is NOT a recommendation for diagnostics, but for monitoring.

[dr.jaimie]

yes for those of u that havent run a bile acids on ur malt..i suggest u do so..... it will be interesting to see how many out there have a high BA and are not symptomatic. if ur malt does come back with a high BA i suggest u contact dr. center with ur bredder/ pedigree info to help her out in her research.