# Question - Bile Acid Test



## Lacie's Mom (Oct 11, 2006)

In this thread by Maltbabe, JMM states that a fluff can have a liver shunt even without symptoms.

http://spoiledmaltese.com/forum/52-maltese-health-behavior/109806-bile-acid-test.html

Does that mean that ALL Maltese (and probably Yokies too) should have Bile Acid Tests as a "routine" test?

If so, at what age should they have it preformed? And should it be repeated if there was no stunt found? If so, how often?

How many of you that have fluffs with no symptoms of a liver stunt have had Bile Acide Tests preformed?

Am I a bad Mom because I haven't had one preformed on any of my 3?

CONFUSED.:blink:


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## MaryH (Mar 7, 2006)

Lynn, I had Maltese long before I knew what a bile acid test was. I have tested everyone involved in breeding and all puppies that I've bred. But I have not tested my older dogs. By the time I learned about bile acid testing my older dogs were 8 and 9 yrs. old and spayed/neutered. I figured they are not going to be bred and they have been healthy for a loooooong time so I was not going to learn anything that I could change or control. Your dogs are not young puppies, they do not have chronic health problems, they have not done poorly under anesthesia. I would venture to guess that you would know by now if something was wrong. I test my puppies because I don't like surprises and don't ever want to set someone else up for heartbreak or financial distress. Bile acid tests do not need to be repeated in most cases. If your dog is tested as a puppy and has abnormal values, no matter how many times you test your dog he/she will still have abnormal values. Better to have an annual CBC panel done.


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## Lacie's Mom (Oct 11, 2006)

Mary -- thanks. That's what I've always thought too. Certainly if I was breeding, testing would be a different matter, and I would do exactly what you're doing.

I do have CBC panels done annually.

And, of course, if something happened that lead me or the Vet to believe that the liver was involved, we would have the test done, but, as you stated, we have not had any type of chronic health issues (knock on wood) and the girls are not puppies.

Thanks for your thoughts.


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## Snowbody (Jan 3, 2009)

I just had Tyler tested a few weeks ago for peace of mind, Lynn. No symptoms but just wanted to know what the baseline was so if he had problems later on they would have known if issue was new or not and would maybe save some invasive procedures later. i think someone here said the test should be done after 16 weeks. Tyler's numbers were normal so I was relieved.


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## jmm (Nov 23, 2004)

Liver shunts commonly present in young adult dogs who were in many cases normal puppies. For this reason breeders like Mary are testing their puppies to ensure the new owners do not have the heartache of liver shunts. 
Testing an older adult...you could argue either way and not really be wrong. If they are heading towards their teens and haven't had a problem, even if they had a congenital shunt you probably wouldn't do anything about it. At this age there are also many, many other reasons they could have elevated bile acids (liver disease due to aging or other disease processes). The argument we have with young dogs is to know when they are young before these other things interfere with the results to you know what you have (and vets can be cautious with certain medications for MVD dogs).


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## jmm (Nov 23, 2004)

A CBC is a complete blood count. This is only one piece of what annual labwork should include. 
A chemistry panel will check the liver, kidneys, electrolytes, glucose level, etc.
A complete blood count checks for anemia, platelets, signs of infection, etc. 
I also include a urine analysis as this can show kidney changes earlier than bloodwork.


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## Lacie's Mom (Oct 11, 2006)

jmm said:


> A CBC is a complete blood count. This is only one piece of what annual labwork should include.
> A chemistry panel will check the liver, kidneys, electrolytes, glucose level, etc.
> A complete blood count checks for anemia, platelets, signs of infection, etc.
> I also include a urine analysis as this can show kidney changes earlier than bloodwork.


I have all 3 of those tests done annually.

Tilly is 4 1/2; Lacie just turned 6 and Secret just turned 9. Do you think I should have a Bile Acid Test done on them?


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## jmm (Nov 23, 2004)

I think that's your personal decision. I've had liver problems in my house so I'm extra paranoid. It is probably not necessary for everyone to share my paranoia. LOL


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## k/c mom (Oct 9, 2004)

Claire was 7 months'; old when I got her and Tonia paid for a bile acids test on her near the time she was heading home to me. Kallie is 8 and Catcher is 6 and they haven't been tested. They have blood work done once a year at a minimum and there have been no abnormalities, so I don't plan to do a BAT on them.


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## Sandcastles (Jul 7, 2010)

Liver problems are a nightmare, a complete nightmare. I know that there are other issues that fluffs have/get that are daunting to go through - but this liver issue has, by far, been the most wrenching . . .


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## Ladysmom (Oct 19, 2004)

If I understand Dr. Center's recommendation correctly, she specifically recommends a bile acid test for puppies of highly affected breeds to establish a baseline and hopefully prevent unnecessary and invasive tests later on.

*At present we recommend that all *** puppies undergo paired bile acid tests before they are adopted into homes (15 weeks or so). Why? Because you do not want a veterinarian to surprisingly find high bile acids when a dog is presented for illness. This results in aggressive testing that may include an expensive abdominal ultrasound and even a liver biopsy in a dog with MVD- consider for example a dog presented for vomiting after eating garbage. A high bile acid test would implicate the liver as being severely affected, and the clinician would be obligated to inform the client that the liver should be investigated. If they already knew the dog had high bile acids as a pup, consistent with MVD, then the medical investigations would be judiciously focused on the vomiting.

*PSVA and MVD Research Summary

Whether or not to BAT an adult dog is a different decision. I personally have found it helpful to have copies of previous lab results/bloodwork when dealing with new vets, specialists, etc. Knowing Lady's "normal" can really help a vet with a diagnosis.


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## Lacie's Mom (Oct 11, 2006)

I think that I may have a BAT done on Tilly because she was rescued from a puppymill situation. 

I know that a BAT was done on Lacie by her breeder as a puppy, and I will ask Bonnie if she has had one done on Secret. I'm not nearly as concerned about them -- but I know that Tilly could be a ticking time bomb.


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## Luna'sMom (Oct 7, 2007)

I didn't have BAT as my vet advised (and the lab path who preforms the tests) that most Maltese have elevated BAT results as a baseline. 

I have had ALT levels checked regularly - after I asked my vet to check before de-sexing. We found that Luna has higher than "normal" ALT levels. I decided after advice from a specialist not to do a biopsy or ultrasound as Luna had no symptoms. We did decide to continue monitoring ALT levels (which I did very 2 months when she was 6 months -1.5 years however now I'm doing it yearly as the level has normalized at "just above normal". 

My vet has no idea what MVD is - she thinks its a heart condition... so we didn't go down that route.


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## SammieMom (Nov 13, 2010)

Ladysmom said:


> If I understand Dr. Center's recommendation correctly, she specifically recommends a bile acid test for puppies of highly affected breeds to establish a baseline and hopefully prevent unnecessary and invasive tests later on.
> 
> *At present we recommend that all *** puppies undergo paired bile acid tests before they are adopted into homes (15 weeks or so). Why? Because you do not want a veterinarian to surprisingly find high bile acids when a dog is presented for illness. This results in aggressive testing that may include an expensive abdominal ultrasound and even a liver biopsy in a dog with MVD- consider for example a dog presented for vomiting after eating garbage. A high bile acid test would implicate the liver as being severely affected, and the clinician would be obligated to inform the client that the liver should be investigated. If they already knew the dog had high bile acids as a pup, consistent with MVD, then the medical investigations would be judiciously focused on the vomiting.
> 
> ...


:ThankYou:Ladysmom for this post I printed it to take to my vet. I find it daunting to remember all.


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