# OMG! Shoni's bile acids



## Furbaby's Mommie (Jul 10, 2004)

:bysmilie: I'm in panic mode...... I had a bile acids done along with pre-anesthetic lab work before the 'neuter and pull baby teeth' surgery. The results sound screwy to me. The vet said she thinks the tubes were mixed up (maybe?). The pre said 61 and the post said 3.3. I presume the post feeding was actually the 61. Anyway that is high.
What is weird is his liver enzymes on the regular panel were not high. We need to get Dr. Center involved and find out what to do first, and if we can go ahead with the surgery. He could wait on the neuter, but his baby teeth need to come out very badly which was going to be done with the surgery.

I've PM and emailed Jaimie but no answer yet, I can use all the help the rest of you who have been involved with the Maltese liver problems can give. Do I get a liver diet going right away? Can he go ahead and have the surgery right away? My vet want to do XRay, Ultrasound and biopsy. I don't think that will be Dr. Center's protocol. :smstarz: 
Tell me this isn't happening! rayer:


----------



## Julie718 (Feb 17, 2006)

The vet thinks the tubes were mixed up???? Can they just do another test? That would really bother me that "think" the tubes may have been mixed up. 

I'm so sorry you are dealing with this.  I don't have any experience with this, but I'm sure others do. Hang in there. :grouphug:


----------



## Andrea&Luci (Jul 30, 2006)

Wait...they think the tubes were mixed up? 
Dee, don't worry. Just stay positive and don't look too far ahead because it could very well be just a mix up... try not to worry,.... :grouphug: :grouphug: :grouphug: :grouphug:


----------



## lillady (Jan 25, 2007)

For sure get new bloodwork done before you worry. Kosmo's numbers were off and the machine that's checks them was down and they tested it without checking to make sure the machine worked. I had him retested twice and everything was fine. Good luck hon! :grouphug:


----------



## kathym (Aug 5, 2006)

I HOPE BABY SHONI TESTS WERE A MISTAKE, AND HE WILL BE JUST FINE


----------



## paris'mom (Jul 14, 2004)

I'm soo sorry Dee! I think it's great that you are seeking second opinion instead of jumping right into surgery. I have no suggestions, but will keep an eye on this post and pray for Shoni. God knows he is too young in life to go through these problems already. On a brighter side, Shoni is lucky you are his mother. With your experience in caring for Frosty and being a good pet parent, he will receive the best care possible. 

God bless, and we love you.

Mimi


----------



## mmo (Sep 4, 2004)

My humble opinion, redo the bloodwork. Just to be sure and don´t put him under the stress of x rays, biopsy and ultrasound without a good reason. Please stay positive, it may have been a mistake.


----------



## Gemma (Jan 19, 2006)

oh boy, maybe just get another test done at another vet? but I don't know what it means if bile acid is high I just remember Pixel's was high too and then it went back to normal next time they did the test. am I right Jaimie?
I never took Sparkey for pulling teeth. I had no idea we have to that at the time. but we kept finding teeth on the floor , I think they just came out naturally. 

don't panic :grouphug:


----------



## casa verde maltese (Apr 7, 2007)

:grouphug: 
I think you should have the bile acid test ran again - and go from there. I'm hoping and praying it is all a mistake, but you should start over again with the test and then see what you get the 2nd time around - hopefully with out a tube mix up.

:grouphug:


----------



## msmagnolia (Sep 8, 2004)

Dee, I don't have any experience with liver stuff. Sadie had a test last year when she was having tummy problems, but the results were fine. 

Don't panic. What does your vet want to do? Do they want to repeat the test and when? Hopefully you'll hear from Jaimie and she'll help you out. Remember that Pixel's numbers were wacky and she got nervous but then did some other test and that was ok. I hope you'll hear from her soon. She usually doesn't get home from work till after 6 CST. So that's at least another hour, though she does check mail at work if not too busy.


----------



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

Dee, I agree with everyone else. Shoni needs to be retested.


----------



## Furbaby's Mommie (Jul 10, 2004)

> Dee, I agree with everyone else. Shoni needs to be retested.[/B]


You are right, that probably is the first step, however, so there isn't a misunderstanding--they didn't mix his tubes up with some other patient---it was just that she thought the results of the pre-food and post-food were reversed.


----------



## The A Team (Dec 1, 2005)

Before I got Tinker tested, I was worried so I went out and got his same food in the "Senior forumla" - it has less protien, sort of in anticipation. It doesn't hurt to cut down on their protein once in a while anyway.

But I agree with the others, have the vet re-do the test. My friend is very active on a liver shunt forum - she has a dog that had a liver shunt and another with MVD. If you would like to talk to her, she would be more than happy to give you lots of information!!! She's always offering to talk to people with questions on that. Don't panic.


----------



## Furbaby's Mommie (Jul 10, 2004)

> Before I got Tinker tested, I was worried so I went out and got his same food in the "Senior forumla" - it has less protien, sort of in anticipation. It doesn't hurt to cut down on their protein once in a while anyway.
> 
> But I agree with the others, have the vet re-do the test. My friend is very active on a liver shunt forum - she has a dog that had a liver shunt and another with MVD. If you would like to talk to her, she would be more than happy to give you lots of information!!! She's always offering to talk to people with questions on that. Don't panic.[/B]


Thanks Pat, you can PM the info to me, or put it here in case anyone else needs to find the liver forum. Since Shoni is still growing I don't want to cut him short on protein unless it is necessary. He just turned 6 mo. I hope to hear what Dr. Center recommends soon.


----------



## vjw (Dec 20, 2006)

Dee, Karli's bile acids run a little high and since she has urinary frequency my Vet. opted to send her to the University of Tennessee for a scintography. Her scintography was normal. I'm going to post a link to U.T.s liver shunt site. On there it talks about bile acids running high in some dogs (maltese) and that usually bile acids are over 100 in liver shunt dogs.

U.T.'s Portosystemic Shunt FAQ page


----------



## Scoobydoo (May 26, 2005)

Oh Dee I am sorry to hear this, it must be a worry for you, but I would wait till you have either retested Shoni or heard from Jaimie as to what to do next.
I will pray that the next test will show a much better result :grouphug:


----------



## jmm (Nov 23, 2004)

RELAX!!!!!!

1. According to Dr. Center in 20% of dogs the pre-prandial sample can be the elevated sample. This is why it is important to do both. This does not mean there is an error or some horrible problem. 

2. Was the sample collected properly? It should have been drawn in plain red-top tubes, NOT the ones with serum separators. Did they note any hemolysis or lipemia in the sample? These can also affect the results. 

3. A VERY LARGE portion of the Maltese population has asymptomatic MVD. That does NOT mean you have a sick dog or a bad breeder. 

4. Invasive diagnostics are NOT indicated in healthy dogs who are not suspect of having a shunt. So don't let your head float to your dog having surgery. There is a simple blood test (Protein C) that can be done to rule out a shunt. 

5. An asymptomatic dog does not require any diet or lifestyle change. Only sick dogs need protein-restricted diets. Feed a high-quality food that your dog does well with. 

6. Dogs can have a normal chemistry panel and have elevated bile acids. This is why just a chemistry panel is not an adequate assessment for a Maltese.


----------



## Furbaby's Mommie (Jul 10, 2004)

> RELAX!!!!!!
> 
> 1. According to Dr. Center in 20% of dogs the pre-prandial sample can be the elevated sample. This is why it is important to do both. This does not mean there is an error or some horrible problem.
> 
> ...


Jackie thank you. I do feel better and won't be ready for anything else until the test is repeated. Shoni's father, Marcus, has had a bile acids that was normal. Shoni seems perfectly healthy.
Do you think it should be done right away, or 3-4 wks.? I really need to get him in to get his double canines out. The baby teeth are still solid and the new ones are in. He obviously is bothered by them, and I don't want them to cause futher problems. We had planned to do it with the neuter this week.
May I copy your post to my vet without names? I will tell her it is from a friend who is very experienced with Maltese liver problems. Or I could just list the procedure as you outlined it. Their office has several new techs and I'm worried about it getting done right. If she speaks to Dr. Center as planned perhaps she will get instructions.
I know they didn't try very hard to feed Shoni what I brought for the test. 99% of it was still in the bowl. This time I could stay and feed him in the car then take him in to have the next draw. Will it make a difference *what* I feed him the night before and for the test? I'm having a hard time most days getting him to eat more then once a day, and then he doesn't eat much most days. I would really appreciate any advice. It looks like most of us will at sometime or other need this same advice. :mellow:


----------



## Maidto2Maltese (Oct 19, 2004)

Just want to say I'm sorry you have this stress of worry but I'll bet there is not cause for concern! I'll be praying that is the case!


----------



## MaryH (Mar 7, 2006)

Hi Dee,

I totally agree with Jackie (especially about the RELAX advice)!! Here's an excerpt from p.5 of Dr. Center's handout that talks about the Serum Bile Acid patterns:

"HOWEVER, we now know that up to 20% of dogs have a higher fasting than postprandial total serum bile acid values. WHY? 1) Because of the physiologic variability among individuals in the rate of stomach emptying after a meal, intestinal peristaltic motility (how fast food moves through the intestines to the area of high bile resorption in the ileum), 2) normal rhythmic contractions of the gallbladder that occurs between meals (even during a fast), and 3) because some bile does not enter the gallbladder but instead flows directly into the intestines."

As for retesting, I'd be tempted to ask the vet to retest at a reduced cost since she cannot tell you for sure that the test was done correctly this time. The two critical factors for getting accurate results are 1) proper handling of the blood (see Jackie's post) and 2) Shoni MUST EAT 2 hours before the second blood draw. Unless your vet can promise you that she will get Shoni to eat a meal before the second blood draw, then you should take him out to your car or back home after the first blood draw and feed him, hand feed him, spoon feed him, whatever it takes to get him to eat a meal.

In summary, welcome to the world of "informed Maltese owner." You probably have what many of us have .... an asymptomatic MVD dog who will live a very long, happy, healthy life.

Mary H


----------



## Furbaby's Mommie (Jul 10, 2004)

Thank you Mary for your very informative words and also words of encouragement. I go to bed tonight filled with information and hope that I have a healthy little Shoni after all. :wub:


----------



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

Dee, I was out of town most of yesterday and just now saw your post. I'm so glad Jackie and Mary H. were here to share their knowledge. Hoping for the very best for Shoni. :grouphug: :grouphug: :grouphug:


----------



## harrysmom (Sep 28, 2007)

Hi Dee!!! So sorry you're going through this.... but I would definitely rerun the tests before I jumped into anything. I would also wait and get a second opinion. My vet wanted to biopsy, also, but I opted to go to Cornell and found out that a biopsy might have killed him. At Cornell, they ran a special kind of ultrasound on Harry in which they could see the blood flow in the liver without surgery. Harry has a rare liver problem... his hepatic vein is obstructed ... so he's not a typical case... which is why Dr. Center saw him so quickly... she said that the test results I gave her from my other vets were not consistent with any of the normal maltese liver problems. . I initially contacted Dr. Center through email and then we spoke on the phone. She was very willing to consult with my vet if I couldn't make it up to Cornell. Her knowledge of this subject is amazing!!! If I can help you with any more information about Cornell or anything, please feel free to PM me. By the way, even with all of his strange problems, Harry is doing great... we are even in the process of weaning him off of his meds... so there is always hope... these little guys are tough!!!! I definitely know what you're going through and I know how upset you must be....I will pray for you and Shoni. Debbie


----------



## jmm (Nov 23, 2004)

I don't think an amount of time will change the results unless he had some other issue going on. Just be sure the procedure is followed and the vet spins down the sample and checks for hemolysis BEFORE you go out the door. 

I agree with Mary about eating. Feed his normal food. If you have to mush it up and syringe him, so be it. 

Remember, MOST Maltese that you test will have elevated values. And most of those dogs are asymptomatic MVD dogs who are NOT sick. 

The inheritance of MVD/PSVA is not yet known. When you test bile acids you are testing the phenotype (what the dog "looks" like), not his genotype (his genes). So we breed with the best knowledge possible, but even a phenotypically normal dog can produce and affected pup. Just because the gene isnt showing itself doesn't mean its not sitting on a chromosome to be passed along to the next generation. Until we have a gene, you do the best with what you have which is KNOWING what you have by testing.


----------



## Bonnie's Mommie (Mar 2, 2006)

Dee, I hope that when you retest, the vet will find that everything is ok. My thoughts are with you and Shoni.


----------



## jazzmalt (Feb 6, 2007)

Dee, I don't have anything to add to the knowledge of what's already been said. Just wanted to drop you a note to let you know that you and baby Shoni are in my prayers that a re-test will set your mind at ease. For what it's worth, when I asked my vet about doing a bile acids test prior to Miko's neutering and canine teeth extraction, he advised against routinely performing the test. It was his opinion that many or most Maltese will have a high value on a bile acids test, and that the majority of them are perfectly healthy. He said that unless Miko seemed unhealthy, or had something off in his chem panel, he saw no reason to do the bile acids test. I'm sure a lot of vets will have disagreements about this, so this is just the opinion of one vet.


----------



## jmm (Nov 23, 2004)

> Dee, I don't have anything to add to the knowledge of what's already been said. Just wanted to drop you a note to let you know that you and baby Shoni are in my prayers that a re-test will set your mind at ease. For what it's worth, when I asked my vet about doing a bile acids test prior to Miko's neutering and canine teeth extraction, he advised against routinely performing the test. It was his opinion that many or most Maltese will have a high value on a bile acids test, and that the majority of them are perfectly healthy. He said that unless Miko seemed unhealthy, or had something off in his chem panel, he saw no reason to do the bile acids test. I'm sure a lot of vets will have disagreements about this, so this is just the opinion of one vet.[/B]


The reason to have your dog tested when they are young is to prevent the confusion when an adult dog gets sick and has elevated bile acids. It is also a good idea to let your breeder know the results so they can keep track of their breeding.


----------



## Furbaby's Mommie (Jul 10, 2004)

Since Shoni's bile acid test was kind of confused.....the vet office wasn't sure they did it right.....we are repeating it tomorrow, and also doing the Protein C test. They are charging me $127. for the Pro C test including shipping overnight. That is more then I thought it would be since Dr. Center's lab says $30. Should I complain? Overnight DHL can't be that much. I presume the extra is my vet's charge. B)


----------



## bellaratamaltese (May 24, 2006)

Good luck on the repeat bile acid test! Makes me nervous to have mine pups tested, that's for sure


----------



## Julie718 (Feb 17, 2006)

I'm glad they are going to do another test since they didn't know if the results were mixed up last time! Keep us posted!


----------



## Missy&Maggie (Jun 17, 2007)

> Since Shoni's bile acid test was kind of confused.....the vet office wasn't sure they did it right.....we are repeating it tomorrow, and also doing the Protein C test. They are charging me $127. for the Pro C test including shipping overnight. That is more then I thought it would be since Dr. Center's lab says $30. Should I complain? Overnight DHL can't be that much. I presume the extra is my vet's charge. B)[/B]



I'd probably ask them about their price, especially since they could have messed up Shoni's bile acid testing. I'd probably consider getting a second opinion. These test are important, so confusing the results or not perform them appropriately, just isn't right! It can't hurt to ask! Good luck on the repeat bile acid testing!! Keep us posted!!


----------



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

Oh, Dee, thanks for posting. I was wondering what was happening. I hope all will be well. rayer:


----------



## 3Maltmom (May 23, 2005)

Praying for good results for our precious Shoni. 

Does the $127 include the office visit, or just the test and shipping? I've never been charged more than the actual cost, if it's shipped to a lab. Not sure what the norm is on that one, Dee.


----------



## paris'mom (Jul 14, 2004)

Dee,

I think you should absolutely bring the cost up to their attention. if this is your regular vet than he should more than value your business and understand that the reason for a second test is because the first one was inconclusive due to error.

let us know how it goes please.

Mimi


----------



## lillady (Jan 25, 2007)

I would certainly bring it up-the lab did Kosmo's wrong the first time and did not even charge me the second time around. I'm so glad you're getting a second test done-hope all is well and it was jus a confusion rayer:


----------



## Furbaby's Mommie (Jul 10, 2004)

> I would certainly bring it up-the lab did Kosmo's wrong the first time and did not even charge me the second time around. I'm so glad you're getting a second test done-hope all is well and it was jus a confusion rayer:[/B]


The $127 is just for the Protein C test. They aren't charging me to rerun the bile acids test.


----------



## msmagnolia (Sep 8, 2004)

Maybe someone whose pup had the protein C test will see this and respond. It seems high to me, but maybe its right on target. I'll be thinking of you and Shoni tomorrow!


----------



## Scoobydoo (May 26, 2005)

Good luck Dee, I hope the tests are done correctly this time and the results are much better for little Shoni :grouphug: 
I have no idea about the cost of the Pro C but Scooby's blood gasses tests is 100+ on it's own from the hospital. We were doing them every 3 months but now are spacing them to 6 months since results have been good. Usually with all the tests combined and the vet visit it runs over the 200 mark. Worth every penny though to know he is doing ok after all he went through


----------



## dr.jaimie (Mar 23, 2004)

well the test at cornell is 30, to overnight ship is another 30, then they have to draw the blood, use a special blood tube, spin it down and separate it and put it in another tube, then pack it on ice. prob isnt too high of a charge i think i charged 100 last time i ran it on another pet


----------



## jmm (Nov 23, 2004)

Around $100 sounds about right to me. I think our cost Fedex overnight was like $40...


----------



## Cathy (Mar 19, 2006)

I had to pay $200 plus 6% tax. Since I'm in Canada and overnight delivery was impossible, mine had to be separated in a special way, flown to a broker in Ontario and then flown to Cornell. It took 2 weeks to get the results.

Cathy A


----------

