# Dewey!s BAT results



## Furbabies mom (Jul 25, 2011)

My vet just called me. She said Dewey's pre test was normal , but post was 53. She said there is something going on with his liver. She is referring me to OSU. I am devastated!!! What does all this mean?? She kept talking about about a liver shunt and the other tests that they need to do. I am in a fog!! I called Den at work crying, I've never had a sick dog before, only healthy BYB dogs that weren't beautiful, but healthy!! I love him so, and will do whatever has to be done, but I am just scared!


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## Lmojeda (Sep 22, 2012)

Oh I am so sorry! I'm praying for u and Dewey!


Sent from my iPhone


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## allheart (Oct 3, 2008)

Oh Deborah, I am so sorry. Gosh, I hope you can feel my hug. Don't you worry, Dewey will be okay. Love you.


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## Snowbody (Jan 3, 2009)

Debbie - I'm so sorry. I don't really know anything about the BAT numbers and quite what they mean but hoping someone, like Mary H, will see this and give you some assurance. I think that members here know more than a lot of vets do. Try to be calm and know we're here for you.


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## Sylie (Apr 4, 2011)

Oh Deborah, this can't be. My interpretation is that if it is normal after fasting, but elevated right after a meal, that a diet change can correct the problem. I hope so. Dewey is going to be fine. Take a deep breath, hold him close to you, and feel him with your soul...feel that he is a strong healthy little boy.


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## CloudClan (Jan 31, 2007)

I am sorry that you are having this scare, but these numbers would not alarm me at all unless your dog is showing symptoms of something going on. Generally, since perhaps 70-80% of Maltese are MVD this would likely indicate MVD which is a condition that is asymptomatic and rarely impacts the health or longevity of your dog in any significant way. Many vets are not familiar with the research on this and tend to raise alarm bells due to what they read in the books saying that anything over 25 is abnormal, but rarely do they seem to have read further to find that the experts generally do not seem to believe a shunt is likely until the numbers are over 100.


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## sassy's mommy (Aug 29, 2005)

Deborah I am sorry to hear this. I hate to admit it, but I am clueless about liver issues. Try to stay calm....some liver issues are easily dealt with. Keeping you and Dewey in our thoughts and prayers. Hugs, :wub:


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## CrystalAndZoe (Jul 11, 2006)

First off, breathe! It's ok. Dewey is most likely asymptomatic MVD like the majority of all Maltese and Yorkies. The next step is the Protein C test. It's a blood draw your vet can do and send it off to Dr. Sharon Center at Cornell. That is what you should do before going to the Univ of Ohio. Dewey is not exhibiting any symptoms or signs of liver shunt is he?


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## Furbabies mom (Jul 25, 2011)

CloudClan said:


> I am sorry that you are having this scare, but these numbers would not alarm me at all unless your dog is showing symptoms of something going on. Generally, since perhaps 70-80% of Maltese are MVD this would likely indicate MVD which is a condition that is asymptomatic and rarely impacts the health or longevity of your dog in any significant way. Many vets are not familiar with the research on this and tend to raise alarm bells due to what they read in the books saying that anything over 25 is abnormal, but rarely do they seem to have read further to find that the experts generally do not seem to believe a shunt is likely until the numbers are over 100.


Thank you ! Thank You! Thank You!


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## CrystalAndZoe (Jul 11, 2006)

CloudClan said:


> I am sorry that you are having this scare, but these numbers would not alarm me at all unless your dog is showing symptoms of something going on. Generally, since perhaps 70-80% of Maltese are MVD this would likely indicate MVD which is a condition that is asymptomatic and rarely impacts the health or longevity of your dog in any significant way. Many vets are not familiar with the research on this and tend to raise alarm bells due to what they read in the books saying that anything over 25 is abnormal, but rarely do they seem to have read further to find that the experts generally do not seem to believe a shunt is likely until the numbers are over 100.


I had to go back over my notes and that is what I have too. Dr. Center says that in shunt dogs, you typically see BAT #'s greater then 100. :thumbsup:


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## wkomorow (Aug 26, 2011)

Deb,

You are such a special and positive person, please do not immediately think the worse. I know that you must be devistated. Ok, you have some information now, referred to a specialist, you will have more information. You do not know it is a shunt yet. Even if it is a shunt, many can be controlled by diet, some by medication, some by surgery. There every reason to believe that Dewey will live a long, full, and normal life. You are getting the help you need to figure out what is going on. Dewey is not showing any signs of problems, always a very good thing. Wishing you Den and Dewey the best. I will be thinking about you as you go through this over the coming weeks. Be well.


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## allheart (Oct 3, 2008)

Furbabies mom said:


> Thank you ! Thank You! Thank You![/QUOTE}
> 
> Bless you Carina. Hugs again Deborah.
> 
> ...


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## Ladysmom (Oct 19, 2004)

I agree with Carina and Crystal. Don't panic. Most likely Dewey has MVD which is pretty common in Maltese.

Here is information about the Protein C test Crystal mentioned:

Protein C Activity Assay


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## bellaratamaltese (May 24, 2006)

I also agree, 53 would not alarm me either. Ask what they fed dewey for the 'meal'. If it's that high fat critical care cr*p, that could affect the results.

I don't know how many bile acid tests that vets do 'routinely' but I know I had to provide Dr Center's research to my vet and forwarded him the info on Protein C because the office had never done one before. This is another case where vets push the 'liver shunt' diagnosis when it may not be necessary. Protein C is the next test that needs to be done, before anything else. Let me know if you need the info and I can send it to you. Mary had sent it to me and then I forwarded it to my vet. 

If Dewey is completely asymptomatic, then don't panic! It's not the end of the world and it surely doesnt' mean a 'sick' dog. Let us know how things progress!


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## Furbabies mom (Jul 25, 2011)

Crystal&Zoe said:


> First off, breathe! It's ok. Dewey is most likely asymptomatic MVD like the majority of all Maltese and Yorkies. The next step is the Protein C test. It's a blood draw your vet can do and send it off to Dr. Sharon Center at Cornell. That is what you should do before going to the Univ of Ohio. Dewey is not exhibiting any symptoms or signs of liver shunt is he?


The only thing that concerned me was on two occasions he would yawn and stretch his neck out. He would do it several times. I think it was his food kind of gummy and sticky(Red Barn in a roll) that got stuck either in the back of his throat or behind his back teeth. Both times he did this I took him to the vet. Blood work was OK. My vet thought possibly a seizure, but he wasn't out of it just acting like he was trying to get something down. He has done this twice and actually this prompted me to get the BAT done.


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## pippersmom (May 21, 2012)

Praying that it turns out cute little Dewey is just fine. Take the advice from the experts on here who say they wouldn't be too alarmed at his numbers and TRY not to worry too much.


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## bellaratamaltese (May 24, 2006)

Furbabies mom said:


> The only thing that concerned me was on two occasions he would yawn and stretch his neck out. He would do it several times. I think it was his food kind of gummy and sticky(Red Barn in a roll) that got stuck either in the back of his throat or behind his back teeth. Both times he did this I took him to the vet. Blood work was OK. My vet thought possibly a seizure, but he wasn't out of it just acting like he was trying to get something down. He has done this twice and actually this prompted me to get the BAT done.



I've had a problem with Red Barn getting stuck in the throat - esp with the dogs that wolf it down like absolute pigs and don't chew. How old is Dewey?


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## Furbabies mom (Jul 25, 2011)

bellaratamaltese said:


> I also agree, 53 would not alarm me either. Ask what they fed dewey for the 'meal'. If it's that high fat critical care cr*p, that could affect the results.
> 
> I don't know how many bile acid tests that vets do 'routinely' but I know I had to provide Dr Center's research to my vet and forwarded him the info on Protein C because the office had never done one before. This is another case where vets push the 'liver shunt' diagnosis when it may not be necessary. Protein C is the next test that needs to be done, before anything else. Let me know if you need the info and I can send it to you. Mary had sent it to me and then I forwarded it to my vet.
> 
> ...


Dewey came home with me after the first draw and he ate his regular food. Red Barn same as the breeder fed him.


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## MoonDog (Jun 6, 2011)

Deb, I was very concerned when I started reading this thread but was very comforted by what Carina and Crystal wrote. Please give that sweet little Dewey a kiss for me.


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## Furbabies mom (Jul 25, 2011)

bellaratamaltese said:


> I've had a problem with Red Barn getting stuck in the throat - esp with the dogs that wolf it down like absolute pigs and don't chew. How old is Dewey?


19 weeks


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## lmillette (Apr 23, 2012)

Sorry to hear this Deborah, but based on the others information (who definitely know what they are talking about) I would try not to worry but easier said then done, I know. Sweet Dewey is in my thoughts and prayers, as are you!! Keep us posted on everything.


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## CrystalAndZoe (Jul 11, 2006)

Furbabies mom said:


> The only thing that concerned me was on two occasions he would yawn and stretch his neck out. He would do it several times. I think it was his food kind of gummy and sticky(Red Barn in a roll) that got stuck either in the back of his throat or behind his back teeth. Both times he did this I took him to the vet. Blood work was OK. My vet thought possibly a seizure, but he wasn't out of it just acting like he was trying to get something down. He has done this twice and actually this prompted me to get the BAT done.





bellaratamaltese said:


> I've had a problem with Red Barn getting stuck in the throat - esp with the dogs that wolf it down like absolute pigs and don't chew. How old is Dewey?



Awww....I'm betting it was the food like Stacy said. Why not try something else and see if you ever see it again. I would go with a lower to more moderate protein and stay away from food that has organ meat. It's just too rich for toy breeds imo.


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## Zoe's Mom88 (Apr 25, 2011)

Deb, so sorry to hear about Dewey. I also agree that it doesn't seem to be anything to be alarmed at. Hope you get to the bottom of it soon.


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## bellaratamaltese (May 24, 2006)

Crystal&Zoe said:


> Awww....I'm betting it was the food like Stacy said. Why not try something else and see if you ever see it again. I would go with a lower to more moderate protein and stay away from food that has organ meat. It's just too rich for toy breeds imo.



I will only feed the lamb one (I think it's lamb) because it crumbles easily and I dont' have to worry about it sticking in the throat. I remember Caira almost choking to death on a piece of Red barn because she was the pig who wolfed it down without chewing.


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

Deborah -- truly not an alarming number, imho. You've received some great info from others, so all I want to do is send you and Dewey a virtual hugs.

:grouphug::grouphug:


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## SammieMom (Nov 13, 2010)

Deb- I am sorry you were scared today. :innocent: Poor thing. Happened to me with Sammie, but with Penny I gave the Vet Dr. Center's protocol for Maltese BAT. She thought over 15 meant a shunt. Scared everyone silly. Just from what I've read about Dewey, I would not be concerned with his results. Sammie is a #57, he has perfect blood panels so far. So all he has to do is 26 and lower protein food. That's it! 
Hugs!
also, Penny was on red barn too. I changed to fromm right away, after reading one of Crystal's posts that is was for all ages. 
PS-
The best thing we can do is give all recommendations for a BAT concerning Maltese to our Vet prior to testing.


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## TLR (Nov 13, 2011)

Deb, I am not educated on this but did want you to know that I will be thinking you and praying for Dewey. It sounds like this may be something very manageable from what all the experts on here are saying. Take it one day at a time and follow the excellent advise you have been given. Hugs to you.


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## SammieMom (Nov 13, 2010)

Crystal&Zoe said:


> First off, breathe! It's ok. Dewey is most likely asymptomatic MVD like the majority of all Maltese and Yorkies. The next step is the Protein C test. It's a blood draw your vet can do and send it off to Dr. Sharon Center at Cornell. That is what you should do before going to the Univ of Ohio. Dewey is not exhibiting any symptoms or signs of liver shunt is he?


Crystal,
Sammie was a #57 on his BAT. I was told by several people and a Vet, that I didn't need to do a PC test. Just feed low protien 26 or lower since he has no signs, and his blood work is normal. Do you think this is normal protocol?


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## Ladysmom (Oct 19, 2004)

SammieMom said:


> Deb- I am sorry you were scared today. :innocent: Poor thing. Happened to me with Sammie, but with Penny I gave the Vet Dr. Center's protocol for Maltese BAT. She thought over 15 meant a shunt. Scared everyone silly. Just from what I've read about Dewey, I would not be concerned with his results. Sammie is a #57, he has perfect blood panels so far. So all he has to do is 26 and lower protein food. That's it!
> Hugs!
> also, Penny was on red barn too. I changed to fromm right away, after reading one of Crystal's posts that is was for all ages.
> PS-
> The best thing we can do is give all recommendations for a BAT concerning Maltese to our Vet prior to testing.


:thumbsup: Just wanted to add that Dr. Tobias recommends milk thistle for MVD dogs. Marin is a great one to use as is Hepatosupport.

ACVS - Hepatic Microvascular Dysplasia or Portal Atresia

MILK THISTLE


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## Snowball Pie's Mommi (Oct 16, 2008)

Deborah, I know how scary it is when we are worried that something is wrong with our fluff babies. However, after reading the responses from our SM members who have experience and knowledge on this subject ... it sounds as though everything is going to be okay with Dewey. I am not an expert by any means. So, I am just sending love and hugs to you and your adorable Dewey.


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## SammieMom (Nov 13, 2010)

Thanks Marj for the reminder! I need to order those products.


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## hoaloha (Jan 27, 2012)

Deb- I know it's easier said than done, but please do not worry about Dewey yet! He is active and growing well . As most have mentioned, it is likely a symptomatic MVD which is highly prevalent in Maltese. Just wanted to let you know that I'm thinking of you and Dewey and pray that the protein C test or any further testing will be perfect. Hugs to you!


Sent from my iPad using PG Free


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## CrystalAndZoe (Jul 11, 2006)

SammieMom said:


> Crystal,
> Sammie was a #57 on his BAT. I was told by several people and a Vet, that I didn't need to do a PC test. Just feed low protien 26 or lower since he has no signs, and his blood work is normal. Do you think this is normal protocol?


From my understanding...and I learned this from Mary H., if the BA #'s are moderately high, between 50-99, you should think about doing a protein c if you are seeing signs of something being off just a bit, ie low weight or difficulty keeping weight on, activity level, episodes of vomiting and/or diarrhea, neurological symptoms, etc...

However...I happen to know of some Malts who have absolutely no symptoms so for my own piece of mind, I would do one. But that's because I'm a neurotic, over worrying mom. :blush:


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## Furbabies mom (Jul 25, 2011)

I am going to talk to my vet tomorrow MORNING , forward all the info that Stacy sent me, and go from there! I thank you all for putting me at ease! I'm usually not so freaked out about things, but I admit I was a basket case when I got off the phone with my vet! Poor Den, there is nothing like a hysterical wife calling you at work!!! LOL he isn't home yet, he probably wonders what's in store for him when he gets here! Thanks again everyone!!!!


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## jmm (Nov 23, 2004)

I would be quite happy with those results on one of my dogs. I would not pursue it unless the dog was obviously having problems.


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## SammieMom (Nov 13, 2010)

Furbabies mom said:


> I am going to talk to my vet tomorrow MORNING , forward all the info that Stacy sent me, and go from there! I thank you all for putting me at ease! I'm usually not so freaked out about things, but I admit I was a basket case when I got off the phone with my vet! Poor Den, there is nothing like a hysterical wife calling you at work!!! LOL he isn't home yet, he probably wonders what's in store for him when he gets here! Thanks again everyone!!!!



So glad your feeling better. :wub:


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## Furbabies mom (Jul 25, 2011)

jmm said:


> I would be quite happy with those results on one of my dogs. I would not pursue it unless the dog was obviously having problems.


NOW I really feel better!!!!!!


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## aprilb (Jul 9, 2010)

CloudClan said:


> I am sorry that you are having this scare, but these numbers would not alarm me at all unless your dog is showing symptoms of something going on. Generally, since perhaps 70-80% of Maltese are MVD this would likely indicate MVD which is a condition that is asymptomatic and rarely impacts the health or longevity of your dog in any significant way. Many vets are not familiar with the research on this and tend to raise alarm bells due to what they read in the books saying that anything over 25 is abnormal, but rarely do they seem to have read further to find that the experts generally do not seem to believe a shunt is likely until the numbers are over 100.


:goodpost:


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## aprilb (Jul 9, 2010)

Dewey will be fine..I disagree with your vet. I don't believe any further testing is necessary unless Dewey is having symptoms..I would be happy with those results..like Carina said, 60-70% of Maltese have MVD and live normal lives.


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## brendaman (Mar 7, 2006)

Deborah,

Kayla's BAT result was 65.3 pre-meal and 37.7 post-meal. I didn't know what to make of tresults, but was told that there is a small % of dogs who have high pre-meal BATs. The post is over 25 and considered "abnormal", but Kayla is asymptomatic. We delayed her spaying and waited to see if she would continue to gain weight (she is on the small side weighing nearly 4 lbs. at almost 8 months) and exhibit any symptoms of being possibly MVD. Because there is quite a bit of links and info here, I was prepared and provided the Dr. Center's protocol and background info, as well as provided info on the Protein C test, because of course our vet's initial reaction was to send me to an internist to do an intrasound. Were the BAT results reliable because Kayla was stressed when we dropped her off. I didn't leave her normal food, so they most likely fed her high, fatty foods, so could this have affected the results? Who knows what other variables affected the BAT?! I received some great advice and support from SM, albeit more offline, and decided to focus on having her spayed before worrying about what to do with the BAT results. 

Kayla was spayed nearly three weeks ago (her blood panel results before the spaying was "unremarkable" so we went ahead with the spaying). She continues to gain weight and exhibits no symptoms of having liver issues. We do treat her as having possible liver issues, so her we feed her low protein. Our vet also discusses her health from the viewpoint of possibly having liver issues (e.g. for her spaying, they used anesthesia and pain meds considered safe for dogs with liver issues).

I am taking the advice of more experienced people here (Carina, Crystal, Jackie, MaryH & Stacy among others) and have had a number of discussions with the our vets and have decided to take things one day at a time. Yes, she could be MVD, so if we see any symptoms or even a sign of a symptom, I'm running to the internist. I could decide to be proactive and have Kayla undergo a Protein C now, but since we have pet insurance, I'm not sure any tests the internist runs would be covered, because we were being proactive. 

I'm there with you Deborah. There are quite a few of us who have had such BAT results for our puppies.


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## ladodd (Jan 8, 2012)

Deborah, 

Addie's post number was 54. But her Protein C was good. When I took Jack to the internist today, I told him Addie's numbers and he was not worried. He said if the post BAT had been over 100 and her PC was not good, he would be concerned. Go do the PC, it takes a week or so to get the results. Please try not to panic.

Laurie


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## MaryH (Mar 7, 2006)

jmm said:


> I would be quite happy with those results on one of my dogs. I would not pursue it unless the dog was obviously having problems.


I TOTALLY AGREE. This is yet another in a recent string of "higher than normal results" situations where in my humble opinion the vets are absolutely failing to EDUCATE THEMSELVES on what is currently known AND AVAILABLE TO THEM regarding liver issues in many toy dog breeds.

I'm heading toward a public flogging here I'm sure and I'm truly not pointing fingers at ANYONE, but it's not fair in my opinion to lay blame only with the vets. Breeders need to start doing a better job of testing their puppies prior to sale, educating themselves, AND educating their puppy buyers so as to avoid concern, confusion and potentially unnecessary repeat testing or worse yet further unnecessary expensive, invasive procedures like ultrasounds, colorectal scintigraphies and/or liver biopsies.

I know, because I was in the same place at one time, how devastating (and scary) it is to hear that bile acid values are higher than normal. However, this is not a death sentence, not even close; for me it was an opportunity to read and learn. This forum has so much good sound information regarding liver issues. So does the Health Section on the AMA website (www.americanmaltese.org). I cannot encourage all of you enough to read this material, print it out and share it with your vets.

I will step off my soapbox now.


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## MaryH (Mar 7, 2006)

Hoping to ease the minds of those dealing with higher than normal bile acid test results, following is "my story" that I copied from http://spoiledmaltese.com/forum/52-...hunt-bile-acid-test-thread-3.html#post1808213

_For me, the answer depends on the puppy itself. So now I'll share my whole story and hope that I don't lose you part way through. I got my first brood bitch hopeful in August 2006 as a 12 wk. old puppy before I knew much about liver shunt, MVD or bile acid testing. In October 2006 a breeder friend (the breeder of my Ch. male) had a puppy returned to her because it was diagnosed with a liver shunt. I knew of Dr. Center because of a rescue dog I had taken in in 2004 with a liver shunt. That dog's shunt was surgically repaired at Angell Animal Medical Center in Boston by a vet who years earlier was a colleague of Dr. Sharon Center at Cornell. He consulted with her while treating Mack, our rescue liver shunt dog. I also knew of Dr. Center's expertise with liver issues thanks to Jackie (JMM) who had been consulting with Dr. Center about her beloved little dog Mikey. So when my friend's puppy was returned for a supposed liver shunt I offered to contact Dr. Center. Dr. Center immediately contacted my friend and there started my education on liver issues. In November 2006 my friend and I drove to Cornell with all of her dogs plus two of mine, my 4-1/2 yr. old Ch. male and my 5-1/2 mo. old female. Brigid, the puppy with the alleged liver shunt did not, in fact, have a shunt. She had very high bile acid values (>100), but after a second ultrasound, a Protein C test, and a cholorectal scintigraphy she was diagnosed with asymptomatic MVD. She ultimately was spayed, placed in a pet home with a Cornell Vet School employee, eats a normal diet, is on no medication, and is at the Vet School on a regular basis, not because she is sick but because she gets to go to work with her human mom. My male has normal bile acid values (<5/18). My female has higher than normal bile acid values (11/68). What a bittersweet moment ... a normal male and abnormal female. My first question was "Is it safe to spay her?" knowing that it's the liver that processes out the anesthesia. The response I got from Dr. Center was "Why would you spay her? She is a normal, healthy, bright, active puppy at a good weight, does not have chronic episodes of diarrhea or vomiting, has normal CBC results, has no neurological issues. You should do exactly what you planned to do. Let her grow up and so long as she remains healthy breed her to your normal male. If you cull everything out of your breed with higher than normal bile acid values you will seriously compromise the gene pool. Bile acid test all puppies and do not sell anything with breeding rights for at least two generations." I asked about having a Protein C test done and was told that I could if I wanted to but that the Protein C test was going to tell me what I already knew just by observation ... I have a healthy asymptomatic MVD dog. She grew up, has always been healthy, has had regular wellness exams, and has been bred twice. Her first litter, sired by my male, produced a singleton girl with normal bile acid values. Her second litter, sired by a different male who also had normal bile acid values, produced 3 boys and 1 girl, two of whom have normal bile acid results, one had just slightly higher than normal values (high 20s), and one with what I consider higher values (low 60s). None of the puppies had Protein C tests done as I felt it was not necessary ... they were all happy, healthy, active puppies and are now happy, healthy, active dogs. If I felt that any of the puppies was not quite "right" I would have done a Protein C test without hesitation. When I sell my puppies, I provide the new owner with a complete health history. I spend a great deal of time discussing liver issues and sharing my knowledge. Should the owner want a Protein C test done, unless the puppy is exhibiting signs of symptomatic MVD, then I believe it is the owner's responsibility to pay for any further testing. If the puppy starts showing chronic symptoms of MVD, then I would offer to have my vet do a Protein C test and I would pay for the testing. Should the Protein C test results indicate that further testing should be done then I would also pay for that so long as I have the vet or vet school of my choosing do the testing. I have spoken at length with more than a couple of breeders who have in their lifetime produced a liver shunt puppy. They have all confirmed to me that they knew by 8-9 wks of age that something was not quite right with the puppy and therefore held on to it until it was of an age where further testing would provide more insightful results. I know my puppies because I spend every free waking moment with them from birth to 16 wks. I would know if something was not quite right and would never dream of withholding necessary diagnostic testing. I hope this helps to answer your questions and feel free to keep the dialogue going._


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

MaryH said:


> Hoping to ease the minds of those dealing with higher than normal bile acid test results, following is "my story" that I copied from http://spoiledmaltese.com/forum/52-...hunt-bile-acid-test-thread-3.html#post1808213
> 
> _For me, the answer depends on the puppy itself. So now I'll share my whole story and hope that I don't lose you part way through. I got my first brood bitch hopeful in August 2006 as a 12 wk. old puppy before I knew much about liver shunt, MVD or bile acid testing. In October 2006 a breeder friend (the breeder of my Ch. male) had a puppy returned to her because it was diagnosed with a liver shunt. I knew of Dr. Center because of a rescue dog I had taken in in 2004 with a liver shunt. That dog's shunt was surgically repaired at Angell Animal Medical Center in Boston by a vet who years earlier was a colleague of Dr. Sharon Center at Cornell. He consulted with her while treating Mack, our rescue liver shunt dog. I also knew of Dr. Center's expertise with liver issues thanks to Jackie (JMM) who had been consulting with Dr. Center about her beloved little dog Mikey. So when my friend's puppy was returned for a supposed liver shunt I offered to contact Dr. Center. Dr. Center immediately contacted my friend and there started my education on liver issues. In November 2006 my friend and I drove to Cornell with all of her dogs plus two of mine, my 4-1/2 yr. old Ch. male and my 5-1/2 mo. old female. Brigid, the puppy with the alleged liver shunt did not, in fact, have a shunt. She had very high bile acid values (>100), but after a second ultrasound, a Protein C test, and a cholorectal scintigraphy she was diagnosed with asymptomatic MVD. She ultimately was spayed, placed in a pet home with a Cornell Vet School employee, eats a normal diet, is on no medication, and is at the Vet School on a regular basis, not because she is sick but because she gets to go to work with her human mom. My male has normal bile acid values (<5/18). My female has higher than normal bile acid values (11/68). What a bittersweet moment ... a normal male and abnormal female. My first question was "Is it safe to spay her?" knowing that it's the liver that processes out the anesthesia. The response I got from Dr. Center was "Why would you spay her? She is a normal, healthy, bright, active puppy at a good weight, does not have chronic episodes of diarrhea or vomiting, has normal CBC results, has no neurological issues. You should do exactly what you planned to do. Let her grow up and so long as she remains healthy breed her to your normal male. If you cull everything out of your breed with higher than normal bile acid values you will seriously compromise the gene pool. Bile acid test all puppies and do not sell anything with breeding rights for at least two generations." I asked about having a Protein C test done and was told that I could if I wanted to but that the Protein C test was going to tell me what I already knew just by observation ... I have a healthy asymptomatic MVD dog. She grew up, has always been healthy, has had regular wellness exams, and has been bred twice. Her first litter, sired by my male, produced a singleton girl with normal bile acid values. Her second litter, sired by a different male who also had normal bile acid values, produced 3 boys and 1 girl, two of whom have normal bile acid results, one had just slightly higher than normal values (high 20s), and one with what I consider higher values (low 60s). None of the puppies had Protein C tests done as I felt it was not necessary ... they were all happy, healthy, active puppies and are now happy, healthy, active dogs. If I felt that any of the puppies was not quite "right" I would have done a Protein C test without hesitation. When I sell my puppies, I provide the new owner with a complete health history. I spend a great deal of time discussing liver issues and sharing my knowledge. Should the owner want a Protein C test done, unless the puppy is exhibiting signs of symptomatic MVD, then I believe it is the owner's responsibility to pay for any further testing. If the puppy starts showing chronic symptoms of MVD, then I would offer to have my vet do a Protein C test and I would pay for the testing. Should the Protein C test results indicate that further testing should be done then I would also pay for that so long as I have the vet or vet school of my choosing do the testing. I have spoken at length with more than a couple of breeders who have in their lifetime produced a liver shunt puppy. They have all confirmed to me that they knew by 8-9 wks of age that something was not quite right with the puppy and therefore held on to it until it was of an age where further testing would provide more insightful results. I know my puppies because I spend every free waking moment with them from birth to 16 wks. I would know if something was not quite right and would never dream of withholding necessary diagnostic testing. I hope this helps to answer your questions and feel free to keep the dialogue going._


 :goodpost:


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## hoaloha (Jan 27, 2012)

MaryH said:


> I TOTALLY AGREE. This is yet another in a recent string of "higher than normal results" situations where in my humble opinion the vets are absolutely failing to EDUCATE THEMSELVES on what is currently known AND AVAILABLE TO THEM regarding liver issues in many toy dog breeds.
> 
> I'm heading toward a public flogging here I'm sure and I'm truly not pointing fingers at ANYONE, but it's not fair in my opinion to lay blame only with the vets. Breeders need to start doing a better job of testing their puppies prior to sale, educating themselves, AND educating their puppy buyers so as to avoid concern, confusion and potentially unnecessary repeat testing or worse yet further unnecessary expensive, invasive procedures like ultrasounds, colorectal scintigraphies and/or liver biopsies.
> 
> ...


:goodpost: thank you, Mary and everyone else for your many years of experience . I agree that we all should play a part in being more educated- whether we are pet owners, breeders, vets, etc... This is another reason why I love SM!


Deborah, I am glad you're feeling better . I just realized that my auto-correct on my phone put a space between the 'a' and 's' in 'asymptomatic' in my prior post. Hope it made sense with the context of what I wrote . Please give Dewey a kiss from me- I have a feeling he will be just fine 


Sent from my iPhone using PG Free


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## Ladysmom (Oct 19, 2004)

MaryH said:


> I TOTALLY AGREE. This is yet another in a recent string of "higher than normal results" situations where in my humble opinion the vets are absolutely failing to EDUCATE THEMSELVES on what is currently known AND AVAILABLE TO THEM regarding liver issues in many toy dog breeds.
> 
> I'm heading toward a public flogging here I'm sure and I'm truly not pointing fingers at ANYONE, but it's not fair in my opinion to lay blame only with the vets. Breeders need to start doing a better job of testing their puppies prior to sale, educating themselves, AND educating their puppy buyers so as to avoid concern, confusion and potentially unnecessary repeat testing or worse yet further unnecessary expensive, invasive procedures like ultrasounds, colorectal scintigraphies and/or liver biopsies.
> 
> ...


Thank you for saying what needed to be said. :thumbsup:

With all the threads we have had recently on Maltese with abnormal bile acids, it is obvious that too many breeders are not getting BAT's done before sending their puppies to their new home.

This should be a wake up call to all of us to insist on a BAT before buying a puppy.

Let me add one more group to the list, the labs that are doing the BAT's. According to my vet, the labs are not giving the correct BAT protocol to vets. My vet was shocked to see Dr. Center's protocol didn't require a fast or a high protein meal like the lab's protocol.

Thank goodness there is so much information available on SM!


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## Summergirl73 (Sep 18, 2011)

Deborah, I'm SO sorry that I am just now reading this. I don't know the first thing about the labs, but I do know how to offer my friends hugs. Sending you LOTS and lots of postive thoughts....and big hugs!


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## Furbabies mom (Jul 25, 2011)

I am faxing ALL the information that I was given here to my vet. She's not in the office today, but I have a call in to her ,for her to call me, after she reads all the info that was sent to her. I am sure that there is info that she has no idea about. I want the protein C test done on Dewey, so I will be sure to talk to her about that also. I will be looking for advice for foods for .Dewey from the forum, after the results of the test . Again I can't thank you all enough for words of encouragement and helping to calm a hysterical woman!!! LOL


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## CrystalAndZoe (Jul 11, 2006)

MaryH said:


> I TOTALLY AGREE. This is yet another in a recent string of "higher than normal results" situations where in my humble opinion the vets are absolutely failing to EDUCATE THEMSELVES on what is currently known AND AVAILABLE TO THEM regarding liver issues in many toy dog breeds.
> 
> I'm heading toward a public flogging here I'm sure and I'm truly not pointing fingers at ANYONE, but it's not fair in my opinion to lay blame only with the vets. Breeders need to start doing a better job of testing their puppies prior to sale, educating themselves, AND educating their puppy buyers so as to avoid concern, confusion and potentially unnecessary repeat testing or worse yet further unnecessary expensive, invasive procedures like ultrasounds, colorectal scintigraphies and/or liver biopsies.
> 
> ...





hoaloha said:


> :goodpost: thank you, Mary and everyone else for your many years of experience . I agree that we all should play a part in being more educated- whether we are pet owners, breeders, vets, etc... This is another reason why I love SM!
> 
> 
> Deborah, I am glad you're feeling better . I just realized that my auto-correct on my phone put a space between the 'a' and 's' in 'asymptomatic' in my prior post. Hope it made sense with the context of what I wrote . Please give Dewey a kiss from me- I have a feeling he will be just fine
> ...


No flogging here. I couldn't agree more. Vets, breeders AND Maltese mommy's and daddy's need to be more educated on these things. Sadly, us as the parents really shouldn't have to be up on these things but since we have so many examples to show us that many vets aren't, we have to be our fluffs advocates. We have so many great threads, some even pinned, to help our members navigate through something like this. I'm one of those people that needs lots of moral support and encouragement when faced with a potential crisis. So even though I may know things, this is still the first place I turn to for support, encouragement, and basically to reinforce what I have already learned. :thumbsup: I know first hand how intimidating it is to have a vet tell you something you know is not correct. Especially when you only have a basic understanding and they can talk circles around you. And I have also had to endure talking to vets who get pretty defensive and truly an attitude when presented with new info. So I've finally learned...go to a new vet that doesn't get offended when presented with new info. Personally, I like a vet that is honest about not knowing something and willing to look at what I have and research it. I like a vet who is willing to dialogue with me so they hear why I feel a certain way about something and then they can tell me why they may feel differently about the same subject. Then I can truly make an informed decision.


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