Bile Acid testing and Vaccinations
By Dr Karen Tobias
Bile acids are still the test of choice if performed properly (fasting and then 2 hours after
feeding). While bile acids can increase with any liver problem, they should not be up over
100 because of vaccinations. Ammonia is only sensitive if done as an ammonian tolerance
test (blood ammonia measured 30 minutes after the dog is given ammonia by oral capsule
or by enema); otherwise it can miss dogs with liver disease. BSP is even less sensitive.
None of these tests are specific for shunts- they only detect
liver dysfunction. KMT
Regarding high bile acid after feeding and lower after feeding…
The vet's suggestions were right on- scintigraphy and then possibly surgery
if there's a shunt. The results of bile acid tests are reversed in about
20% of dogs (high fasting, low fed) because either the dog was not fasted
for 12 hours before the first sample or, more likely, the dog had a normal
contraction of its gallbladder in the middle of the night (feeding cause
the gall bladder to contract, making the bile acids go up, but dreaming
about food can cause the gall bladder to contract too!). KMT
Willis After PSS Surgery at the University of Tennessee
Cassie After PSS Surgery at the University of Tennessee
and Cassie had their Liver Shunt surgeries at University of Tennessee in
Knoxville on February 17, 2005 when they were 8 1/2 months old. Since
their recoveries they have acted like nothing ever happened. They
play and play and play!! Although still "small", they have gained so
much weight. Cassie now weighs in at 4 pounds 7 ounces and Willis weighs
5 pounds 4 ounces (and is still technically smaller than Cassie). They
are now 1 year and 2 months old.
We re-ran their Bile Acid's in April and both Willis and Cassie's weren't back to normal. We were told to redo the tests again in June or July. We re-ran the BAT's in July and Cassie's indicated possible MVD. With Liver Shunt surgery, there is a 15% chance of acquired MVD. We knew this going into their surgeries. We will find out more about this in the months to come. For now, Cassie is still on her Hill's L/D and her Lactulose and is VERY healthy and happy!! Willis' BAT's weren't as bad, but weren't normal. Willis is still on Hill's L/D and Lactulose, as well. We are still praying that his BAT's will return to normal. Willis is also VERY healthy and happy, too!!!
I never thought I'd get to watch my babies enjoy their lives like this. They are little miracle babies!! The energy they have is amazing!! I just know that Terri Shumsky is watching over them every step of the way!!
UPDATE: June 2006
Both Willis and Cassie are VERY happy and HEALTHY!! Neither of their BAT’s have returned to normal. We, along with our vets, suspect that they both have “Acquired MVD”. Willis and Cassie remain on their prescription diet and their Lactulose. I receive extremely wonderful guidance from my vets and from the GREAT people in my chat group. I’m very fortunate to have such knowledgeable and caring people in my life!!
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