Panicking--abnormal bloodwork

[drabinowitz43]

Ok, I am trying to remain calm and not be an alarmist, but I am having a tough evening. Joey who is 8 months was at the vet yesterday for his pre-op bloodwork as he was supposed to be neutered tomorrow. We were waiting for him to grow a little (which he has, to a whopping 3 lbs) and for some of his baby teeth to fall out. The vet called me today and said his liver bile acid test (something like that) was very high. Should be around 7 and his is 74. I am bringing him in tomorrow for further tests, one that includes fasting and a urinalysis. The vet mentioned a liver shunt. Please give me whatever advice you can based on this skimpy info. Can it be anything else?

[cpuff35]

I'm sorry to hear. Unfortunately I don't know anything about liver shunt but I'm sure others on YT will be able to help. Also you may want to do a search on other threads for 'liver shunt', you might find alot of helpful info. Good luck.

[Ellie May]

I'm sorry about your pup.

Liver shunt is very common in Yorkies as is microvascular dysplasia (small shunting throughout the liver). That bile acid number is quite high but not extreme. Did the vet do a pre meal and post meal bile acids blood draw?

It is good that your vet did all of this first because the anesthetic protocol for future surgeries will need to be altered to protect him.

Do you have the blood panel results?
Does he have any symptoms like shaking, seizures, drooling, gi upset, lethargy, picky eating, urinary issues, walking into walls, etc.?

[drabinowitz43]

He is acting completely normal. I don't know the results of the rest of his panel, but this is the only one the vet mentioned on the phone and I didn't think to ask. The initial liver bloodwork was done more as a screening. Tomorrow they are doing the tests where firsts he fasts and they draw blood, then he eats, etc. He'll be there all day. They had such trouble drawing his blood yesterday that they had to draw the blood from his neck. I am absolutely sick over this. Thanks for your help.

[Ellie May]

Try not to be too concerned about the jugular blood draw. Yorkies have tiny veins and this is much easier for some vets. That is the only place that Ellie's vet draws from on Ellie most of the time and she does okay.

[MyFairLacy]

I'm sorry It sounds like he was fasted for surgery and they just took a fasting (pre-meal) sample this time? If that is the case, that is very high for a pre-meal sample. Most likely his post-meal sample will be much higher when you redo the bile acid test. It's always important to have a paired sample around a meal time for most accurate results.

[Ladymom]

I am so sorry to hear this. Yorkies are 36 times more likely to have a liver shunt than all other breeds combined.

Thank heavens you got the pre-op bloodwork.

Here is a great article for you:

Portosystemic Shunts FAQ

[Patti]

Sorry to hear this. My Cali has a very mild MVD and her Bile acid results were 0/80 and 0/47 or close to those figures. She needs no treatment. Hoping your baby is fine and test results were just a fluke.

[drabinowitz43]

Thanks for all your replies. The blood test was done as part of his pre-op screening to be neutered so he wasn't fasting and there were no paired results. We are doing that tomorrow. Keep me in your thoughts and prayers and thanks again.

[TLC]

Hi Donna - I wrote to you on your profile page too

Try not the freak...He is going to be ok. You are following the right proceedures. BAT and Bloodwork and Urinalaysis. Once you get those results, please shar them with us and we will work with you

What food is he eating? What treats? Any 'odd' behaviors?

-Nicole

[drabinowitz43]

Hi, thanks for writing. I just posted a new thread that I went to the vet today and he opted to send me to Oradell (NJ) to see a surgeon and a sonographer who specializes in diagnosing liver shunts. Skipped all that other stuff, which I wasn't happy about, but he said with a 74, there was no question his liver was compromised. He eats a mix of California Natural Lamb/Rice small bites and Solid Gold Just a Wee Bit. I also have an almost one year old Yorkie so I went off puppy food. Treats vary, Buddy Bites, Buddy Bisquits, flossies, texas toothpicks. I live near NYC, but Oradell is a very highly regarded animal hospital in the Tri-State area.

[TLC]

Originally Posted by drabinowitz43

Hi, thanks for writing. I just posted a new thread that I went to the vet today and he opted to send me to Oradell (NJ) to see a surgeon and a sonographer who specializes in diagnosing liver shunts. Skipped all that other stuff, which I wasn't happy about, but he said with a 74, there was no question his liver was compromised. He eats a mix of California Natural Lamb/Rice small bites and Solid Gold Just a Wee Bit. I also have an almost one year old Yorkie so I went off puppy food. Treats vary, Buddy Bites, Buddy Bisquits, flossies, texas toothpicks. I live near NYC, but Oradell is a very highly regarded animal hospital in the Tri-State area.

I have to be honest that he is rushing and freaking you out
Try to calm down. Pre-op blood work will indicate things that are off with the liver. But the next step is to have a Bile Acid Test done. Those results will give you more info onto whether there are liver issues.

Usually if the Post# from the BAT is OVER 100 - they will lean more towards a Liver Shunt. If the Post # is below 100 - they will lean more towards MVD.

MVD is tiny microscopic shunts thru-out the liver and NOTHING can be done. MVD is managed thru a special diet and supplements.

I would really suggest having a BAT done BEFORE you consider an Ultra-Sound. The U/S is only about 60% accurate, and the person reading the U/S has to be extremely skilled at reading a U/S. Plus the U/S costs about $300 to $500

-Nicole

[MyFairLacy]

Originally Posted by TLC

I have to be honest that he is rushing and freaking you out
Try to calm down. Pre-op blood work will indicate things that are off with the liver. But the next step is to have a Bile Acid Test done. Those results will give you more info onto whether there are liver issues.

Usually if the Post# from the BAT is OVER 100 - they will lean more towards a Liver Shunt. If the Post # is below 100 - they will lean more towards MVD.

MVD is tiny microscopic shunts thru-out the liver and NOTHING can be done. MVD is managed thru a special diet and supplements.

I would really suggest having a BAT done BEFORE you consider an Ultra-Sound. The U/S is only about 60% accurate, and the person reading the U/S has to be extremely skilled at reading a U/S. Plus the U/S costs about $300 to $500

-Nicole

I agree. You need to do a paired bile acid test first. You should also do a urinalysis. There are steps to diagnosing liver disease, and I don't think you should just automatically jump to something big before doing the smaller steps.

I did do an ultrasound (doppler over the vessels) for Lacy...the person doing her ultrasound was very skilled. But ultrasounds are only as accurate as the person doing them. The cost for the ultrasound here at Texas A&M University was under $300. We also did a blood ammonia test which came back normal for her, and blood ammonia is usually high with a shunt. We had also done an x-ray before the ultrasound and her liver appeared to be a normal size. So with her normal blood ammonia, normal liver size, and no shunt seen on ultrasound, we were confident she did not have a shunt. However they did find abnormal areas on her liver so they are going to do a liver biopsy on those.

I would really suggest having the BAT done first and then either and depending on the numbers, you can do an ultrasound and then scintigraphy or just do a scintigraphy and no ultrasound.

[Ellie May]

Did he have any vaccines, flea preventatives, heartworm medications or had he gotten into anything that could be considered toxic within a few weeks before this 74?

[mscat]

I am very sorry ;( There are some very good replies on here , that I personally would follow. I have no experience with LIver Shunts, but some YT'ers have. Hope everything turns out well for Joey. My thoughts and prayers going out to him and his family.