Everyone is stumped! Yorkshire Terrier. First clinical sign at age 2 mos was focal seizures, particularly after eating. The puppy would stare ahead, twitch her head lightly, and lose her balance. Only lasted 2 seconds on average, and she acted as though nothing happened. After initial blood work in 9/08 showed her bile acids were high, she was put on Hills K/D diet and scheduled for ultrasound, which was abnormal, then a liver biopsy. Biopsy in 12/08 results were normal - surgeon says the liver appeared healthy and the correct size. Re-checking of bile acids 1 month later in 1/09 were still abnormal. Taken off K/D diet in spring of 09 due to urine crystals and 2 urinary tract infections, eating all natural science diet (nature's best) now. Focal seizures ceased in early december 08 after diet change, never returned. Most recent bile acids test in 10/09 still abnormal, checked for pancreatitis as an explanation, but test was negative. Dog is healthy in appearance, soft shiny coat, tall and lean build, active, strong, and very intelligent.
My vet is stumped. Her biopsy was normal, but her post bile acids are still not - though the pre bile acids have become normal. My vet thinks since she is not symptomatic, she should be fine. I'm fearful to ignore this - can high bile acids cause damage to her body? Aside from the liver, what other organs can cause high bile acids? Is there something else I could have her tested for? Not asking for a diagnosis or suggested treatment, just information on possible causes of high bile acids that a dog with her history could/should be tested for. I love this dog so much and want her to have a healthy life. Her blood/ultrasound/biopsy results are below:
Blood work was all normal except for the following:
September 2008 (age 3 mos - weight 3.5 lbs)
PHOS: 7.7 (2.1-6.3) *H
Bile Acids: 21.4 (>7) *H
Bile Acids ACPP: 51.5 (>15) *H
LYMPHS: 46 (12-30) *H
MONOS: 2 (3-10) *L
NEUT SEG: 47 (60-77) *L
*Reactive Lymphocytes Present*
January 09 (age 7.5 mos - weight 7 lbs)
Bile Acids: 7 (>7) *Normal - slightly high
Bile Acids ACPP: 48 (>15) *H
October 09 (Age 1 - weight 9 lbs)
Bile Acids: 4 (>7) *Normal
Bile Acids ACPP: 64 (>15) *H
Spec cPL (Pancreatitis check) *Normal
Ultrasound Results - Sept 08
Liver appears "older." Liver size in lower limits. Spleenomegaly. Portal Vein disproportionately large. Kidney size upper limits of normal. No ascites, no shunt.
Biopsy Results - Dec 08
No sign of liver disease or hepatic microvascular dysplasia, liver normal size and healthy in appearance.
Wow...you have a lot of detailed information here....that's great!! You are truly a dedicated pet parent!
I think this is a great question to post to our experts in the Ask A Vet forum. They can help you understand the results of the tests so far and maybe even give you some guidance for what to watch for in the future.
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