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Dr. Saunders and Dr Coder. They did not mention a Protein C test first. How long does that take and how long for the results?
 

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First Timer here.

I have a Maltese Jake, 2 years old. We bought him from a great breeder. As a matter of fact both of our dogs are from the same breeder. He has been a great dog, always a little small, full of life and fun. This week Jake went into a deep stare and seemed to lose himself. We immediately took him to the Vet and his ALT was 712 - very high!. He did come back full throtle after a little bit and has been fine since. But we scheduled him for a Acid Bile Test. The results came back this AM. Before the BAT his numbers were 32. After the test they were 97. I know these are elevated and I know I am more than likely getting these confused but you may understand what I am talking about. My question is this. We have him scheduled to go to an Internal Medicine Vet on Sat for a complete workup. With everyones experience here, what are some things that I need to ask the Vet? He is going to Florida Veterinary Specialist in Tampa. Any input would be greatly appreciated.

Tony[/B]
Hi Tony,

I'm from Sarasota, so not too far from Tampa. You also might want to check out the University of Florida's small animal clinic. I took my puppy, Maggie, there after my vet discovered a heart murmur. I know that it is a very different situation, but UF has a top vet school and therefore, amazing vets and the best equipment. I know that is a drive from where we are, but it is well worth it. I was very happy that I made the trip to take Maggie up there. We are very lucky to live in a state with a Vet school. I just looked on there website and they have a Dr. who specializes in liver disease. You might want to check it out. I hope that Jake is ok!! :grouphug: UF Small Animal Clinic
 

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Thanks!

Dr. Saunders and Dr Coder. They did not mention a Protein C test first. How long does that take and how long for the results?[/B]

i sent the protein C test off on my baby and got the results in about 3 days. cornel university is the only place that runs the test. its a fairly new test so ur vet may not know about it. you can also have ur vet contact dr center at cornell now to get more info on the protein C. i will see if i can find some info on the vet forum about it for u to bring to ur vet
 

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ok i found an article...so if u or ne one PMs me ur email i can email it to u
 

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Discussion Starter #46
First Timer here.

I have a Maltese Jake, 2 years old. We bought him from a great breeder. As a matter of fact both of our dogs are from the same breeder. He has been a great dog, always a little small, full of life and fun. This week Jake went into a deep stare and seemed to lose himself. We immediately took him to the Vet and his ALT was 712 - very high!. He did come back full throtle after a little bit and has been fine since. But we scheduled him for a Acid Bile Test. The results came back this AM. Before the BAT his numbers were 32. After the test they were 97. I know these are elevated and I know I am more than likely getting these confused but you may understand what I am talking about. My question is this. We have him scheduled to go to an Internal Medicine Vet on Sat for a complete workup. With everyones experience here, what are some things that I need to ask the Vet? He is going to Florida Veterinary Specialist in Tampa. Any input would be greatly appreciated.

Tony[/B]
Doesn't sound like your numbers are confused at all. A blood draw is taken before a meal and then again 2 hours after a meal. Generally (but not always) the values are lower for the first (pre-prandial) blood draw and higher for the second (post-prandial) blood draw. A value ≥ 25 uMol/L, whether pre- or post-prandial (about 20% of all dogs tested have higher pre-prandial values than post- prandial values) is considered abnormal in the Maltese breed. The best next step (least invasive and least expensive) is to run a Protein C test. Your regular vet can draw the blood and send it off to Cornell University for testing. Because Jake's ALT was so high, I might also ask your vet to examine a urine sample looking for ammonium biurate crystals. If the Protein C test results are normal you can pretty safely assume that Jake has MVD. For an asymptomatic dog with MVD no medical or dietary management is needed. However, if your dog does appear to be symptomatic you should discuss your options for dietary (low protein diet like Hills L/D) and medical management.

If you click on the following link you can read about my experience with the specialists. Good luck with Jake and keep us posted.

Mary

http://spoiledmaltese.com/forum/index.php?...st&p=442151
 

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I'm going to kindly agree with the recommendation to see an internist AND have the Protein C test done. Certainly, shunt needs to be ruled out here, HOWEVER, Jake still had an episode of something that may be related to liver disease. A symptomatic dog should be carefully evaluated and likely receive some treatment. Honestly, even with Dr. Center's long-distance care, I feel it is important to have an internist at home-base if at all possible.
 

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Discussion Starter #48
I'm going to kindly agree with the recommendation to see an internist AND have the Protein C test done. Certainly, shunt needs to be ruled out here, HOWEVER, Jake still had an episode of something that may be related to liver disease. A symptomatic dog should be carefully evaluated and likely receive some treatment. Honestly, even with Dr. Center's long-distance care, I feel it is important to have an internist at home-base if at all possible.[/B]
I totally agree with seeing an internal medicine specialist, especially because of the seizure-type episode, but I'd still start the diagnostic process with the Protein C test. I cringe every time I hear about one of our little ones being subjected to all kinds of invasive procedures as a first step rather than as a later step if necessary.
 

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Ok , Jake went to the Vet on Sat and had an Ultrasound. We had this setup already and just went ahead with the appointment. There was no indication of an Extrahepatic Shunt. No sign of bladder stones. The vet did discuss the poosibility of an Intrahepatic Shunt and MVD. He discussed a biopsy that would rule out a shunt. However, we were not comfortable with the biopsy because of the trauma that he could face. He is only 4 lbs and that I think would be cruel to a point since if a shunt is found, it could be in an area that would be very risky for the liver if removed or maybe not removable at all. We did mention the Protein C and he was not as convinced about the test as those on this board. However, he was a critical care vet. He does agree there is "something" going on and we need to find out what it is. We have started him on medicine/diet as if he were diagnosed with MVD. We will see his regular vet on Tuesday and will schedule him with the Internist in Dec for a consult. We are going to ask for our regular vet to take the blood sample a(Protein C) and send it to Dr. Center so it is available for the consult with the Internist. He continues to be very playful with his brother and very alert. I could not ask for a better dog.

Can anyone give me additional info on Protein C that I can give to my Vet. Dr. Center's address or how we go about this.

Thanks for all your help and concern!!!!

Tony
 

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Hi Tony! I have a 9 month old maltese named Harry who has serious liver disease. We started out much the same way as you, by visiting an internist. The internist wanted to do a biopsy, since they didn't see a shunt on the ultrasound...but I didn't feel right about it, so I brought Harry to Dr. Center. (I live 4 hours away from Cornell...but it was well worth the drive.)

You can read my earlier posts about what went on with Harry at Cornell. I tried to post a link to my other posts here, but I don't know how :brownbag: ...the topic was "Harry's visit to Cornell".

Harry is doing really well today. The doctors at Cornell put him on a special diet....brown rice, tofu, and cottage cheese! It seems to have made a difference in his behavior...he's back to being a pup. :chili: I am going to Cornell with Harry on Wednesday for some blood work. Eventually they are going to let me have the blood work done around here so that I don't have to drive 8 hours in one day,,, but they want to make sure that Harry is stable before they agree to that. (Luckily I'm a substitute teacher, so I can take the days off to be with Harry with no problem.) We don't know how long we have with Harry...so we're enjoying each day that we have.

This forum is a great resource. I believe that the information I got from the members of this forum saved Harry's life!!! :aktion033: Good luck...I'll be praying for you both!

Debbie
 

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Discussion Starter #52
Hi Tony! I have a 9 month old maltese named Harry who has serious liver disease. We started out much the same way as you, by visiting an internist. The internist wanted to do a biopsy, since they didn't see a shunt on the ultrasound...but I didn't feel right about it, so I brought Harry to Dr. Center. (I live 4 hours away from Cornell...but it was well worth the drive.)

You can read my earlier posts about what went on with Harry at Cornell. I tried to post a link to my other posts here, but I don't know how :brownbag: ...the topic was "Harry's visit to Cornell".

Harry is doing really well today. The doctors at Cornell put him on a special diet....brown rice, tofu, and cottage cheese! It seems to have made a difference in his behavior...he's back to being a pup. :chili: I am going to Cornell with Harry on Wednesday for some blood work. Eventually they are going to let me have the blood work done around here so that I don't have to drive 8 hours in one day,,, but they want to make sure that Harry is stable before they agree to that. (Luckily I'm a substitute teacher, so I can take the days off to be with Harry with no problem.) We don't know how long we have with Harry...so we're enjoying each day that we have.

This forum is a great resource. I believe that the information I got from the members of this forum saved Harry's life!!! :aktion033: Good luck...I'll be praying for you both!

Debbie[/B]
Hopefully this will work ....

http://spoiledmaltese.com/forum/index.php?showtopic=27264
 

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What is really condsidered high? My dog had a Bile Acid level of 13. The lab sheet says it may be suggestive of liver disease. My vet said he wouldn't even worry about such a low number. He said itis problematic at the 200 - 300 level. my dog is asymptomaitc, but he is only 6 months.
 

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What is really condsidered high? My dog had a Bile Acid level of 13. It say it may be suggestive of liver disease. My vet said he wouldn't even worry about such a low number. He said itis problematic at the 200 - 300 level. my dog is asymptomaitc, but he is only 6 months.[/B]

Under 25 is normal.
 

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Are Maltese breeders routinely running bile acid tests on adults before breeding them? I've seen ads/websites for Yorkies and Havanese that state that bile acids tests have been done on the parents and the puppy, but never seen it in an ad for a Maltese or on any of the show breeders websites.

Are Maltese breeders just behind the eight ball on this issue?[/B]
I bought my Ava Jane from a breeder on the AMA list. I thought I had asked all the right questions and commented on the Code of Ethics. The breeder told me that in 20 years she had "never had any healthy problems with her dogs." Well, when Ava's blood work and then Bile Acids came back elevated (pre-eating 60, post-eating 266) I questioned the breeder about the bile acid tests done on the parents. She told me, "I've never tested them. I've never had to." Well, as many of you may have read Ava had a shunt, which we had repaired back in February. So, even breeders on the AMA list are not following any health screening standards. By the way, I did contact my breeder to let her know what happened and I have never heard back from her.
 

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This maybe a dumb question, but I am going to ask anyways. Can a Maltese develop liver issues over time like a shunt or MVD or is it something that is noticed by a certain age or something that they are born with? How often should a dog be bile acid tested? I am starting to get worried because it seems like liver issues are becoming more prevalent. Thanks![/B]
Hi,
My last Maltese showed elevated liver enzymes at age 4, but have no idea how long they had been elevated because they
had never been checked before. Are you worried for any particular reason? Has she shown any symptoms or had any
abnormal test results? If you have some reason for concern, have the liver enzymes done first, and if they're high, have
the bile acids. I think in most cases the liver issues are genetic, but may not show up right away. If you're really concerned,
I certainly think once a year would be often enough. Good luck.
 

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Hi,
My last Maltese showed elevated liver enzymes at age 4, but have no idea how long they had been elevated because they
had never been checked before. Are you worried for any particular reason? Has she shown any symptoms or had any
abnormal test results? If you have some reason for concern, have the liver enzymes done first, and if they're high, have
the bile acids. I think in most cases the liver issues are genetic, but may not show up right away. If you're really concerned,
I certainly think once a year would be often enough. Good luck.[/B]
A normal chemistry panel does not rule out perfusion disorders of the liver (MVD/shunts). Even dogs with shunts can have normal ALTs and no symptoms.

Bile acids do not need to be repeated for asymptomatic MVD dogs. For every time you do them, you will get a different number. If they are abnormal, bottom line is they are abnormal. Repeating them annually would not provide you with any further information for the typical asymptomatic MVD Maltese.
 

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After reading this thread, I'm a little confused as to whether or not you should insist on a bile liver test BEFORE bringing your puppy home. Can somebody clear this up for me? I have been in touch with Bea Ane's Maltese and when I asked her if she did this test, she told me that she doesn't need to because her dogs are healthy and she wouldn't sell a sick pup.

Thanks.
 

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QUOTE (Lori @ Jul 14 2008, 05:11 PM) index.php?act=findpost&pid=605269
After reading this thread, I'm a little confused as to whether or not you should insist on a bile liver test BEFORE bringing your puppy home. Can somebody clear this up for me? I have been in touch with Bea Ane's Maltese and when I asked her if she did this test, she told me that she doesn't need to because her dogs are healthy and she wouldn't sell a sick pup.

Thanks.[/B]

I would ask that the bile acid test be done before I purchased the puppy. No one can tell whether a puppy has a liver shunt or MVD unless the dog is tested, no matter how healthy the line seems to be.
 
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