[jmm]

I have the study on Maltese. They hypothesized the cause of the elevated bile acids as a chemical in Maltese that isn't present in other breeds. Nobody actually knows if this is the case, if we have a lot of MVD, or what. Other vets have hypothesized that there is a high rate of asymptomatic MVD in the breed.

So, bile acids is a good starting point with Maltese along with a chemistry panel. From there, ammonia tolerance testing can be done and, depending on the numbers, scintigraphy. On a bitch sold as pet, a liver biopsy can be take at the time of spay.

Most vets use 25 or 30 as the upper end of normal for bile acids in a Maltese.

According to Dr. Sharon Center at Cornell, elevated bile acids are not normal for Maltese, but in some dogs they could potentially not be an indicator of disease.

 

[jmm]

If the bile acids results are suspiciously elevated or the dog has elevated liver enzymes, further testing (ammonia tolerance, scintigraphy, ultrasound depending on the elevation) are recommended. No decent vet is going to recommend surgery or something drastic for a dog with slightly elevated bile acids but otherwise normal indications of liver function and no problems. Bile acids 100+ post prandial definately need to be looked in to in any breed of dog. This may be indicative of a liver shunt which can actually go unnoticed for years before causing problems because the liver has shrunk so much.

I think the fact that Maltese tend to have elevated bile acids has been thrown around as normal too much. I use to think it was normal until I spoke with liver specialists and found out they actually didn't know why. There is a more expensive way to measure bile acids which can be done for Maltese, but very few places have the ability to do it...

 

[jmm]

Originally posted by Tavish@Apr 16 2005, 10:42 PM
Have you looked into the studies done in Australia? I remember reading about one that showed bile acid levels in healthy maltese much higher than the 25 most look for. The post results ranged from 20 to over 100, and many of the pre results were high as well. After further testing none were found to have liver shunts. Of course, this isn't to say that if you have a reading over 25 you shouldn't investigate further, however it is interesting to note that there is no other breed which seems to fluctuate as widely in results as the Maltese when it comes to bile acids.
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I have the 1995 Tisdall study. They only biopsied a total of 9 dogs...so who knows about the rest. MVD was only published on by Sharon Center in 1995 and in the Tisdall article, they briefly mention the possibility. They did not do scintigraphy on the other dogs, only ammonia tolerance tests... According to Sharon Center, we still don't know enough.

 

[jmm]

Originally posted by Tavish@Apr 18 2005, 12:12 AM
Nine is a pretty small number. The studies done in Australia included over 100 Maltese.
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This is the same study. They did bile acids on over 100 but only biopsied 9.

 

[jmm]

I pulled out the study...

200 Malts had bile acids
106 with elevated bile acids had ammonia tolerance testing
11 had biopsies

"A large proportion of healthy Maltese of all age groups had increased PPSBA concentrations compared with mixed-breed dogs. It is unclear why this should be so. Recognition and investigation of this phenomenom is important because of its potential to confound the clinicopathological evaluation of sick Maltese dogs" (Tisdall, et al 1995:125)

Sorry I got the biopsy number mixed up with another number...but 11/200 still is rather insignificant IMO.

So, bile acids are a starting point, but not the end all and be all of testing.