My Yorkie has high bile acids and liver issues. Could it be a portosystemic shunt?

There is really very little sense in speculating. Even a positive bile acid test will not definitively diagnose a portosystemic shunt. Only advanced imaging techniques can capture this condition. Alkaline phosphatase is an enzyme that is sometime utilized to support diagnoses of the liver and bile duct system. However, alone the number doesn't tell us much particularly in a young and from what it sounds like otherwise healthy puppy. The elevation you mentioned is also very mild, and we frequently see elevations in this enzyme in young growing animals. Just as it is found in the liver, it is also found in the bones which is why it is elevated during the time that pups are getting larger. I obviously don't know the whole situation and there is always the possibility your dog could have a shunt. However, so far you have given me no reason to suspect a serious problem. Please feel from to obtain a consult if you want to discuss the case in any greater detail.

Hi and thanks for your post. A Bile Acids of 46 is not terribly alarming but should be addressed. Elevations over 100 would be more concerning. I would recommend monitoring Bitzy and rechecking her bile acid levels in a several weeks. A Rx diet may help as well as an ultrasound guided fine needle aspirate can help in diagnosis. The food I would recommend for Bitzy is linked below: https://www.royalcanin.com/products/royal-canin-veterinary-diet-canine-hepatic-dry-dog-food/3927 Best wishes to you and I hope this helps!

I would recommend adding on a Spec CpL test to look for pancreatitis, or you can have her referred to a specialty hospital who can perform ultrasound. Bloodwork doesn't always show changes in light of important diseases like cancer or gastrointestinal disease.

Hi there and thank you for using Petco Pet Education Center, formerly Petcoach to address your concern. Chronic stress is never good for the body and if stress can be reduced, this is ideal. Stress can certainly worsen pre-existing diseases and I would recommend reducing stress as much as possible. There are natural products such as the Adaptil products, which can be found online quite easily or supplements such as NaturVet Quiet Moments calm chews with melatonin. If these do not work well, I would recommend discussing other means of reducing stress with your veterinarian. I hope this helps guide you in the right direction! Please let me know if you have any other questions or concerns and I would be more than happy to help you further.

Hi, thanks for using Petco Pet Education Center, formerly Petcoach! Poor Holly! I would consider doing a bile acid test if her ALT is still elevated at the recheck. That can help with the diagnosis of a liver shunt. Yes, dogs can live a relatively normal life if the symptoms of the liver shunt can be managed with diet, antibiotics and laxatives. That is if she is even experiencing hepatic encephalopathy signs. I hope this help and I wish Holly the very best!

Congratulations on your new baby! He is adorable! The most common tests we start with to evaluate for liver shunts are baseline labwork (which includes a full chemistry, complete blood count and urinalysis) as well as a pre and post prandial bile acid profile. The bile acid profile is to specifically look at the liver function. Any of those tests results are available within a couple of days. Unfortunately, sometimes those test results are inconclusive, and we have to do additional testing. I have included a link below with more information about liver shunts. https://www.veterinarypartner.com/Content.plx?P=A&S=0&C=0&A=2533 Good luck! I hope that was helpful! Thanks for using PetCoach.

Thank you for using Petco Pet Education Center, formerly Petcoach. There is no clinical significance to a low amylase, and I do not believe I would have been concerned with this finding. That bile acid result is high, but I don't see a fasting level. I'm not sure if the blood was obtained only once, or if you did a 12 hour fast and then offered a fatty meal and had another blood sample drawn. Regardless of how it was obtained, it is a high value, and I suppose it is hard to completely ignore. There are a couple different ways to approach this. Recommending ultrasound and biopsy is not wrong, but you could be a little more conservative and simply recheck the bile acids in 2-4 weeks. I would definitely recommend a 12 hour fast for the pre-prandial blood draw, and then feeding a fatty meal, and then obtaining another sample two hours later. A single bile acid level is not enough information. If upon recheck the findings are abnormal, then you can feel more justified in pursuing ultrasound and biopsy. I hope this helps.