Bile Acid Test

answered by Dr. Karen Tobias
                                                                          
                                                                          
                                                                          

Question:

I know that the ideal age for bile acid testing would be over 6 months. I also am aware that this test is not conclusive.  I want to test all of my puppies in litters but would need to do this between 10 weeks and 12 weeks of age.  Am I wasting time and money at this age or do you feel this would give us some sort of insight into the normalcy of each puppy?  I, of course, would also include a guarantee against this defect but I would never sell a puppy that was "suspect" and break a family's heart.



Answer:

 Unfortunately there have been no studies on the "ideal" age for bile acids testing.  There has been one pediatric study that looked at healthy puppies and found that their bile acids stayed the same from 4 weeks of age onward.  Here's what we've seen:

We have repaired shunts in puppies as young as 9 weeks of age, so we know that their bile acids can be abnormal that early in life.

We have had several puppies that have had "reasonably normal" bile acids (not in the normal range but  less than 25) at 6 or 8 weeks of age that have had bile acids of 40 at 6 months of age when they were spayed or castrated.  These dogs had congenital portal hypoplasia (MVD) on liver biopsy.

We have had puppies with almost normal bile acids (< 15) at 6 months of age that have had MVD on liver biopsies.

We have had shunt puppies that have had  normal fasting bile acids and high fed bile acids or  that have had normal fed bile acids and high fasting bile acids.  Fed bile acids are supposed to be higher than fasting bile acids because the gallbladder contracts after a fatty meal and releases bile.  We think that about 20% of dogs have gallbladder contractions in the middle of the night, which reverses their samples (the fasting sample is really a "fed" sample, because the gallbladder contracts as if the dog ate).


As you can see, there is a lot of variation with bile acids. If I were trying to rule out shunts, I would feel comfortable testing bile acids at 10 or 12 weeks of age.  If I were trying to rule out MVD, I wouldn't count on any blood tests to do that.

If I were able to get a population of Yorkies and follow them from 8 weeks of age to 1 year, I would love to do the bile acids study.  Unfortunately, all it would tell us is whether bile acids change.  What we really need to do is to get liver biopsies when the dogs are spayed or castrated as well.  We are going to apply for funding for such a study so that we can offer free liver biopsies and bile acids to healthy Yorkies being spayed or castrated.   Maybe we'll be able answer your questions if we can get this study going.

                    

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