Elevated Bile Acids

Elevated Bile Acid Test numbers are seen in dogs that have poor liver function or possibly a dog Liver Shunt or MVD.

The Bile Acid Test measures how the liver functions and performs, as opposed to a liver enzyme level reading, that can indicate degree of inflammation or damage.

 If your dog has Elevated Liver Enzymes - Click here

How is the Bile Acid Test performed?

Your dog is fasted, blood is drawn, then your dog is fed a fatty meal. Two hours later, the blood is drawn again. The blood tests measure pre- and post- meal levels of Bile Acids, which are acids stored by the gall bladder and secreted by the liver. If the levels are high, there may be a problem with the liver or hepatic blood vessels.

What are bile acids used for, anyway?

When animals (humans included) eat, they need the bile acids along with other digestive elements secreted by the pancreas. The gall bladder, a bile storage unit, contracts to release bile into the small intestine as needed for digestion. From there, the Bile Acids do their work breaking down fats during the process of digestion. The Bile Acids are then absorbed by the intestine into the liver (portal) bloodstream and returned back to the liver. If the liver is functioning properly, the bile acids are removed from the bloodstream and returned to the gall bladder until they are needed again. This is called Enterohepatic Circulation, and is the body's way of "recycling" the Bile Acids.

What do the test results mean?

You will get two numbers on the test:  a pre-prandial number and a post- prandial number.  These are just fancy words for after fasting/before eating (pre-prandial) and two hours after eating (post-prandial).  Comparing the two blood levels (pre and post meal) allows the veterinarian to see how well the liver, bile ducts, and blood flow to the liver are functioning. Bile Acids are removed from liver (portal) blood by the liver cells (hepatocytes). If the liver cells are not functioning well, the bile acids remain in circulation and enter the body’s blood supply where the elevated levels are measured by this test.

In conclusion:

If post-meal (or even in some cases, fasting) blood levels of bile acids are high, this means that the liver may not be doing its job of removing the bile acids from the blood as it should. It could also mean that blood is being diverted around the unhealthy liver and this diverted blood is not getting filtered of the bile acids.  This would mean that your dog has a liver shunt or Microvascular Dysplasia (MVD).

The actual numbers that are considered "normal" vary with the laboratory used, so please discuss numerical lab findings with your vet.  In general, BAT numbers over 100 are thought to confirm a liver shunt and BAT numbers under 100 are thought to confirm MVD. 

In most cases of abnormal numbers, the post-prandial number is much higher than the pre-prandial number.  In about 20% of dogs, the pre-prandial number is higher which will have you scratching you head wondering why.  This scenario is usually seen due to a recent meal (not enough fasting time), gall bladder contraction during fasting, or delayed emptying of the stomach after eating.  

The recommendation is often to actually ignore the elevated pre-prandial result when the post-prandial number is normal or close to it. Sometimes dogs can get a high pre-prandial Bile Acid Test number even if they merely smell food. The smell of food to a dog who is fasted can cause the gall bladder to contract and can cause an elevation in bile acids. 

Abnormally high post-prandial BAT results usually indicate poor liver function.    Your vet may conclude from these results that a liver shunt or MVD is present.  This may or may not be true.   But if a liver shunt or MVD is present, this is just the body's attempt to deal with the poor liver health, in my opinion. 

Using natural healing methods like a proper whole food diet and whole food supplements can provide the nutrients your dog's body needs to heal itself and bring the BAT results back into normal ranges over time.  Natural healing takes time, so full results may not show for 6 to 12 months or more.  In fact, test results can look worse before they get better in the early months.

A natural healing approach takes patience and perseverance.   Your perseverance will be rewarded with improved liver health for your dog and a lifetime of optimal health.  Poor liver health can be eliminated FOREVER. 

Traumatic and expensive liver shunt surgery can likely be avoided.  Further expensive testing may also be unnecessary.

Please request a FREE CONSULTATION so that I can help you. There may be a better path then the one that you are on now.