Thursday, March 2, 2017

UPDATE on Ruffin. Bile Acids test results prove nothing.

The Bile Acids Test results came back today and the one test that I was hoping Ruff would fail appears to be the one test that he passed. For had he failed this test it would have been a clear indication that Ruff's liver problems had caused a condition called Hepatic Encephalopathy in Dogs. Not only did Ruff pass this test within normal parameters but the results were upside down. So once again after another search for an explanation for the readings of this test I found a testing laboratory that posted a chart that suggested a retest was in order in a few weeks. 

The Bile Acids Test requires an absolute 12 hour fast but Ruff had a few small biscuits between 11PM and Midnight the night before so when I dropped him off I told the Vet not to do the test before 11AM or Noon. Then I read today the 12-hours rule is a minimum time frame and could be longer. The test begins with a blood test to determine the preprandial (before meal) level then a meal is given followed by a second blood test two hours later. Ruff's test had slightly higher values than normal (19.5) before he was given food and afterward his score was lower than normal (16.9) for post-meal.

A PDF chart I found on IDEXX Laboratories explained how the results can be skewed: "Preprandial values will occasionally exceed postprandial values. This is usually attributed to spontaneous gall bladder contraction or preprandial specimen obtained prior to a sufficient fast. When preprandial values exceed the postprandial values, always check the pre- and postprandial samples are properly identified."

When my Vet called today with the results he suggested waiting two weeks for another blood test to check on Ruffs liver enzymes. When I take Ruff in I am going to have the Bile Acids Test done once again. The costs so far have begun to really add up. Each blood test was $67.50, then two bottles of liver supplement pills $201.19 plus two visits to the Ophthalmologist $500. Plus another $330 at the Emergency Hospital when Ruff was vomiting for three days. But the course of this is minimal compared to a CT Scan ($1000) and radiation treatment which, even still, may be needed once the tests have eliminated everything except a tumor.

For well over six months now I had been growing more and more concerned over Ruffin's declining eyesight. And then about six weeks ago I took Ruff to an Ophthalmologist for an eye exam and by then Ruff had become totally blind. The doctor said the cause of the blindness was not in Ruff's eyes and more likely was the result of something like a tumor on his optic nerve. He suggested a CT Scan and the hospital that did that work wanted a blood test to show he was healthy enough for anesthesia.  

The first blood test revealed extremely high enzyme spikes from Ruff's liver and over the course of 5 weeks Ruff had four more blood tests and the enzyme levels only declined a slight bit as his doses of prednisone were reduced to zero. This led to hours and hours searching for likely causes and I thought I had found a solid connection. I have frequently read lists of symptoms for different diseases but never before had I seen so many that matched what Ruff was now going through so I had my hopes the Bile Acids test would be the cause of Hepatic Encephalopathy instead of an astronomically expensive CT Scan and assorted radiation treatments for a brain tumor.
Symptoms and Types of Hepatic Encephalopathy in Dogs
    Circling, running into walls and acting confused after meals
    Learning disabilities (difficult to train)
    Sluggishness (lethargy) and/or drowsiness or sleepiness
    Aimless wandering
    Compulsive pacing
    Head pressing
    Blindness related to brain abnormality
    Sudden aggression
    Lack of appetite
    Increased urination or lack of urination (inability to urinate often seen in male dogs)
    Frequent voiding of small volumes ( small poops )
    Orange-brown urine (often seen in male dogs)
    Increased thirst
    Excessive salivation
When anything new comes up I will post it. I am prepared to do whatever is necessary to save my best friend. 



  1. First off, thank you for the update & for the love and care of dear Ruff.
    I hope you can see the light at the end of the tunnel soon. I know how frustrating & frightening it can be when we find no answers and fear of losing our babies. Keeping everything crossed for you & Ruff. Take care..Angela