Dog has high bile acids, but no symptoms. Should I get a liver biopsy?

Question

My dog been receiving ab’s for uti and struvite stone. Her urine ph has gone from 8.5 to 6 just with increase in fluids. During routine blood panel, vet discovered she had low amalayse (395 u/l). All other blood work ok including alt, ggt, alkaline, tbil etc. She then ordered a bile acid stim test which shows elevated levels (57.7 umol/L). now wants to get a detailed uss scan of liver and biopsy. No clinical signs at all. Bright, feeding well, peei/poo ok. Is biopsy ok just on basis of 1 test? Pet's info: Dog | Cockapoo | Female | spayed | 4 years and 6 months old | 18 lbs

Dr. Kristin DVM · Accepted Answer

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.

Dog has high bile acids, but no symptoms. Should I get a liver biopsy?

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