Re: Biliar acids

Alex Gough — Sat, 30 May 2009 11:29:40 GMT

I have seen portosystemic shunts with low resting bile acids and post stimulation results in the range 50-100. However, a 4 year old with a post stim bile acid only just over 50 makes PSS less likely. However, there may be some other liver disease going on, and it would be worth liver ultasound +- biopsy. If you can rule out significant liver disease on biopsies, then work up for the epilepsy eg MRI +- CSF, dependingon what other signs are present, or possibly just trial phenobarbitone depending on owner finances. Remember though that if you start phenobarbitone you cant withdraw it abruptly if its not working, or if the seizures go away. You need to withdraw it slowly over 2-3 months to prevent rebound seizures.

Hope this helps,

Alex Gough MA VetMB CertSAM CertVC MRCVS

Bath Vet Referrals

Re: Biliar acids

vs0u — Sat, 30 May 2009 09:09:07 GMT

I think it has to be >100 umol/l pre and post. for PSS