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Post-Prandial Bile Acids, High

The patient has hepatic encephalopathy, which responds to Clindamycin and Lactulose. Bile acids pre: 127, post: 260.

A 4-year-old MN Maltese was presented for an annual exam, but the dog had been noted to be losing weight. Physical exam was unremarkable. Blood chemistry revealed hyperphosphatemia, and elevated ALT, and AST enzyme activities . CBC found leukocytosis consisting of a neutrophilia, lymphocytosis, and monocytosis. The patient was nonresponsive to antibiotic therapy over a 3 week period. The patient was doing well on re-evaluation; he had a good appetite, but was still losing weight. Recheck blood chemistry still showed persistently elevated liver enzyme activities, hypocholesterolemia, low urea and creatinine concentrations. The neutrophilia and monocytosis were still present on the CBC, however thrombocytopenia was also present. Serum bile acids were severely elevated, both pre and post-prandial. A coagulation panel was within normal limits.