Providing the explanation took much longer than expected. I did numerous rewrites, checked my facts, had my sister who is a microbiologist proof it, and read it to various people to see if it was easily understood.

The sister who proofed it is the one who has the 1.5 year-old son with no functional small intestine and a liver that was failing. The link about baby Bo is in the side bar under “My Nephew’s Rare Disease

I have not done the ALT or bilirubin write-ups yet, but they’re coming. Please note that the BAT is usually one of several tests in a panel of tests for liver disease.

Back to the BILE ACID TEST (BAT). First, if you haven’t seen Shaili, the athletic Pug, she is featured two posts down. Her recent blood work came back with some high Bile Acid Test numbers:

Fasting Bile Acid Test (BAT):

    Shaili’s result: 13.4 µmol/L **HIGH**
    Normal range: (0.0-12.0) µmol/L

2HRS Bile Acid Test (BAT):

    Shaili’s result: 44 µmol/L **HIGH**
    Normal range: 5.0-25.0 µmol/L

“But what does this all mean?!” you ask?

Most dogs are given the BAT to determine if there is a problem with their liver, or if another test they had done for liver disease was inconclusive.

For instance, as in Shaili’s case, if liver disease is suspected, but the biliruben test shows normal levels, the BAT is run because it is a more sensitive test for liver damage.

The BAT result numbers show how much bile acid is in the blood stream at the time each blood sample was taken.

    1) On an empty stomach (no food for 12 hours)
    2) Two hours after a (high-fat) meal is eaten

A high amount of bile acids in either blood sample means the liver is not adequately doing it’s job of pulling bile acids out of the bloodstream, which indicates liver damage.

The bile acid level in the blood sample two hours after the meal should only be slightly higher than the bile acid level before the meal because a healthy liver is able to remove most of the bile acids after two hours.

When a dog eats, food going into his body is in part “digested” by the bile acids that break down fats. Those bile acids are initially released from the gall bladder into the intestine to help with digestion.

After the food is digested, the bile acids go into the blood stream where the liver retrieves them and returns them to the gall bladder for storage until the next meal. This is why some articles state that the liver “recycles” bile acids.

Here is a simplified progression of the events upon feeding the dog:

    1) The dog eats, triggering bile acids to be released from the gall bladder into the intestines.
    2) While in the intestines, the bile acids help digest the food and break down fats from the meal.
    3) After the food has been digested, the bile acids in the intestines move into the bloodstream.
    4a) At this point, a properly and fully functioning liver would efficiently take the bile acids out of the bloodstream and return them to the gall bladder to be released and used again at the next meal.
    4b) If the liver is damaged and not functioning properly, it will not be able to remove the bile acids at a normal rate, so the blood sample taken will show a high level of bile acids in it.

Upon eating, the body triggers the release of BA from the gallbladder into the intestine, where it helps break down fats ingested. Once the food is digested, the BA goes back into the bloodstream where it is recaptured by the liver.

Even though this test is a good indicator of liver disease, the results do not provide information on how severe the damage is, what caused the damage, whether the liver can recover and what the expected outcome would be.

Shaili’s “Fasting” Bile Acid Test is a bit higher than the normal range, and her “2-Hour” BAT level was double or more than levels in the normal range. Look at these results again along with the BAT results for a Pug Puppy that likely has a liver shunt:

Fasting Bile Acid Test (BAT):

    Normal range: (0.0-12.0) µmol/L
    Shaili’s result: 13.4 µmol/L **HIGH**
    Pug Pup with suspected liver shunt: 287 **VERY HIGH** This is 21 times Shaili’s BAT level

2HRS Bile Acid Test (BAT):

    Normal range: 5.0-25.0 µmol/L
    Shaili’s result: 44 µmol/L **HIGH**
    Pug Pup with suspected liver shunt: 1877 **VERY HIGH** This is over 42 times Shaili’s BAT level


    • “µmol/L”  is  “micromoles per Liter”
    • A mole (mol) is an amount of a substance that contains a large number (6 followed by 23 zeros) of molecules or atoms.
    • A micromole (µmol) is one-millionth of a mole. (definition from Healthwise web site)

A note about the Pug puppy above. If this puppy does have a liver shunt and it is operable, it actually has a chance of living a good quality of life as well as enjoying a longer or even normall life span given that it’s condition is managed by proper diet and supplements.

If you are looking for more information, a support group, and practical advice from experienced dog liver disease moderators, please visit the Dog Liver Shunt and Disease (DLSD) Yahoo Group. You are not alone if you have a dog with liver disease or suspected liver disease. There you will find hope and help for managing the condition, reducing the symptoms, and increasing the life span of your dog..