URINE BILE ACID TESTING




We all know how important pre- and post- bile acid testing is for dogs on phenobarbital. Since about 20% of the dogs on Pb develop liver disease, chemistry panels with the liver enzymes GGT, ALT and Alkaline Phosphatase shouold be run every 3 to 4 months. Bile acid testing should be done every 6 months to make sure that your dog is not developing liver dysfunction. Dr. Dodds says that LIVER DISEASE can only be detected by blood chemistries which include liver enzymes; LIVER DYSFUNCTION can only be detected by the bile acid test. Both tests are therefore necessary.

But, it's a hassle to do the pre- and post- bile acid testing! You have to fast your epi (and fasting is difficult for some of our epi dogs), go to the vet for the first blood draw, feed 1/2 can of dog food and wait 2 hours for the second blood draw, or leave your dog up and pick them up later. For most of us, this means either we are late to work or miss a whole day of work OR, we don't do pre- and post- bile acids. Now you won't be nervous having your dog on Pb.

You don't have to go through all of this for bile acid testing unless you absolutely want to. There is a NEW test for bile acids that is less expensive, doesn't require fasting, and you don't have to wait 2 hours at your vet or leave your dog there. The new test is called Urine Bile Acids Testing

Dr. Dodds says that this new method of testing for liver dysfunction is as good if not better than the standard pre- and post- bile acid blood draws. Studies of urine bile acids testing in humans have shown this to be a sensitive test for liver dysfunction. In May of 2003 Dr. Dodds wrote an article on Urine Bile Acids which you can take to your vet:

http://www.antechdiagnostics.com/clients/antechNews/2003/may03_01.htm


URINE BILE ACIDS TESTING

ADVANTAGES
There are several advantages of urine bile acids testing over blood serum bile acids measurement:
1. This test requires no fasting.
2. One urine sample is all that is needed: no double blood draws.
3. The urine sample should be collected 4-6 hours after eating -- no need to go to the vet's office unless you have problems collecting the sample yourself.
4. This test is less expensive than pre- and post- bile acid blood draws, which require a vet visit in addition to the test fee.
5. The test is as sensitive as the pre- and post- bile acid blood draws.

INSTRUCTIONS

WHAT YOU WILL NEED:
1. A very clean, scrupulously rinsed and air dried collection container, such as a bowl or pie plate.
2. A very clean, scrupulously rinsed and air dried glass container (jar or bottle) with a screw top, large enough to hold 1 tablespoon of urine.
3. Bubble wrap, a cold pack, and a sturdy box.
4. A completed information form from our website at Information Form Link.
5. A trip to the post office for Express Mailing on Monday, Tuesday, or Wednesday only.

COLLECTING URINE FROM YOUR DOG is not as difficult as you may imagine. What you will need is a very clean and very well rinsed and air dried container (a bowl or pie plate does nicely). Now, you do have to follow your dog around with the container to collect the urine. I would try to do this when there are no neighbors around because it is going to look a little "different." When your dog squats or lifts a leg, position the container to collect the flow. You may have to make more than one attempt at first, but once you've done it, it gets easier.

TIPS ON COLLECTING URINE by other owners you will find below.

HOW MUCH URINE TO COLLECT AND HOW TO STORE IT BEFORE SHIPPING: You want to collect at least 1 tablespoon of urine. For mailing the urine, you will need a small clean (and scrupulously rinsed and air dried) glass bottle or jar that has a screw top. Or, you can ask your vet for a vial that will hold about 1 teaspoon of urine. Transfer the contents of the bowl carefully to the bottle, jar, or vial. Immediately put this container into the refrigerator until you are ready to mail it. It is IMPORTANT that the urine sample be kept cold until it gets to Dr. Dodds.

HOW TO SHIP THE URINE: The same day as the collection, wrap the refrigerated glass container in bubble wrap and then put a cold pack near the bubble-wrapped container. You don't want the urine to freeze so make sure the cold pack is not directly on the glass container. Put this and any extra bubble wrap you need into a sturdy box along with the information form from our website, and a check for $43.00. Ship through the post office by OVERNIGHT EXPRESS MAIL to Dr. Dodds. Be sure to specify that the test results are faxed to your vet. (See Information Form)

I hope that the added convenience of this new test will mean that all dogs on phenobarbital will be tested regularly, every 3 to 4 months. Nothing devastates me more than when we lose a dog unnecessarily to liver failure. Please don't let this happen to your dog.



TIPS FOR COLLECTING URINE

Linda and Bailey (Collie)

With my girl pups, I've used the plate method (slip a clean dessert sized paper or plastic plate under the pup while they're squatting, then transfer the sample to a clean container) and they didn't seem to mind. However, with my boy pups, the plate method had some splashing problems (yuck!), so I've found the clean "plastic container on a stick" method was better to collect their samples.

Our Vet had to do a needle urine collection on one of our pups. It didn't seem to be painful for our pup, however personally I would rather try to collect the samples with the containers first!

One "finer point" I've learned is to make sure you take the pup out on a leash...this way you're not chasing them across the yard in hopes of collecting a sample! Also, wait until they just start going before you try to collect the sample. Catches them off guard and in my experience, it's easier to collect the sample!


Doretta and Dakotah (German Shepherd)

I used a smaller flatter Tupperware container and taped it on to the end of a yardstick. I would follow Dakotah around the yard just pretending to be out there enjoying the yard, but making sure that I was to her back so that when she squatted she wouldn't see me slip the contraption under her. I got the idea from what they showed me at the vet's office. I'll never forget the look on her face when she finished and turned around to look at me..."What in the heck are your doing?" But it worked!!


Lori and Tango

I caught a urine sample from my male dog by using a clean empty Kemp's ice cream pail...Tango lifted his leg and started shooting and I just put the pail in the line of fire and caught plenty. With our female dog, I cut apart one of those plastic disposable plates that have three sections (the step up from paper plates). I cut out the largest section, rounding off any sharp edges and also took a plastic cup with me. Once Jojo squatted and started to pee, I slipped the plastic plate section under her from behind and she didn't even notice. I then immediately transferred the sample to the plastic cup so not to spill it. My vet tried to get a sample from her once w/a pie pan taped to a yard stick...didn't work...she was too distracted by the contraption...Another vet said they can usually "massage" enough out for a sample...they just need a little...


Debbie and Baxter (Dalmatian)

There are several ways to get a urine sample. One...use a soup ladle. This allows for a bit of distance from the pee-er! TWO...your vet CAN squeeze out a sample but only if the bladder is full. And THREE...your vet can extract a sterile urine sample with a needle. this can be done even if the dog has just urinated.


Cara and Boomer (Chocolate Labrador)

When I had to get a sample from Boomer it was actually real easy. I just used a throw away plastic container, a square shaped one, when he started to go, I put it under him. a ladle would work too, but when I tried it the urine seemed to splash out. After I had collected the sample, the vet brought out what he usually gives to people to collect the sample. It is a small bowl, attached to a stick. The dog doesn't know anything is being done when it is placed under him or her once they have started their thing.



Joanne Carson, Ph.D.,
Metabolic Therapist
Founder - Canine Epilepsy Guardian Angels


www.canine-epilepsy-guardian-angels.com
Please note:
The opinion(s) expressed above is/are for informational purposes only.
Suggestions and advice offered are not to be misconstrued as an
alternative to personal and professional veterinary care. Please contact
your veterinarian to discuss any changes in your dog's medication or care.