The Yorkshire Vet: Heidi’s liver test was as easy as pie - Julian Norton
Heidi was brought in by her owner at nine o’clock in the morning, as instructed. The dog’s lead was held firmly in one hand. In the other, a paper-wrapped pork pie. The effervescent young Labrador was in for a Bile Acid Stimulation Test.
The dog’s lead was held firmly in one hand. In the other, a paper-wrapped pork pie. The effervescent young Labrador was in for a Bile Acid Stimulation Test.
This, I think, sounds a complex procedure but, in fact, it just involves taking two blood samples. It is a way of assessing liver function and it works like this.
The liver has (according from my second- year pathology notes from vet school) thirteen different functions. It is the engine room for processing all our nutrients, amongst other things. A six-hundred-and-fifty-word piece in a Saturday supplement of The Yorkshire Post is no place to go into details, but suffice to say, handling bile acids is another. Bile acids are delivered into the intestines directly from the gallbladder to facilitate the digestion of fatty foods, then reabsorbed after eating a meal. If the liver isn’t working properly, it cannot recycle the bile acids correctly and they become elevated in the blood, especially after food. So, a good way to assess whether the liver is working as it should be, is to measure the bile acids in the blood stream before and after eating a meal.
Now, I was taught (admittedly a long time ago) that the best way to get a clear result from a bile acid stimulation test was to blood test before and after a fatty meal. My mentor in small animal internal medicine at university, who knew literally everything about the illnesses of dogs, recommended using a pork pie as said fatty meal.
It was simple to take the first blood sample from Heidi. She was a perfect patient. Next, like all good Labradors, she devoured the pork pie, which was understandable- it smelt delicious and was still warm. As she was eating the pie, various staff members passed by and almost every one of them asked the same question: “why are you giving that dog a pork pie?” To each I answered that I was performing a bile acid stimulation test, that I’d just taken a pre-prandial sample and that I’d take the second blood sample two hours after the fatty meal. Everyone seemed to look confused or perplexed and it led me to wonder whether the feeding of a pork pie for a bile acid stimulation test was still recommended by the experts. Later that day, I checked the protocol issued by the laboratory. Current advice appears to be to feed the dog’s “normal tinned diet”, and for dogs over five kilograms at least two tablespoons of food were required. It did not explain what to do if the dog’s normal diet was not tinned dog food. In the intervening two hours, I put Heidi in a kennel, where she relaxed and slept, fully satiated. I continued my consultations and pondered the change in policy over the recommended type of food to achieve the best results for this test. Happily, a brief conversation with an experienced colleague, who had previously worked north of the border, confirmed my approach. “In Scotland we used to feed a battered sausage. The rule was, half the battered sausage for the dog, and half for the vet!”
Either way, I felt certain that pork pie would work every bit as well in 2026 as it would have worked back at Cambridge Vet School, thirty years ago. And the results- hot off the emails just now- showed that Heidi’s levels (both pre- and post-pork pie) were reduced compared to previously, which is a sure indication that her liver function is improving. The plan is to repeat the test in another couple of months to check the recovery; the only other question is what tasty food to use?