High Bile Acid - Please Help!

Hi, I have a shih tzu which will be coming up 14 years of age in March next year. Recently I noticed she started to drink an excessive amount of water, so I took her to the Vet. He decided to take her bloods which came back with high levels of bile acid. The options he offered where to perform an ultra sound on the liver to see if there was any masses In the liver, but ultimately said if they find one it would lead the surgery. The other option was to leave her and monitor her. I came to the conclusion that at her age I didn't think surgery was a good idea and decided to just monitor it. The vet visit was about 3 weeks ago now. Since then during the day her behaviour has been pretty normal, however during the night she is drinking an excessive amount of water and then asking to go outside, but she will then come back in and carry on drinking water. This can happen multiple times during the night until she finally settles. Obviously I am concerned about her behaviour at night and the amount of excessive water. Is there any advice, treatment or diet which would make her more comfortable? Or anything you think the Vet should of suggested? Any help would be much appreciated.

Hello!  You sound to have made a decision to assume cancer and not try to look for the cause of the high bile acids.  Is your vet alongside in this case, or are there other possibilities that they would like to rule out? I ask because drinking excessive water is a red flag.  It can signify cancer I'm afraid, or potentially other liver disease (can be connected with high bile acids), kidney and hormonal diseases.  The body tricks itself into thinking it's thirsty. This sign needs to be reported to your vet as soon as possible - tell the receptionist what is wrong on the phone - and if you can catch a sample in a clean, dry container for them on the way, they may find this helpful. You may then have some decisions to make.   Best of luck.

I'm sorry - I have just reread and seen that the excessive drinking was present at the outset, but seems to have worsened, so your vet is aware of the situation.  I guess then, that this is a steady progression of the signs.  Again, your choice is between a work-up - looking for the cause - and letting things be, in which case it seems likely that the polyuria/polydipsia (drinking and weeing) may prove progressive and lead to further problems, for example dehydration (because the water is going straight through and not into the dog, who is still thirsty).   Therefore this can become a welfare issue for the dog.  There are many causes of polyuria / polydipsia so it may not be cancer, but it sounds as though that is what your vet suspects in this case.  If it is something else but goes undiagnosed, it seems likely that the situation won't improve either. It may be time to speak to your vet again and talk through your options.  Wishing you all the best.