Extrahepatic shunt

[SassyAnn101]

I am very sorry to hear about your baby. I lost my Gizmo on February 1st after having the liver shunt surgery at the University of Tennessee. He was almost 4 years old. He was a very sick puppy for the first year, but then he did better until this past November. From there he went down hill quick. He almost stopped eating, and when he did eat he would get very sick. It had been mentioned when he was a puppy that he could have a shunt, but I chose not to have him tested. In January of this year we had tried everything and he was only getting worse. I took him to UT for testing and sure enough threre was a shunt. They told me after the surgery that his liver was very small and the blood vessles were also very small. They told me that him being older and his liver had been compromised for so long his chance of recovery was less than that of a young puppy. He did come through the surgery and lived for two days. We lost him after he developed Pneumonia. Everyone was great at UT eventhough he did not survive. I would recommend them if at all possible.

[bailey12]

Hi. I think it is very confusing because there is so much info, and every dog's situation is different. Zeus was very difficult to diagnose as he did not present with the "typical" symptoms. I have had Zeus on many of the recommended products over the years. I, with my vet's support, decided to wean him down to what was necessary for him to lead a high quality life and most importantly, to feel good. He is able to do that on a prescription food and denosyl SD4. That is what works for him. If and when he needs additional "help" we will have some options. That probably isn't the answer for every dog, but as the caregivers we can sort through all the "stuff" and find the right protocol for our pet's particular situation. Zeus will be 7 on the 25th and is doing great, which is way more than I could ever have hoped for when he was diagnosed at 10 mos. I watch him and have annual bloodwork done to keep track of any changes. That is just my experience with Zeus. I don't claim it's right for all, just what works for him. Juliet

[pack leader]

Thank You for all that valuable info. He has a bile acid number of 130 and wakes up in the morning very lethargic with trouble walking. He doesn't
take Nutrical voluntarily any more.
I've just asked my vet for lactulose and an antibiotic. He gave me metronidazole a couple of months ago and I've started him on it again.
My poor Bubba just looks at me a whimpers because he's hungry but doesn't
like anything I put down.
He started coughing a bit today.
I've talked to UTK and Dr. Roy in Palm Beach. UTK charges 1600-1800
and Palm Beach is 2800-3000.
They both use the constrictor, which I'm told is the best way.
Can I manage his condition for a couple of weeks, until I can arrange to
fly to Tennessee? Or do you think I should max out my credit card and get it
done in Fla?
I don't want to do anything stupid and compromise him any more.
Thanks,
Pack Leader

[RMKC]

What a heartbreaking Story, and pray for a good outcome.
scrappymomma is going through these surgery's as we speak with 2 of her babies. Diesel is under 3 pounds and Sissy under 4
How sad that these little ones have to go through this. I pray for them all !

[pack leader]

Where are they having the surgery? And is it the liver shunt?
Thanks,
Pack Leader

[Yorkieluv]

Originally Posted by pack leader

Thank You for all that valuable info. He has a bile acid number of 130 and wakes up in the morning very lethargic with trouble walking. He doesn't
take Nutrical voluntarily any more.
I've just asked my vet for lactulose and an antibiotic. He gave me metronidazole a couple of months ago and I've started him on it again.
My poor Bubba just looks at me a whimpers because he's hungry but doesn't
like anything I put down.
He started coughing a bit today.
I've talked to UTK and Dr. Roy in Palm Beach. UTK charges 1600-1800
and Palm Beach is 2800-3000.
They both use the constrictor, which I'm told is the best way.
Can I manage his condition for a couple of weeks, until I can arrange to
fly to Tennessee? Or do you think I should max out my credit card and get it
done in Fla?
I don't want to do anything stupid and compromise him any more.
Thanks,
Pack Leader

The reason he is refusing food is because the food makes him sick. Too much protein at one sitting will produce lots of ammonia which will enter the bloodstream and cause the pickiness...He attributes his ill feelings to food. My yorkie actually had seizures on u/d because of the pork liver which is also in the k/d. I would ask that they change foods for him immediately. It's best to stabilize your baby's condition as much as possible and have him as strong as possible before the surgery.

It's very important that you feed small, frequent meals. If you normally food 2-3 meals per day, you should break up that amount into 4-6 meals. It makes the load on the liver much lighter and will help get him stronger and keep his blood glucose levels from plummeting.

Your baby is exhibiting H.E. (hepatic encephalopathy) symptoms, and it's important to get these under control. The lethargy is not a good sign...

This is done by giving smaller, frequent meals, giving absolutely no animal proteins because they are too hard on the liver, keeping the protein within the recommended amount (2-3 grams of protein per kg of body weight per day...closer to 2 if symptomatic like your baby, and then as your baby gets better you can slowly increase). Also, splitting up the lactulose into 3 doses per day to make him have 2-3 soft stools per day...This is very important for a liver compromised dog as constipation and hard stools lead to inappetance, lethargy and H.E. symptoms as well. Supplements to support the liver like denosyl and milk thistle are important too...

Have you joined the liver shunt and mvd group on yahoo groups?? I'll post the link in a second...

[Yorkieluv]

Liver_Shunt_And_MVD_Support : Liver Shunt & MVD/HMD Support

Please join this group as they can give you guidance and support. There is also a wealth of valuable information in the Files section and things you can print up and take to your vet.

Have you had the Protein C test done?

[iwannalollipop2]

Well, if you're asking me, like I said Lacy has no symptoms whatsoever.

For people struggling with finding diets for liver-compromised yorkies, I would recommend wholeheartedly making your dog's food yourself. Actually, I would recommend that for any dog of any breed. I'm not being an organic freak or anything, and I don't think that much about the processed food that I eat. But have you ever really thought about dog food--really? It didn't even exist until the 1960s or 1970s in heavily manufactured form. It's made for profits, not health. Even the better brands are made with fillers like ground up chicken by-products and corn. I loveeeee "Dog and Cat Diets" by Donald R. Strombeck, DVM, PhD. We took it out to show the veterinary internist and she got all excited, "Ohhh we love that book--we have photocopies for every patient for diet management!" He includes regular diets for healthy dogs, along with a selection of special diets for hepatic disorders, renal disorders, weight management, heart diseasew, all kinds of stuff. And it's all really wholesome and easy to make: usually some form of protein (beef, chicken, or tofu or eggs for shunt dogs), carbs (white rice, cooked potatoes, pasta), vitamins, etc.

What we do is make a big batch of a recipe and freeze it into little yorkie-sized muffin tins, then take one or two out and thaw them in the microwave for every meal (which are 4 times a day now).

Here's one of the hepatic disorder diets that we give Lacy all the time:
"Cottage cheese, tofu, and rice diet (moderate sodium):
1/2 cup cottage cheese, 1 percent fat
1/3 cup tofu, raw firm
1 1/2 cups rice, long-grain white, cooked
1 tablespoon chicken fat
1/4 teaspoon salt substitute (KCl)
3 bonemeal tablets (10-grain or equivalent)
1 multiple vitamin tablet
Provides 651 calories, 36.9 grams protein, 21.8 grams fat, .28% sodium. Two to 3 ounces or ore can be added to increase bowel movement frequency." Once you get the tricky-to-find ingredients in large quantities, it's really easy to just make up a batch and freeze it to feed your dog for a week or two. No chemicals, no preservatives, and quality sources of protein and carbohydrates for shunt dogs.

[pack leader]

Thanks for the recipe. Hopefully, I can have the operation next week
and he won't be so finicky anymore. Recently I have tried brown rice
with a small bit of chicken breast, cheerios, Life cereal, carrots, green beans,
cottage cheese, yogurt (3 flavors), Nutrical (used to love it), egg whites and peas. I also tried the goat cheese with honey...he had a couple of bites and
lost interest. I then put down some Ricotta cheese which (to my surprise)he
ate a couple of tablespoons.
The vet gave me lactulose today and I will get some antibiotic tomorrow.
I finally reached a vet in Deerfield Beach (4 miles from me) who sounds
awesome, caring and experienced. My vet said she would be his choice.
Her first opening is Tuesday and I booked it. Hopefully, my little Bubba
will stabilize with all the meds and special foods. Maybe the meds will
give him an appetite again.
When this surgery is behind us, maybe I can make your recipe and give it
to all three of Yorkies! My 5 pounder is about 1 pound overweight and my
4 pounder gained a pound (she was 3) after being spayed during her C-section birthing Bubba! So the ladies can stand to lose a few ounces and
the little guy needs to gain a few. Isn't it always the way?
Thanks so much for all your input. This is a great website with very nice
people...but of course, we all LOVE YORKIES!
Pack Leader

[Ladymom]

This is a great article that explains which foods are good for liver compromised dogs and has a recipe.

Liver | B-Naturals.Com Newsletter

It's important to remember that these diets are for symptomatic shunt dogs. Dr. Center does not recommend a special/low protein diet for asymptomatic MVD dogs. Too little protein can actually make liver problems worse so it's important to consult your vet before making any diet changes.

[pack leader]

My little Bubba's vet says he's 110% sure he has a shunt based on the bile
acid test (130) and his symptoms of throwing up, lethargy and constipation.
He will have the surgery this Tuesday. I'm under the impression he will still
have to be on this special diet for a few months after surgery.
Bubba actually ate some egg whites with ricotta cheese! I gave him two
doses of Lactulose yesterday and he seems to be much better already.
Thanks so much for you info....I will check out the link.
Pack Leader

[bailey12]

When Zeus was really ill he ate canned LD. He would eat 3-4 bites at a time and in the beginning I hand fed him. He would eat this small amt several times a day. I would lay in the floor with him and feed him until he had the will/appetite to eat on his own. I don't think he had ever felt well eating. When he had the will to eat on his own he would scratch at the floor to let me know he was ready for his "few" bites. Juliet

[bailey12]

Oh, I forgot. Zeus now eats 2 meals a day and does great.

[pack leader]

Did Zeus ever have the shunt operation?

[bailey12]

He did have the surgery. That's when they discovered he had MVD, not a shunt, so they closed him up and told me he probably wouldn't see 2 yo. He definitely surprised them!!!!! They couldn't surgically correct his problem but he has done really well and is living a happy and "healthy" life. If you don't know he has liver disease, you would not guess. Juliet