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05-22-2008, 09:31 AM | #1 |
Donating Senior Yorkie Talker Join Date: May 2006 Location: Toronto, Canada
Posts: 1,275
| Words of encouragement, or... anything at all I've been away from YT for awhile now, but here I am back again looking for some help, as YT has always been helpful for me with my two yorkies. My little Ruthie, just under 3lbs, has been diagnosed with liver shunt. I've read some threads on here on the subject, and have been researching as much as I can online about the subject for the past few weeks. I THOUGHT that since she was two, I was 'in the clear' - afterall, I was familiar with the condition and the symptoms that accompanied it. Ruthie wasn't head pressing, didn't act 'drunk' after meals, had never had a hypoglycemic episode, etc. — I took her to the vet in the first place for a bit of a cough and lethargy — which came out of nowhere and progressed over the course of a week. She just seemed 'off' - not herself at all. The vet could find no reason for her cough - said her heart and lungs sounded great (of course, she didn't cough WHILE we were at the vet OR throw up). Anyways, while we were there, we decided to do her yearly exam and they collected blood. There were 'slight abnormalities' in her bloodwork (small red blood cell, and something else) that could indicate a shunt, so he suggested we do a liver panel to be sure. Her bile acid test results were through the roof — 249 before, and 231 after. Based on this alone, my vet felt strongly that it was a shunt, but referred me to an emerg vet to have an ultrasound done. Had I known that ultrasounds were SO inconclusive beforehand, I would have opted for another type of test (Protein C or Scintigraphy) — as it is, the ultrasound showed basically nothing, so it was a waste of $600 on my part. According to the ultrasound, there were no bladder stones and her kidneys were not enlarged (symptoms of shunt) and her liver and the portal vein were only slightly undersized. The emerg vet said he would recommend surgery regardless of what the ultrasound showed - that the BAT results were elevated enough to indicate shunt. I did NOT book the surgery that day (this was about 2 weeks ago now I guess) — and left the hospital feeling totally overwhelmed and unsure of what to do. So here I am — no clue. I've read so much about shunts my head is swimming. Everyone has differing opinions on what to do - some think surgery is always the way to go, some think it should be maintained with meds/food. Right now she is on Lactulose and Metronidazole and K/D food (which i've now read is NOT good for compromised livers???). She perked up and went back to her old playful self after just 2 days of being on these meds and low protein food — which the vet also said indicated she had a shunt. Anyways… I have no idea what to do. One day I think surgery is the way to go, the next I think I can't bear to risk surgery on her. She's so small. She made it through her spay with absolutely NO complications — but I'm afraid to put her through another surgery. The thought of watching her health slowly deteriorate if I don't do surgery is agonizing — the vet said some people do prefer to maintain with meds/diet rather than opting for surgery - but that ultimately at some point, her liver will fail. Whether it's 6mths from now or years down the road there's no way to know. She's only TWO, I can't bear to lose her. I've been discussing everything with Ruthie's breeder as well — she strongly feels that I should NOT do surgery. I've heard that dogs living on low protein diets can show the effects of that — like a lack-lustre coat (minor detail) and very low energy. I really want ruthie to be able to be just a normal dog and play with Oscar like she always has. I've had to take away all of her bones — which means Oscar doesn't get bones either — and she LOVES to chew (not only that, but her teeth are already suffering for it). Does anyone know of a bone/chew that is safe for liver shunt dogs?? I could use any advice here guys — based on her size, age, test results would you do surgery? Or would you keep her on meds and the special diet for the rest of her life (however long that may be). Any helpful information would be appreciated. It's a horrible decision to have to make. I've already spent $1,000 just trying to get a diagnosis, and the emerg vet has quoted me $3,500-$4,000 for the surgery. I don't have a good feeling about the emerg hospital doing the surgery… mind you, I don't think I'd have a good feeling about anyone doing it. I'm afraid that if I put it off too long, even weeks, that she will no longer be a good candidate for the surgery. Oh, on top of this, Oscar has broken his leg TWICE in 6 mths - so that was another $4,000 — ALL of this has come up in LESS THAN A YEAR. I love my dogs dearly — just the thought of losing them brings me to tears — talk about your dumb luck.
__________________ Janice, Oscar and Baby Ruth "The more people I meet, the more I love my dog." |
Welcome Guest! | |
05-22-2008, 09:36 AM | #2 |
Bella Boo & Diggy Too! Donating GS Member | my suggestion...PM Yorkieluv she is VERY educated on this and she is my go to girl when I have health issues.....She has a baby named Miko who is liver compromised. Good luck and keep us posted!
__________________ ALL DOGS GO TO HEAVEN |
05-22-2008, 09:54 AM | #3 |
Donating YT 10K Club Member | The high range of her bile acid results are indicative of liver shunt. Have you done the protein C test? That would tell you whether or not it's a shunt. Before electing for surgery...I would want definitive proof of a shunt. Even if it required additional testing. If those tests indicated a shunt, yes, I would opt for surgery. The earlier surgery is completed...the better the chances for the dog. As far a special diet...it's likely even with the surgery she would still require that. I would advise finding a specialist if possible to do the surgery. The university of Tennessee does the surgery for around 2000. Yorkieluv can give you the link for a yahoo group for liver shunt/mvd.
__________________ Deb, Reese, Reggie, Frazier, Libby, Sidney, & Bodie Trace & Ramsey who watch over us www.biewersbythebay.com |
05-22-2008, 09:57 AM | #4 |
And Rylee Finnegan Donating Member Join Date: Apr 2007 Location: Metro Detroit, MI
Posts: 17,928
| I'm so sorry. Because the ultrasound was inconclusive, I would not go to surgery just yet. There is no reason to risk anesthesia if a shunt hasn't been diagnosed. Although high numbers like that usually do mean shunt, there is a slight chance that is could be microvascular dysplasia for which there is no cure, only management. I would consider doing a Protein C test on her and possibly scintography. Then if a shunt is diagnosed surgery probably should be attempted. There are risks to the surgery but there is a fairly good success rate and she would have a better chance at living a long life. Here is an article written by Dr. Tobias from DVM News: Surgery STAT: CPSS surgery and aftercare - - DVM Because Dr. Tobias is probably the most knowledgeable person about liver shunt (along with Dr. Center), I'd have to go with her recommendations. If at all possible, it would be best to have the surgery done at University of Tennessee. Dr. Tobias was the first to do it with the constrictor and the surgeons there are highly trained. I think it is also one of the cheapest places (usually under $1800 with spay or neuter and maybe even testing). UofT has the best success rate as far as I know and less post-op problems. Of course, there is a risk wherever it is done. As for the food, K/D is not recommended because one of the ingredients is liver and K/D and L/D kibble contain ethoxyquin. L/D canned or Royal Canin LS Hepatic 14 kibble are recommended, however, Royal Canin has made several Yorkies very itchy. If you feed kibble you may want to soak it in equal parts water because moisture is very important for liver compromised dogs. What supplements are you giving? Are you a member of the Yahoo Liver Shunt group yet?
__________________ Crystal, Ellie May (RIP), Rylee Finnegan, and Gracie Boo🐶 Last edited by Ellie May; 05-22-2008 at 09:58 AM. |
05-22-2008, 10:42 AM | #5 |
Donating Senior Yorkie Talker Join Date: May 2006 Location: Toronto, Canada
Posts: 1,275
| Thanks for the replies so far! Let's see… I live in Toronto Ontario, so UT is out of the question. There is a teaching hospital at the University of Guelph which has been highly recommended to me by several people, so if I do decide to do surgery, it will likely be there. I've read about the scintigraphy (*sp), and that does seem to be the next step in diagnosing. My gut tells me that she does have a shunt… which makes me reluctant to keep putting money into diagnosis when ultimately I would have to pay for a surgery anyways. I was under the impression that such high BAT results kind of ruled out MVD? I thought MVD generally gave results of 100 or lower?
__________________ Janice, Oscar and Baby Ruth "The more people I meet, the more I love my dog." |
05-22-2008, 10:54 AM | #6 | |
Slave to My Rug-Rats Donating Member Join Date: Jun 2005 Location: Long Island
Posts: 7,247
| Quote:
I honestly suggest speaking with a Specialist and doing a Protein C test, which isn't expensive at all and then go from there. As far a the post # - anything is possible. I do believe that Miko (Yorkieluv) had a post of 300 and he DOESN'T have a shunt - he has MVD Keep us posted | |
05-22-2008, 11:02 AM | #7 |
My hairy-legged girls Donating Member Join Date: Jan 2007 Location: lompoc, ca.
Posts: 12,228
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05-22-2008, 11:11 AM | #8 |
Senior Yorkie Talker Join Date: Mar 2008 Location: Ontario, Canada
Posts: 227
| I have no experience with what you are going through but I have had experience with Guelph University. I had to have my Vet contact them to make an appointment with a specialist there. If I ever had serious problems again, it is definitely the place I would go. All the Best.
__________________ Linda owned & training in progress by MacTavish, Madeline, Mocha & Mr. Cooper |
05-22-2008, 11:17 AM | #9 |
And Rylee Finnegan Donating Member Join Date: Apr 2007 Location: Metro Detroit, MI
Posts: 17,928
| I understand that UofT would be a stretch but even with travel expenses you might find that you would be spending the same since UofT is so cheap. I wouldn't want to put more money into testing either but I wouldn't want to risk anesthesia for nothing either. Could you at least do a Protein C test first? I know it does get expensive. I am out over $550 for liver testing for Ellie but thankfully nothing appears to be wrong. If you join the Yahoo group there should be Canadian members on there and maybe they can direct you.
__________________ Crystal, Ellie May (RIP), Rylee Finnegan, and Gracie Boo🐶 |
05-22-2008, 11:24 AM | #10 |
No Longer A Member Join Date: Aug 2005 Location: NEW YORK
Posts: 16,218
| Just want to send prayer's your way for both you and your baby. |
05-22-2008, 11:38 AM | #11 |
YT 500 Club Member Join Date: Nov 2004
Posts: 980
| I feel so bad for you. I can understand how very up-set you are. I lost my 3 yr old 4# Yorkie to strokes, and it actually broke my heart. It is quite a worry and a BIG decision as to what to do. I know they wanted me to go to Washington with Snoodles and have Mri and spinal taps done. Then told me there was nothing that could be done anyway, but I would know where the problem in the brain was. Cost-around 2,000. I didn't go. Didn't want to put her through any more tests for nothing. So, good luck and let us know what you are going to do. Pat |
05-22-2008, 12:26 PM | #12 |
Donating YT 500 Club Member Join Date: Apr 2008 Location: Tennessee
Posts: 647
| I lost my Gizmo this past Feb after Liver Shunt Surgery. I took him to The University of Tennessee, and they are very good. Gizmo would have been four years old in June. He was sick alot before he turned one. After that he did not have alot of bad times, and had two good years, but this past November he took a turn for the worst, and nothing could turn it around. His little liver was giving out. He did pull through the surgery, but passed away two days later. If it were me, I would have the protien test and the Stingonphy tests ran. This way you will know if it is a shunt and if so where and how many there are. This will help in making the final decisions about surgery or medication management. I would also go to a specialist who has much experience with liver shunts, and if surgery is decided on make sure they use the constrictor. It has the best success rate. Good luck with your baby. I hope all goes well. |
05-22-2008, 03:16 PM | #13 |
YT 1000 Club Member Join Date: Jun 2007 Location: Beverly
Posts: 1,042
| There are other threads specifically about shunts here , just like yours... Go ahead and PM them, get opinions from good outcomes.... Good luck... i have no better advice !!!
__________________ "The reason a dog has many friends is because it wags it's tail instead of it's tong " [I]Smartpuppiepets@yahoo.com /I][ |
05-22-2008, 03:44 PM | #14 |
Yorkie Yakker Join Date: Mar 2007 Location: san francisco
Posts: 33
| I'm sorry to hear about Ruthie. My bobby went throgh something similar. I sugest that before you make a decision about a surgery you should get a second opinion with a specialist. Ask for a copy of all the tests that were done to Ruthie and take them to a specialist i have learn that the emergency clinics are not as specialize as they seem. I spent about a week with bobby in an emergency clinic he was there 24hrs under IV they told he he has a liver shunt, kidney failure and many other mixed results, and then they gave up they couldnt find out what was really wrong with him because his blood test will sugest a liver shunt but a ultrasound will sugest otherwise and even x-ray. I was so sad and dissapointed that i decided to take bobby to a specialist. He didnt have any of the illness they pointed out, he has to be on medications maybe for the rest of his life but he's very happy, energetic which is what makes me happy... |
05-22-2008, 04:47 PM | #15 |
Love my handsome boys Donating Member Join Date: Feb 2006 Location: Windham, NH
Posts: 1,821
| Janice - I'm so very sorry to hear about little Ruthie. I do not personally have experience with liver shunt, but know of a support group that can offer tons of information: Liver Shunt Stories
__________________ Andrea , Jaxon & Andrew |
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