So Sad! Need Info About Liver Shunts Please let me know what you think!

[Gigi Girl]

Hi my 2.9 pound six month old yorkie Oliver went in to be nutered today and they did the routine blood work and his liver ALT was 278 so they did a bile test pre food was 30 and post food was 30 they are sending him for a ultrasound friday please let me know what you all think I am broken hearted and also stressed about the cost for a operation how much does a shunt operation cost? and from the info about his test does he sound like he definetly has a shunt? Please help any info you have would be appreciated!

[RONLYNN]

Hi! I'm so sorry to hear about your dog....I went through the same thing 1 year ago. Teddi had a liver shunt and was in the hospital this very week. I would suggest you to go this site: Liver_Shunt_And_MVD_Support@yahoogroups.com

someone on YT suggested I go there a year ago and I was so grateful. The surgery here in CA was going to be $4,500 to $6,000 (on top of the $2,500 for her being in the hosptial and for the stintigraphy test) but that group told me about going to University of Tennessee vet teaching hospital and the surgery there was $1,200, not to mention it is the best place possible to have the surgery since the doctors there study this condition. Good luck and definitely check out that group....they are very very helpful. BTW...my Teddi is all better and living a full and happy life!

[TLC]

I think you may be 'jumping' the gun on the Ultra Sound.

Those number are not very high and I think he may be a tad young for an accurate BAT. Also did he have any flea/tick treatment, how about vaccines or heartworm? These thing may throw the number off a tiny bit

I think you should do the BAT again in a few weeks. I would pass on the U/S right now, they are only 60% accurate (I think). So even if they don't see one there could be one, etc...

[megan_kat22]

I have had a Yorkie with a liver shunt, we maintained him for 3 years because he was not severe. PM me with anything you need :] When he finally needed surgery it costed us about $2000. But that was 2 years ago, and my baby is all better, never been better :]

[Gigi Girl]

Thanks for the info. October 20th he had the Distemper parvo la vaccine before that he hadheart guard on October 4th and on Semptember 7th hed had Advantage flea and tick. Was this long enough ago to not make a diff in his blood work?

[Gigi Girl]

Ohh! 278 is not that hi why is my vet freaking me out and was # is considered high? My vet said it was 3 times higher than it should be. Should I be looking for a new Vet?

[bchgirl]

None of his vaccines or flea meds should've affected the test...they were all given well over a month ago.

Bile acid tests simply indicate the function of the liver. The levels are not constant every day. 30 is not particularly high...and most dogs with shunts have figures in the 3 digit range. He has no other symptoms? Head pressing, circling, seizures, lethargic after eating?

Personally I would wait and have him re-tested. He is plenty old enough to get an accurate reading.

He may have MVD...which is controlled by diet and supplements.

If you were to proceed with testing...you need to ask for a protein c test. That will determine whether it's a shunt or not. Ultrasounds aren't reliable for "seeing" shunts.

As far as your vet...many of them are not very familiar with liver shunt. You may want to search for a specialist.

[my2boyz]

According ot everything I've been told the ideal time to give a bile acid test is about 16 weeks. Did your vet give you a pamphlet that explains your dog's blood work and that shows what the 'normal' ranges for each one is? According to the one I have from my vet the ALT normal range is from 18 to 50. I would ask your vet for a pamphlet and another explanation of the numbers. If you are still concerned or not sure I would seek a second opinion. You can also do a Protein C test rather than a sonogram...I've heard they are accurate and less expensive. Here is a Bichon website that explains your dog's blood work...

http://www.bichonfriseusa.com/caninebloodwork.htm

[my2boyz]

And here is a website that explains the normal numbers for bile acid tests...

The University of Tennessee College of Veterinary Medicine - Liver Shunt Research

From what I read on another site a sonogram is more accurate in larger dogs...you might want to ask about that.

[Gigi Girl]

I have been worried about him before the blood work today but the vet never seemed worried he sleeps a ton and is often cold and shivers not sure if he is cold or scared when he does. I noticed he was very sleepy and had the shivers bad after giving him the heart guard meds so I will not give that to him again. He has barked at my husband and I before as though he didnt know who are but stopped once we talked to him. So I have been worried about his sight and from what I read they can have bouts of blindness with a liver shunt. I got him when he was 16 weeks old and he weighed 2.9 pounds and still does his dad weighs 4 pounds and mom weighs 5 so I expected him to get a bit bigger though I love him just the way he is it just made me worry about him a bit that he didnt gain any weight.

[my2boyz]

If he shivers like he's cold are you sure that isn't hypoglycemia? Do you keep Nutrical on hand? If so give him a little bit the next time you notice him shiverring and see if that helps. Also, have you had his thyroid checked?

[Ladymom]

Originally Posted by my2boyz

According ot everything I've been told the ideal time to give a bile acid test is about 16 weeks. Did your vet give you a pamphlet that explains your dog's blood work and that shows what the 'normal' ranges for each one is? According to the one I have from my vet the ALT normal range is from 18 to 50. I would ask your vet for a pamphlet and another explanation of the numbers. If you are still concerned or not sure I would seek a second opinion. You can also do a Protein C test rather than a sonogram...I've heard they are accurate and less expensive. Here is a Bichon website that explains your dog's blood work...

A typical blood chemistry panel usually includes

Dr. Center recently revised her age recommendations for BAT testing from sixteen weeks to twenty weeks. Her research indicated that the organs may not be developed enough at 16 weeks to get an accurate result.

At six months, though, he is old enough. The cut off for abnormal bile acids is over 25 so his are only slightly elevated. Don't waste your money on an ultrasound as they can be as low as 60% reliable according to Dr. Center. I'd just retest in a month and if they are still high, have a Protein C test done. That will tell you if you are dealing with a shunt or MVD.

Comparative Coagulation -- NYS Animal Health Diagnostic Center

[Yorkieluv]

It sounds to me like your vet did an IDEXX Snap Bile Acid Test which only reads up to 30...You need to have your vet do a regular bile acid test that needs to be sent out to a lab.

278 is a high ALT....That should not be taken lightly. It's at least double if not more the normal levels...

I think others who posted were saying that the 30 pre and post BAT results were not that high, but I don't think they took into consideration that this is probably an IDEXX Snap BAT which will not give you numbers over 30. It needs to be redone.

6 months is old enough to get an accurate reading on a BAT.

[Ladymom]

Originally Posted by Yorkieluv

It sounds to me like your vet did an IDEXX Snap Bile Acid Test which only reads up to 30...You need to have your vet do a regular bile acid test that needs to be sent out to a lab.

278 is a high ALT....That should not be taken lightly. It's at least double if not more the normal levels...

I think others who posted were saying that the 30 pre and post BAT results were not that high, but I don't think they took into consideration that this is probably an IDEXX Snap BAT which will not give you numbers over 30. It needs to be redone.

6 months is old enough to get an accurate reading on a BAT.

You are probably right. Good thinking!

[Lorraine]

Originally Posted by Gigi Girl

Hi my 2.9 pound six month old yorkie Oliver went in to be nutered today and they did the routine blood work and his liver ALT was 278 so they did a bile test pre food was 30 and post food was 30 they are sending him for a ultrasound friday please let me know what you all think I am broken hearted and also stressed about the cost for a operation how much does a shunt operation cost? and from the info about his test does he sound like he definetly has a shunt? Please help any info you have would be appreciated!

He is too young and too small to be neutered anyway. I would waith until at least 8 months old or even older, let him grow some more first and retest later. If he is nonsymptomatic anyway, no rush.