Liver disease

[ILUVSADIE]

When Sadie was very young, they diagnosed a heart murmur with her - and my vet wouldn't perform any surgery (even spaying) until she had a transesophageal echocardiogram performed on her. A vet from another ciy had to perform this procedure - and the results were fairly benign - she haxd her surgery performed with incident - THANK GOD

[MauiGirl]

Just got the results back, and bile acids are 2.1 fasting, then post prandial is 47.5. Urinalisis was all good. They are suggesting ultrasound as the next diagnostic test, and we discussed it's limitations, however they still recommend it in case it does see a shunt, then we'll know. If it doesn't then we'd do Protein C, and liver biopsy. They said it won't hurt to start denosyl w/milk thistle, and lower her protein/fat intake. On xray, liver appears slightly small.

How bad are these results so far? A reminder, Tiki is 7 months old, 7 lbs., and has no symptoms of liver disease.

It may be 4-6 weeks until the vet who does ultrasound comes over to our island, and the cost will be $350 & up.

Please help me interpret these results, and guide me to the next steps.

Many Thanks

[RONLYNN]

I'm so sorry to hear about your dog. I would definitely join this group: Liver_Shunt_And_MVD_Support : Liver Shunt & MVD/HMD Support

My Teddi had LS surgery 1 year ago. She had absolutely NO symptoms for one year and then I came home one day and found her drooling and then started our adventure. The people on that group are so knowledgeable and will be your best bet for help with this. Good luck!!

Here is Teddi's story: Teddi's Story

[Yorkieluv]

Shunts are not always seen on an ultrasound, so I don't usually recommend that people spend the money on it unless they're checking size of liver and if they're checking for stones. A small liver is not a good thing, so they should probably check into that...

Those BAT results aren't outrageous, but they ARE above normal. Did they do a blood panel? If so, was ALT elevated?

[MauiGirl]

Originally Posted by RONLYNN

I'm so sorry to hear about your dog. I would definitely join this group: Liver_Shunt_And_MVD_Support : Liver Shunt & MVD/HMD Support

My Teddi had LS surgery 1 year ago. She had absolutely NO symptoms for one year and then I came home one day and found her drooling and then started our adventure. The people on that group are so knowledgeable and will be your best bet for help with this. Good luck!!

Here is Teddi's story: Teddi's Story

Thanks, I just joined that group and am compiling background info.

[MauiGirl]

Originally Posted by Yorkieluv

Shunts are not always seen on an ultrasound, so I don't usually recommend that people spend the money on it unless they're checking size of liver and if they're checking for stones. A small liver is not a good thing, so they should probably check into that...

Those BAT results aren't outrageous, but they ARE above normal. Did they do a blood panel? If so, was ALT elevated?

I had them fax me the blood results, even though I don't know what it all means. ALT (SGPT) is high at 245 (ref. range 5-107), also AST (SGOT) was 56 (ref. range 5-55). Everything else was within normal range. They will send the liver xray out for a second opinion if I want for another $80. Next week their head surgeon will be back and talk me thru the options.

Thanks for your input.

[MauiGirl]

Originally Posted by RONLYNN

I'm so sorry to hear about your dog. I would definitely join this group: Liver_Shunt_And_MVD_Support : Liver Shunt & MVD/HMD Support

My Teddi had LS surgery 1 year ago. She had absolutely NO symptoms for one year and then I came home one day and found her drooling and then started our adventure. The people on that group are so knowledgeable and will be your best bet for help with this. Good luck!!

Here is Teddi's story: Teddi's Story

Oops, that's not the same group I joined. I followed another link from the YT Sick and Injured thread about LS. I'll have to join this too.

[yorkiecrazy]

I'm sorry you're going though this. I wish you the best and will keep you and your baby in my thoughts.

[Yorkieluv]

Elevated ALT signifies liver cell death, so it does concern me that both ALT and the BAT results were elevated.
Let us know what the specialist says next week...

[Ellie May]

The BAT itself isn't too bad but the high ALT would make me nervous.

While I might be talked into an ultrasound in this case, I don't think it is the best way to go. Why don't they do scintography or are they looking for bladder stones? If a scintography shows no shunt and the vet thinks it's MVD, there is really no good reason to open her up for a biopsy that I know of. It would probably be a good idea to do one when she is spayed though...

[MauiGirl]

I don't even know what scintography is, but will ask about it tomorrow when I pick up supplements. Even with ultrasound, I'd have to wait until the vet from Big Island comes to Maui which usually is every 4-6 weeks. They also mentioned that biopsy would be done when they spay her, once they determine it is safe.

They suggested switching to a lower protein/fat diet. Any quick suggestions for a kibble since I have to go buy some tomorrow? I was ready to move Tiki and Meika (6 lb. Morkie) off puppy food, into adult anyway.

Thanks for input; this is really shaking me up.

[Ellie May]

Originally Posted by MauiGirl

I don't even know what scintography is, but will ask about it tomorrow when I pick up supplements. Even with ultrasound, I'd have to wait until the vet from Big Island comes to Maui which usually is every 4-6 weeks. They also mentioned that biopsy would be done when they spay her, once they determine it is safe.

They suggested switching to a lower protein/fat diet. Any quick suggestions for a kibble since I have to go buy some tomorrow? I was ready to move Tiki and Meika (6 lb. Morkie) off puppy food, into adult anyway.

Thanks for input; this is really shaking me up.

Liver disease is scary and the lack of knowledge on it is frustrating. I'm sorry you're going through this.

Portosystemic Shunts FAQ
Scintography is explained here.

Did they offer you a prescription diet?
You can go with Natural Balance vegetarian if now or there are a couple others that I either have looked into or don't like peronally. One of htem is Avoderm something or other. I think California Natural is low in protein (don't quote me) but it really isn't the right kind of protein, especially the lamb. I would stay away from all red meat, pork and even exotics until this is figured out.

[Ladymom]

Wellness Super Mix for seniors is low in protein:

WELLNESS® - Healthy Dog and Cat Food

Solid Gold also has a low protein kibble:

Holistique Blendz Adult Dog (fish)

[Yorkieluv]

Originally Posted by MauiGirl

I don't even know what scintography is, but will ask about it tomorrow when I pick up supplements. Even with ultrasound, I'd have to wait until the vet from Big Island comes to Maui which usually is every 4-6 weeks. They also mentioned that biopsy would be done when they spay her, once they determine it is safe.

They suggested switching to a lower protein/fat diet. Any quick suggestions for a kibble since I have to go buy some tomorrow? I was ready to move Tiki and Meika (6 lb. Morkie) off puppy food, into adult anyway.

Thanks for input; this is really shaking me up.

Crystal makes a really good point....For as expensive as the ultrasound is combined with the consultation with the specialist, a scintigraphy will likely only cost a little more. It will determine if there is a shunt and if she needs surgery. If you can get Natural Balance Vegetarian, this is the one I would use..There are no animal proteins in it, and it's safe if your other dogs eat it. Like Crystal said, stay away from red meats (lamb, beef, etc.) and exotics. The Solid Gold Holistique Blendz is not one I would recommend because of the fish meal which is high in purines...
Good luck and keep us posted!!
Keep your chin up...I know it can be scary, but just try to learn as much as possible about liver disease so that you can be prepared.

[Ellie May]

I am so hesitant to say that I wouldn't do ultrasound because it can show some shunts and stones but after what Ellie's been through, I'm hesitant to say go for it too. We did an ultrasound. We got a diagnosis...pancreatitis. Great to know about it but not what we were looking for. The liver looked okay. We did a biopsy during spay. Only one sample was taken but it was pretty large...shows no MVD. Just because the ultrasound showed no shunt doesn't mean there isn't one and since several samples of the liver weren't taken, only widespread MVD can be ruled out. So, a whole lot of money later and we are treating sort of like MVD. We don't have answers but Ellie was having bladder issues too and stones were ruled out. So, every dog is different it can be very difficult to decide which tests to do. In Ellie's case, ultrasound did need to be done.