So Sad and Scared

[laniesue]

Eight days ago, I took our little LuLu to the vet. She had been vomiting during the night and was restless, sleeping did not occur for either of us. The vet gave her something for nausea and something for the vomiting. Long story short, I took her to a second vet that afternoon for a second opinion. Her blood sugar was very low when the vet checked it so she did an x-ray which showed minerals in her tummy. She had me give her NutriCal (?) until she started eating again and a laxative to try to push things along. Two days later I took her back because she just was not herself and her B/S was even lower than the first day I took her there. Blood Work showed two elevated liver enzymes but normal billirubin. Vet was immediately suspicious of liver shunt. Told me to feed her brown rice and chicken, which I have been doing, and now mu LuLu is back to her sweet and wild little self. I was hoping it was all just a fluke but yesterday she had the fasting Bile Acid test. The vet just called with the results and it is high, in the 200's. She is scheduled for an appt with a specialist for a special type of ultrasound next week. LuLu was a year old in November. She weighs 4 lbs and has been so healthy up until this episode. She has been such a Blessing to us and I am terrified that we will lose her. My understanding is that L/S surgery is very expensive. The vet tells me that maybe since she has been problem free up until now that maybe it is a small partial shunt that can be managed with diet. Anyone have similar situation with their baby?

[rubymoon2072]

there are alot of threads here on this. i think i remember reading some are managed with diets but i am sure others with chime in with sound advice and experience. sending many prayers for your lulu i hope it is the best case scenario. hugs to you.

[rubymoon2072]

http://www.yorkietalk.com/forums/gen...ss-report.html

thats a link to a thread where the diet is helping for now and Ladyjane has a lot of knowledge about LS.

[Maximo]

Welcome to Yorkie Talk. I am sorry LuLu has been ill and I can imagine how scary this must be.

I do not have personal experience with liver shunt, but I have been reading the threads here on Yorkie Talk for 4 years. Diet is only a short term fix as Ladyjane indicates in the thread linked above. Surgery will be required for your girl's health and longevity. Yes, surgery is expensive. However, it will likely be less costly than the countless vet visits and potential ER visits that would likely come with future illness due to the LS and side effects.

Care Credit is a great option for financing the surgery. It's easy and fast to apply for, and depending on the vet, interest free for up to 2 years.

I'm sure the people here who are experienced with LS will give you great advice about how to proceed. Scintography I believe is one of the best way to diagnose, and there is a vet school in Tennessee that is one of the best in dealing with LS in Yorkies.

Best wishes for LuLu and you.

[Maximo]

I forgot to add -- additional testing may show that LuLu does not have a shunt, and she may have a liver problem that can be managed with diet and meds. Definitely worth seeing a specialist!

[ladyjane]

Originally Posted by rubymoon2072

http://www.yorkietalk.com/forums/gen...ss-report.html

thats a link to a thread where the diet is helping for now and Ladyjane has a lot of knowledge about LS.

While that person posted that about her pup; it is not the recommended treatment for liver shunt.

I personally would not share that with people as an option.

A pup with a liver shunt can live a long life if the shunt is repaired...not so with diet. That is a temporary bandaid.

[ladyjane]

Originally Posted by Maximo

Welcome to Yorkie Talk. I am sorry LuLu has been ill and I can imagine how scary this must be.

I do not have personal experience with liver shunt, but I have been reading the threads here on Yorkie Talk for 4 years. Diet is only a short term fix as Ladyjane indicates in the thread linked above. Surgery will be required for your girl's health and longevity. Yes, surgery is expensive. However, it will likely be less costly than the countless vet visits and potential ER visits that would likely come with future illness due to the LS and side effects.

Care Credit is a great option for financing the surgery. It's easy and fast to apply for, and depending on the vet, interest free for up to 2 years.

I'm sure the people here who are experienced with LS will give you great advice about how to proceed. Scintography I believe is one of the best way to diagnose, and there is a vet school in Tennessee that is one of the best in dealing with LS in Yorkies.

Best wishes for LuLu and you.

Originally Posted by Maximo

I forgot to add -- additional testing may show that LuLu does not have a shunt, and she may have a liver problem that can be managed with diet and meds. Definitely worth seeing a specialist!

[MauiGirl]

Welcome to Yorkie Talk. I'm sorry that Lulu is having problems, and I can understand how scared you must be. You are on the right track, having the vet do testing so you will have a better idea of what you are dealing with.

I want to tell you one important thing up front, having a liver shunt is NOT a death sentence. If there is one, it is treatable, and it may turn out not to be that at all and could possibly be something like microvascular displasia MVD, which can be managed with diet and supplements.

I know the overwhelming fear you have right now, I had that myself when my Tiki was in the same position at the age of 7 months. I almost went crazy as we navigated through the diagnostic process, and in her case a shunt was not found, and they determined she most likely has MVD. I have fed her low protein/low fat diet, and made sure she is not exposed to toxins that her liver cannot process..... and I'm happy to say she is now 6 and doing just fine.

Here are links to some easy to understand information about liver disease that will help you become familiar with the various tests:
http://www.vet.utk.edu/clinical/sacs...NAL-201304.pdf
Portosystemic Shunts FAQ

I hope for the best for Lulu, and send hugs to you both. I know it is a heartbreak to have our lil fur kids be sick..... but hang in there, and let's hope this is something that can be fixed.

[yorkietalkjilly]

Here is a website another member on YT gave me when my Tibbe was being worked up for possible liver shunt and I was told that the Dr. Tobias who writes the article is a leading expert in the field of diagnosing and caring for dogs with liver shunt and MVD.

Portosystemic Shunts FAQ

My own Tibbe was finally diagnosed with probable MVD after a couple of years of minimal symptoms which gradually got worse, leading to a high bile acids test, which called for a scintigraphy/abdominal sonogram and he's done well with just eating a hepatic diet for the past year. Since his symptoms were not that bad, the nuclear radiologists who performed his scintigraphy and sonogram decided he didn't really need to undergo a surgical biopsy for confirmation of the MVD and that just changing his diet would likely fix him up. It did. He's only had 6 or 7 bouts of spitting up bile and foam since that time, while his avoidance of eating, lethargy and head-rubbing have stopped and he's back to his feisty, playful, inquisitive self. He's allergic to the Hill's I/D Hepatic canned food so I feed him half that and half Hill's I/D GI kibble to keep his itching to a minimum but just that much of a diet change made a huge difference in his life. You baby could have the lesser liver disease of MVD and maybe won't need surgery but only a change of diet. They told me that dogs with MVD can live as normal dogs once they are on their special diet and restricted from other foods and can live out a normal small-dog's life expectancy.

I'll sure be praying that your baby doesn't have liver shunt but maybe is just dealing with MVD. Try not to be so scared - there have been several dogs on this website who have done very well after the shunt surgery when it was diagnosed early on after symptom or diet change for those with MVD.

[laniesue]

Thank each and every one of you for taking time to reach out to me. I appreciate all the information you have passed along and MOST OF ALL, I appreciate your prayers for my sweet LuLu girl! She is scheduled for her ultrasound next Thursday. I will keep you all updated.

PS....I was feeding her brown rice, chicken and a few green peas. She started picking the peas out first and laying them aside (maybe she thought the cats would eat them ), now she wont eat the rice....only the chicken. Any ideas or suggestions on what else to add?

[Maximo]

Originally Posted by laniesue

Thank each and every one of you for taking time to reach out to me. I appreciate all the information you have passed along and MOST OF ALL, I appreciate your prayers for my sweet LuLu girl! She is scheduled for her ultrasound next Thursday. I will keep you all updated.

PS....I was feeding her brown rice, chicken and a few green peas. She started picking the peas out first and laying them aside (maybe she thought the cats would eat them ), now she wont eat the rice....only the chicken. Any ideas or suggestions on what else to add?

Try shredding the chicken and then take a fork and mash the chicken into the rice. This is what I have to do to make Teddy eat rice. Popping it in the microwave for a few seconds also helps blend the flavors.

Keeping Lulu and you in my prayers. Looking forward to your updates.

[laniesue]

I took LuLu to see the specialist last Thursday. They did the ultrasound, however, he was unable to confirm if she has a liver shunt. He said he was not "sold" on her having a shunt, but would not be surprised if she does. His report says "The ultrasound is highly suggestive of a shunting vessel but not confirmative. No radolucent calculi were noted in the urinary bladder." I asked him if he had a "gut" feeling and he said atypical Addsion's Disease came to his mind as soon as he read LuLu's chart.
He said he hated to recommend surgery right now because it may not be needed. He discussed scintigraphy and vascular contrast CT, indicating that both are quite expensive. I asked what we should do next and he said a protein C assay to aide in differentiating MVD from a shunt and a baseline cortisol to make sure she couldnt also have atypical Addsion's disease. I am so frustrated.I hate the "unknown". Meanwhile, my baby is just as spunky as ever. She is eating well, too. I just wish I could draw an easy breath. Keep the prayers going up for my sweet LuLu, please. Any ideas or input appreciated.

[Teegy]

My friend took her Yorkie to OVC they did an MRI and xrays and found a shunt and did the surgery all at the same time while he was under. Don't you be worrying yourself, he is on his way to a full recovery and his bouncy little self

There is a Yahoo group for MVD you will get a ton of advice on there

[rubymoon2072]

Originally Posted by ladyjane

While that person posted that about her pup; it is not the recommended treatment for liver shunt.

I personally would not share that with people as an option.

A pup with a liver shunt can live a long life if the shunt is repaired...not so with diet. That is a temporary bandaid.

sorry was only trying to help with links. not very well versed in the LS area. did not mean to share something unhelpful.

[Maximo]

Originally Posted by laniesue

I took LuLu to see the specialist last Thursday. They did the ultrasound, however, he was unable to confirm if she has a liver shunt. He said he was not "sold" on her having a shunt, but would not be surprised if she does. His report says "The ultrasound is highly suggestive of a shunting vessel but not confirmative. No radolucent calculi were noted in the urinary bladder." I asked him if he had a "gut" feeling and he said atypical Addsion's Disease came to his mind as soon as he read LuLu's chart.
He said he hated to recommend surgery right now because it may not be needed. He discussed scintigraphy and vascular contrast CT, indicating that both are quite expensive. I asked what we should do next and he said a protein C assay to aide in differentiating MVD from a shunt and a baseline cortisol to make sure she couldnt also have atypical Addsion's disease. I am so frustrated.I hate the "unknown". Meanwhile, my baby is just as spunky as ever. She is eating well, too. I just wish I could draw an easy breath. Keep the prayers going up for my sweet LuLu, please. Any ideas or input appreciated.

Lulu and you remain in my prayers. I have not been through this myself, but based on what I have read of numerous other cases here, I would do the scintigraphy, and the blood tests that the specialist recommended to you to rule out atypical Addison's.

As I wrote above, Care Credit might be a good option if you need financing. It's interest free for large expenditures (usually over $200), length of time depends on the vet, up to 2 years.