University of Tennessee is probably the best place to get the liver shunt surgery. Dr. Karen Tobias has
extensive experience with liver shunts and actually heads up the research for liver shunts...They do everything from pre-tests to post-op work for around $1400. I know of several people who have had their yorkies' surgeries done there and are extremely happy with the outcome.
I'm so glad your little girl is feeling so much better!! I know it's scary to watch them go through those things...
My yorkie also has a liver shunt, but unfortunately, his was not repairable...
I cannot stress enough the importance of the lactulose. The amount of lactulose should depend on the stool consistency. The stool should be soft but formed and difficult to pick up. Not firm and not diarrhea. If your babies stools are firm, she can get backed up again and the ammonia will go through her system causing HE symptoms(salivating, seizures, head pressing, etc.). If her stool is firm that means she's not getting enough lactulose. Your specialist should be able to tell you how to adjust the lactulose properly.
Also, do not give her any treats that have animal protein in them. Stick to all natural ones for now like apples(peeled and cut up), watermelon(no seeds), carrots, yogurt is very beneficial for them...
I'm sure your vet explained it to you, but animal protein is very hard on their livers because it produces ammonia which in a normal body, is filtered through the liver, but when there is a shunt, it bypasses the liver altogether and the ammonia enters their system causing the symptoms...
Please join
http://pets.groups.yahoo.com/group/L...d_MVD_Support/
The people there are extremely knowledgable and can help you. Also the files section is incredible and has lots of useful information. Just post your situation, and you will get lots of helpful answers.
Also, you could start her on denosyl(sam-e) and/or milk thistle(or marin)...These two supplements are recommended for liver compromised dogs because it helps prevent further damage to the liver and actually helps repair damage that has been done....
Good luck, and if you have any questions, please ask!