Originally Posted by magicgenie  That information is very helpful. I'm worried about accepting an ultrasound report that says "appears to be a vein..." I'd prefer to see "clearly visible shunt...,"
Ultrasounds are only as good as the person reading them when it comes to looking for a shunt. They are not completely accurate. U/S are better for determining if the liver has atrophied and if there are bladder stones which are secondary to liver disease. How is your dog's urine? Dark? Ever had a UTI?
and a BAT over 100 before opening up the poor puppy.
Sometimes they go for exploratory surgery
Are those reports usually more conclusive?
The scintigraphy is much more accurate in determining if there is an actual shunt. The Protein C test helps determine if it is more likely to be a shunt or MVD (multiple tiny shunts throughout
I also got a very bad feeling about the vet herself when I saw she vaccinated twice in two months for Lepto, which is suspected of causing liver malfunction. I know it doesn't cause shunt, but I've been reading of cases where something looked like shunt and got traced back to a lepto reaction. The puppy happens to have started little tremors after getting the first shot...
Dogs with liver disease do not handle vaccinations very well at all. I would stop giving vaccinations completely until your dog gets better.
I've had some bad vet experiences this year with other things, so I know for a fact they do not always tell the truth, and this is too important to screw up. Do they ever come back after surgery and say "oops, it wasn't really l/s."
Yes, but in these cases, it's important that they take a biopsy of the liver to check for liver disease. A biopsy will tell you if there is MVD, fibrosis, or cirrhosis for sure. Sometimes they do just go in for exploratory surgery if all signs point to shunt.
Another bothersome thing is they talk about how the puppy will be on meds and diet for life.
If the dog has an extrahepatic shunt that is completely corrected, then he will only need to be on meds and special food until his BAT results come back normal, unless he blows more shunts because it can't handle all the blood flow. Also, many times, they may have an extrahepatic shunt AND MVD. In which case, the dog will need special diet, care, and supplements for life. That's why it's important that they do a biopsy if they go in. The third scenario is that the dog has MVD and no extrahepatic shunt. In this case again, the dog will need special diet, care, and supplements.
I thought the objective of surgery was a complete cure. !?!?!
If there is an extrahepatic shunt, it should be repaired. If they say they think it's a single extrahepatic shunt and they can see it on ultrasound, and with BAT not being very high, ordinary common sense tells me it's a small shunt that should be 100% repairable, or close to it. Anyway, all the paperwork has been sent off for another vet opinion. |