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Oscar's Mummy · 05-22-2008, 09:31 AM

I've been away from YT for awhile now, but here I am back again looking for some help, as YT has always been helpful for me with my two yorkies.

My little Ruthie, just under 3lbs, has been diagnosed with liver shunt. I've read some threads on here on the subject, and have been researching as much as I can online about the subject for the past few weeks. I THOUGHT that since she was two, I was 'in the clear' - afterall, I was familiar with the condition and the symptoms that accompanied it. Ruthie wasn't head pressing, didn't act 'drunk' after meals, had never had a hypoglycemic episode, etc. — I took her to the vet in the first place for a bit of a cough and lethargy — which came out of nowhere and progressed over the course of a week. She just seemed 'off' - not herself at all. The vet could find no reason for her cough - said her heart and lungs sounded great (of course, she didn't cough WHILE we were at the vet OR throw up). Anyways, while we were there, we decided to do her yearly exam and they collected blood. There were 'slight abnormalities' in her bloodwork (small red blood cell, and something else) that could indicate a shunt, so he suggested we do a liver panel to be sure. Her bile acid test results were through the roof — 249 before, and 231 after. Based on this alone, my vet felt strongly that it was a shunt, but referred me to an emerg vet to have an ultrasound done. Had I known that ultrasounds were SO inconclusive beforehand, I would have opted for another type of test (Protein C or Scintigraphy) — as it is, the ultrasound showed basically nothing, so it was a waste of $600 on my part. According to the ultrasound, there were no bladder stones and her kidneys were not enlarged (symptoms of shunt) and her liver and the portal vein were only slightly undersized. The emerg vet said he would recommend surgery regardless of what the ultrasound showed - that the BAT results were elevated enough to indicate shunt. I did NOT book the surgery that day (this was about 2 weeks ago now I guess) — and left the hospital feeling totally overwhelmed and unsure of what to do.

So here I am — no clue. I've read so much about shunts my head is swimming. Everyone has differing opinions on what to do - some think surgery is always the way to go, some think it should be maintained with meds/food. Right now she is on Lactulose and Metronidazole and K/D food (which i've now read is NOT good for compromised livers???). She perked up and went back to her old playful self after just 2 days of being on these meds and low protein food — which the vet also said indicated she had a shunt.

Anyways… I have no idea what to do. One day I think surgery is the way to go, the next I think I can't bear to risk surgery on her. She's so small. She made it through her spay with absolutely NO complications — but I'm afraid to put her through another surgery. The thought of watching her health slowly deteriorate if I don't do surgery is agonizing — the vet said some people do prefer to maintain with meds/diet rather than opting for surgery - but that ultimately at some point, her liver will fail. Whether it's 6mths from now or years down the road there's no way to know. She's only TWO, I can't bear to lose her. I've been discussing everything with Ruthie's breeder as well — she strongly feels that I should NOT do surgery.

I've heard that dogs living on low protein diets can show the effects of that — like a lack-lustre coat (minor detail) and very low energy. I really want ruthie to be able to be just a normal dog and play with Oscar like she always has. I've had to take away all of her bones — which means Oscar doesn't get bones either — and she LOVES to chew (not only that, but her teeth are already suffering for it). Does anyone know of a bone/chew that is safe for liver shunt dogs??

I could use any advice here guys — based on her size, age, test results would you do surgery? Or would you keep her on meds and the special diet for the rest of her life (however long that may be). Any helpful information would be appreciated.

It's a horrible decision to have to make. I've already spent $1,000 just trying to get a diagnosis, and the emerg vet has quoted me $3,500-$4,000 for the surgery. I don't have a good feeling about the emerg hospital doing the surgery… mind you, I don't think I'd have a good feeling about anyone doing it. I'm afraid that if I put it off too long, even weeks, that she will no longer be a good candidate for the surgery.

Oh, on top of this, Oscar has broken his leg TWICE in 6 mths - so that was another $4,000 — ALL of this has come up in LESS THAN A YEAR. I love my dogs dearly — just the thought of losing them brings me to tears — talk about your dumb luck.

05-22-2008, 09:31 AM	#1
Oscar's Mummy Donating Senior Yorkie Talker Join Date: May 2006 Location: Toronto, Canada Posts: 1,275	Words of encouragement, or... anything at all I've been away from YT for awhile now, but here I am back again looking for some help, as YT has always been helpful for me with my two yorkies. My little Ruthie, just under 3lbs, has been diagnosed with liver shunt. I've read some threads on here on the subject, and have been researching as much as I can online about the subject for the past few weeks. I THOUGHT that since she was two, I was 'in the clear' - afterall, I was familiar with the condition and the symptoms that accompanied it. Ruthie wasn't head pressing, didn't act 'drunk' after meals, had never had a hypoglycemic episode, etc. — I took her to the vet in the first place for a bit of a cough and lethargy — which came out of nowhere and progressed over the course of a week. She just seemed 'off' - not herself at all. The vet could find no reason for her cough - said her heart and lungs sounded great (of course, she didn't cough WHILE we were at the vet OR throw up). Anyways, while we were there, we decided to do her yearly exam and they collected blood. There were 'slight abnormalities' in her bloodwork (small red blood cell, and something else) that could indicate a shunt, so he suggested we do a liver panel to be sure. Her bile acid test results were through the roof — 249 before, and 231 after. Based on this alone, my vet felt strongly that it was a shunt, but referred me to an emerg vet to have an ultrasound done. Had I known that ultrasounds were SO inconclusive beforehand, I would have opted for another type of test (Protein C or Scintigraphy) — as it is, the ultrasound showed basically nothing, so it was a waste of $600 on my part. According to the ultrasound, there were no bladder stones and her kidneys were not enlarged (symptoms of shunt) and her liver and the portal vein were only slightly undersized. The emerg vet said he would recommend surgery regardless of what the ultrasound showed - that the BAT results were elevated enough to indicate shunt. I did NOT book the surgery that day (this was about 2 weeks ago now I guess) — and left the hospital feeling totally overwhelmed and unsure of what to do. So here I am — no clue. I've read so much about shunts my head is swimming. Everyone has differing opinions on what to do - some think surgery is always the way to go, some think it should be maintained with meds/food. Right now she is on Lactulose and Metronidazole and K/D food (which i've now read is NOT good for compromised livers???). She perked up and went back to her old playful self after just 2 days of being on these meds and low protein food — which the vet also said indicated she had a shunt. Anyways… I have no idea what to do. One day I think surgery is the way to go, the next I think I can't bear to risk surgery on her. She's so small. She made it through her spay with absolutely NO complications — but I'm afraid to put her through another surgery. The thought of watching her health slowly deteriorate if I don't do surgery is agonizing — the vet said some people do prefer to maintain with meds/diet rather than opting for surgery - but that ultimately at some point, her liver will fail. Whether it's 6mths from now or years down the road there's no way to know. She's only TWO, I can't bear to lose her. I've been discussing everything with Ruthie's breeder as well — she strongly feels that I should NOT do surgery. I've heard that dogs living on low protein diets can show the effects of that — like a lack-lustre coat (minor detail) and very low energy. I really want ruthie to be able to be just a normal dog and play with Oscar like she always has. I've had to take away all of her bones — which means Oscar doesn't get bones either — and she LOVES to chew (not only that, but her teeth are already suffering for it). Does anyone know of a bone/chew that is safe for liver shunt dogs?? I could use any advice here guys — based on her size, age, test results would you do surgery? Or would you keep her on meds and the special diet for the rest of her life (however long that may be). Any helpful information would be appreciated. It's a horrible decision to have to make. I've already spent $1,000 just trying to get a diagnosis, and the emerg vet has quoted me $3,500-$4,000 for the surgery. I don't have a good feeling about the emerg hospital doing the surgery… mind you, I don't think I'd have a good feeling about anyone doing it. I'm afraid that if I put it off too long, even weeks, that she will no longer be a good candidate for the surgery. Oh, on top of this, Oscar has broken his leg TWICE in 6 mths - so that was another $4,000 — ALL of this has come up in LESS THAN A YEAR. I love my dogs dearly — just the thought of losing them brings me to tears — talk about your dumb luck. __________________ Janice, Oscar and Baby Ruth "The more people I meet, the more I love my dog."