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Originally Posted by Itspuppyluv  Anyone with any advice? It would be greatly appreciated. I'm so upset and unsure about the next step.
He had a bile acid test. It was 86.7.
I've read about the ultrasound not always being accurate but that's what my vet wanted to do and I thought it couldn't hurt. If they found a shunt, we'd have the answer.
The vet that did the ultrasound agreed about the accuracy but still feels it is probably not a shunt but MVD.
There weren't any abnormalities found.
Here is the diagnosis:
A portosystemic shunt is not identified, and the hallmark signs of portosystemic shunt such as a small liver, urinary calculi and large kidneys are not seen. Microvascular dysplasia/portal vein hypoplasia is a possibility, alternatively a central nervous system lesion may be causing these signs.
Recommendations: A possible next diagnostic step would be to obtain a liver biopsy under general anesthesia. At this time, with the patient completely still, a more thorough assessment of the portal vein may be possible.
My regular vet told me she's never treated a dog with MVD, if that is what it turned out to be, and would either be working with a specialist or would refer me to one. I have yet to speak with her (ultrasound was yesterday) but want to ask about doing the Protein C test some of you have suggested before going back to the other doctor for the biopsy. If the Protein C test is done does that mean he won't need the biopsy? I'm not clear exactly what the test shows. Is this what you'd recommend?
Anything else I should know or do?
I'm learning about things such as milk thistle, denosyl, the different vitamins that might help and diet. We've only thought liver shunt for five days and now MVD for one so I have a lot to learn. |
At least your vet was honest about the fact she had never treated a dog with MVD. Most vets just don't know that much about liver disease because they don't see enough of it. They can waste a lot of time and money. The ultrasound is a good example. Dr. Center, the developer of the bile acids test, estimates that ultrasounds can be as low as only 60% reliable.
The next step after a high bile acids test is a protein C test. Then, depending on the results, a scintigraphy might be recommended.
Do you have a vet school near you? That would be your best place to take your Yorkie.
I've attached some informative links for you:
Hepatic Vascular Disorders - WSAVA 2006 Congress Portosystemic Shunts FAQ