Quote:
Originally Posted by MauiGirl  After a long consult with the vet/surgeon, we have decided to manage Tiki with diet and supplements and NOT do further invasive diagnostics/surgery at this time.
Her bile acids are not terribly high, ultrasound did not find a shunt, she shows no symptoms, so it will likely turn out to be MVD (and hopefully mild). As far as doing spay, and a liver biopsy, the vet says spay is easy, but adding biopsy means larger incision, longer time under anesthesia.... and if he were to do that then he should also be looking for a shunt and trying to fix it which increases mortality risk. That is all just TOOOO much.
So, I'm not even going to get her spayed right now. I'm just going to enjoy her and give her the best diet and supplements to support her compromised liver. I asked if we should repeat bile acid tests at some point, he said he feels there is no need as long as she is eating well and producing 1-2 stools per day. No problem there, she loves her homecooked food and vegetarian kibble. I'll continue to fine tune her diet with the help of the YT members and the yahoo groups, and possibly a dietitian. |
Sounds like a good plan. We had a Maltese on another forum get very sick following a liver biopsy during her spay. She had internal bleeding and needed several transfusions to save her life. It turns out all she has is asymptomatic MVD, but she had a vet who wasn't knowledgable about the current protocol for liver shunts/disease and recommended a biopsy during Adrian's spay.
This is one of the main reasons Dr. Center recommends all Yorkie puppies have a BAT test as puppies. This is from page 22 of Dr. Center's seminar handout:
"2: The best approach to avoid "over diagnosis" is to test bile acids in young dogs of highly affected breeds (at 4 mths of age) while they are clinically healthy and before they are adopted into pet homes. Highly affected breeds include: Yorkshire Terrier, Cairn Terrier, Maltese, Tibetan Spaniels as well as many other "terrier" type breeds (Miniature Schnauzer, Lhasa Apso, Shih Tzu, Dachshund, Bichon Frise, Pekingese, Toy and Miniature Poodles, and Havanese and others). Proactive assessment of serum bile acids will limit the awkward circumstance imposed when an MVD dog, with minor health issues, is suddenly recognized to have abnormal bile acids by a pet owner's veterinarian.
This circumstance can lead to unnecessary diagnostic confusion and unwarranted invasive tests such as liver biopsy and portovenography. How old dogs should be at he time of initial testing has not been established. Typically, abnormal bile acids DO NOT normalize as a dog ages ..... "