Quote:
Originally Posted by MyFairLacy  I also posted on a great Yahoo MVD/livershunt group that I had joined over a month ago just to learn....I'm just not 100% confident in the vet we're seeing so far as this issue goes I guess and so I wanted some advice from some of you who have gone through this with your dogs to see what you all have done. The vet I saw did mention someone at the vet school that was great with ultrasound so we may just do that next after a urinalysis. I just haven't had enough classes yet to know indepthly about liver diseases yet...and I do know that some info is great online and some not.
The diet thing is a difficult one. I will not put her on prescription diets....I would want to go to homecooked if we no longer could do the raw. On the Yahoo liver group they have a receipe from Dr. Dodd that is homecooked with cod fish as a protein source so I'd probably try that. I just want to do what's best for her to keep her healthy, as I want to with all my pets. Low protein diets are so opposite of what I feed now so it would be a big change....especially with figuring out treats because ever treat I have in my pantry is a grain-free, meat treat...
the high pre value really confuses me....any info on that?? Especially since she was fasted almost 12 hours just doesn't make a lot of sense to me.
So what tests are you suggesting? Doing the urinalysis and then an ultrasound?
I know a liver biopsy is the only way to 100% diagnose MVD...but would you just jump to that or would you only do that with major symptoms? |
I would not open up a dog with suspected MVD for a biopsy alone.
It may be a good thing to do if the dog is being spayed (varying opinions).
Of course that isn't the case here.
Urinalysis is a good idea.
You could go to the Protein C test or ultrasound.
While Dr. Center's protocol is BAT, then Protein C then scintography if that is elevated, the assumption then is all Yorkies who have high bile acids and normal Protein C have MVD I guess. That obviously can't be right but I'm not sure how often that is the case and I'm not sure when she does recommend other testing. If you want to see the size of the liver and look at everything going on, the u/s is fine. If you are looking for a shunt diagnoses, it is as low as 60% accurate for that. We did a u/s and all we got out of it was a pancreatitis diagnosis. We did a biopsy and all we got out of that was mild bile stasis.
Remember if you get everything under control and she is "completely" asymptomatic, you can start increasing her protein as long as that protein is the right type. There is really no reason to leave an asymptomatic dog on 20 or so % in my opinion. That doesn't mean you would go to 40-50% either though. Too little protein isn't a good thing. While she is having symptoms and since it may be her liver, I would drop the protein % and get her on a better type as soon as possible.
I typically look at the post number. Haven't read too much on the pre but 95% of dogs with shunts have elevated pre. Most shunt dogs have a post over 100 though.