[Ellie May]

lol, you're not a nut case.
Vision issues can accompany the hepatic encephalopathy from the toxins building up as does the appetite change.

Any reason after he got the second shunt and the vet realized this was going to be an issue that he wasn't put on Denosyl, milk thistle, vitamin e, omegas and lactulose for any neurologic symptoms?

Are you using the canned or dry L/D?

I would definately be talking to Dr. Tobias or Dr. Center as soon as possible.