[iwannalollipop2]

It has now been about a year since we took little Lacy into the vet and got a blood test, showing sky-high liver ALT values. She was then and is still completely asymptomatic, but further tests still proved something was going on with that liver. We visited a specialist, who did the BATs and got the astronomical 150 and 248 pre and post-prandial values. They also did an ultrasound about a year ago, but her liver was so small they could barely tell if it was a shunt. There were also small calcifications in her urinary tract and/or bladder, I'm not sure. That vet did not recommend surgery on the possible shunt because of Lacy's size, and so we stuck to making her homemade food for dietary management (consisting of mostly rice, tofu, and cottage cheese for protein and carbohydrates, along with vitamins and fat sources).

Recently, she went in for her checkup and we had a new vet. This vet recommended we discuss the matter more, and even consult surgeons to see what they say about the possibility of closing a possible shunt. No vet ever mentioned that Lacy may instead have a combination of MVD and a small shunt, but from research I now think that may be possible and may explain her seemingly perfect health. A recent urinalysis shows calcium oxalate crystals at a "moderate" level, which isn't a good sign either. I did more research, and produced the papers for the Protein C test to the vet yesterday. She was pretty clueless about it, and took a while to read the instructions and figure them out for the blood draw. I think she got it right, but I don't know. It's on its way to Cornell, and I guess the next step is scintigraphy to confirm the presence of a shunt alone, or in combination with HMD, or HMD alone.

In the meantime, I'm worried about the crystals in her urine. I've tried to read documents about dietary management of calcium oxalate crystals, but it's all very confusing. Apparently tofu is high on the list of purine content, so I cut it out of the food and made a modified diet with just the cottage cheese and rice. There are also recipes listed for just stone management, but not liver management--the one recipe seems to include only black beans as a source of protein (I guess to limit both the calcium and oxalate) and includes brown rice instead of white. Should we try this diet? Do we need to be giving her more salt to get her to drink more, or will this affect her liver?

Sorry this post is so long, but there's just so much to think about now, and we're so worried about her. Lacy turned three in February, and on the outside is totally happy and healthy at four pounds--shiny fur, bright eyes, always barking and playing, and no signs whatsoever of encephalopathy (even after meals). If anyone has experience with an asymptomatic dog with a possible shunt, please share any advice! Thank you everyone!