I think your doing a great job and you have medical experience. She is responding to you and her home.
I have to agree that she may be too young, too tiny and too fragile right now to go through the Bile Acid Test. Even though the 12 hour fast is NOT required anymore (Vets still need to be aware of the new protocol), I don't think she should do the Post Draw either right now....I think when she gets stronger - then yes the BAT is important.
I think if you trust your Vet and they say to continue with the IV, then I would do that, and the antib's too.
...BUT...I still think she has a Liver Shunt and I see no reason why she can not start on the meds and low protein diet.
Even if the shunt is confirmed, no surgeon would darn to LS surgery on a 9 week old, tiny and fragile sick pup. She needs to get strong and more weight before any good surgeon would consider her a candidate for LS surgery.
I would get her on Lactulose. Lactulose, a disaccharide sugar containing galactose and fructose, is used for the treatment of hepatic encephalopathy in veterinary medicine. The active ingredient, lactulose, works by reducing the ammonia build up in the blood. The large number of resident bacteria in the intestine consumes the unabsorbed lactose as their food and release lactic, acetic, and formic acid and carbon dioxide gas. These acids draw fluid into the colon, softening the stool. The acidification of the bowel contents draws ammonia from the bloodstream and locks it there to be emitted with the stool. This action aids the prevention of a form of dementia called hepatic encephalopathy.
I would get her on the proper food. Either Hills L/D wet or Royal Canin Hepatic LS 14 (prescription) (dry). Or take my suggestion about the egg and noodles. The issue with Meat, Chicken and Organ is that they are very high in protein AND very high in purines. They are basically poison to her little body. The toxins are so much and if she has a LS, those toxins can not be filtered by her liver, instead they escape thru the shunt and go right into her blood stream directly to her brain and so on. Being that she is so tiny and so young and so fragile right now, YES this can kill her....sorry to have been so blunt, but you need to know....
Protein from veggies and dairy (eggs and cottage cheese, goat cheese) is very low, and they are very low in purines too. So when you feed this type of protein (in small amounts, spaced out) her liver is not being stressed to the max, and the amount of ammonia that passes thru the shunt is very minimal, but that's where the Lactulose comes in, bc it will bind to those escaped toxins and help rid them thru her waste. But a diet needs to be mostly carbs, then veggies and then a very minimal amount of quality protein, hence a low protein diet.
She needs to be pooping often (like soft ice cream). The poop build up in her body is poison too. Until you get Lactulose, try feeding her a little apple sauce, this will help her at least get the poop building up out.
You guys are in my prayers, and please let me know if I can do anything at all more for you.... |