Also info from a similar thread:
Originally Posted by
kjc http://www.yorkietalk.com/forums/ima...s/viewpost.gif after skimming through some of the posts here I need to give some more info: Liver damage can be reversed to some extent with proper medication and feeding. The liver can regenerate and the medications support this regeneration. After you give her the Lactulose, you may see marked improvement within 24-48 hours if not some immediate improvement.
This is what happens: All puppies have a liver shunt. The shunt carries dirty blood past the pups liver to the mom before they are born and the mom's liver does the job of cleaning it. Normally this shunt will close up after birth and the pup will maintain normal liver function. In a Liver shunt pup, it does not close and the some of the dirty blood is taken to the heart or the brain and released back into the circulatory system. The pup becomes toxic after a while depending on the severity of the shunting.
When you feed the pup, bacteria in the gut break down the food and ammonia is released. Normally the liver removes this. In an LS pup the ammonia circulates in the blood stream and can cause symptoms like shaking, incoordination, seizures, head-pressing, etc. To help the pup, antibiotics are given to kill the bacteria and stop the ammonia production. Lactulose is given to absorb/bind the remaining ammonia, so the liver has less work to do remove it. It also hurries the food from the gut so it spends less time in the pup and he poops it out. Then Denemarin (or similar product) is given to support the liver by helping to remove toxins, preventing liver cell death, and promoting liver cell regeneration.
Feeding low protein, vegetable protein foods help by not overworking the liver. It is recommended to feed nothing over 18-19% protein. Hard boiled egg and cottage cheese contain good, easily digested forms of protein and can be added to her food.
So even though she's very sick now, on these medications her health can improve greatly. Some pups with LS are managed solely with proper food and medications, and can live a relatively normal life.
Originally Posted by
kjc http://www.yorkietalk.com/forums/ima...s/viewpost.gif after skimming through some of the posts here I need to give some more info: Liver damage can be reversed to some extent with proper medication and feeding. The liver can regenerate and the medications support this regeneration. After you give her the Lactulose, you may see marked improvement within 24-48 hours if not some immediate improvement.
This is what happens: All puppies have a liver shunt. The shunt carries dirty blood past the pups liver to the mom before they are born and the mom's liver does the job of cleaning it. Normally this shunt will close up after birth and the pup will maintain normal liver function. In a Liver shunt pup, it does not close and the some of the dirty blood is taken to the heart or the brain and released back into the circulatory system. The pup becomes toxic after a while depending on the severity of the shunting.
When you feed the pup, bacteria in the gut break down the food and ammonia is released. Normally the liver removes this. In an LS pup the ammonia circulates in the blood stream and can cause symptoms like shaking, incoordination, seizures, head-pressing, etc. To help the pup, antibiotics are given to kill the bacteria and stop the ammonia production. Lactulose is given to absorb/bind the remaining ammonia, so the liver has less work to do remove it. It also hurries the food from the gut so it spends less time in the pup and he poops it out. Then Denemarin (or similar product) is given to support the liver by helping to remove toxins, preventing liver cell death, and promoting liver cell regeneration.
Feeding low protein, vegetable protein foods help by not overworking the liver. It is recommended to feed nothing over 18-19% protein. Hard boiled egg and cottage cheese contain good, easily digested forms of protein and can be added to her food.
So even though she's very sick now, on these medications her health can improve greatly. Some pups with LS are managed solely with proper food and medications, and can live a relatively normal life. To clarify: Melody needs to be on Amoxicillin, Lactulose, and Denamarin
I wanted to post this info again...
Medications will help, probably more than surgery right now. Melody screams because the ammonia levels in her blood have gone to her brain. This is what causes all the neurological problems Krystal is seeing. This means this pup is very toxic. The AB's and Lactulose will immediately begin to remove and limit the amount of ammonia getting into her circulatory system, and will make surgery safer as she will have cleaner blood when she does have the sx.
Lactulose can also be given as an enema
during a seizure to immediately decrease ammonia levels in the bowel.
That Melody have survived this long tells me that she has some part of a functioning liver. The Denamarin helps to protect and regenerate the working parts, while the AB's and Lactulose stop toxins from reaching the liver from the intestines (digesting the food she eats).
And about the surgery: Not all pups are good candidates for surgery. The ones that are are young, and have one shunt located outside of the liver.
A band (made with milk proteins) is placed around the shunt and closes it off as it absorbs fluid. This takes about 3 weeks to happen. Then, if the liver doesn't throw another shunt, all should be good. If the liver produces another shunt, surgery will need to be performed again.
The pups with multiple shunts, and/or internal shunts (inside the liver itself) or MVD (Hepatic Microvascular Dysplasia) are not candidates for surgery. Tests to determine the type of shunting in a pup runs between $500-$1000, and surgery runs between $1400-$4000. The U of T tries to keep the price down as this is such a common problem, and it adds to their research.
Hope this helps...