Jon...this really saddens me, I feel so bad for you and Cooper.
I am not sure what type of relationship you have with your Vet...BUT...honestly, I do not think they are very experienced with Liver Shunt dogs. I am beyond shocked, that your Vet has racked up $1200 in tests and a Bile Acid Test was only just done yesterday...On a known Liver Shunt Dog, a BAT should have been the first test done, especially when the dog is walking into walls and drooling. These are classic symptoms of Hepatic Encephalopathy (HE)
Hepatic Encephalopathy
Who did Cooper's Liver Shunt surgery? Was it your general Vet or a Specialist? What were is BATs result before the shunt surgery? What were his BAT results after the shunt was closed?
I am not sure how far you are from U of Tenn??? But Dr. Tobias and her team are the leaders in Liver Shunt Surgery, and honestly, if possible that is where I would be heading in your case now with Cooper.
Portosystemic Shunts
...in the meantime, I would call your Vet and insist on getting an Rx for BOTH Lactulose and Metronidazole.
If your Vet will write you a prescription, Walmart or Costco will fill a larger bottles of Lactulose at a very minimal cost. The Metro has to come from your Vet though.
* 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.
Dietary protein restriction is helpful to lessen signs of hepatic encephalopathy, and antibiotics such as neomycin or metronidazole and other medicines such as lactulose can reduce ammonia production and absorption in the intestines.
Next is diet. Most dogs do very well on ROYAL CANIN Veterinary Diet® canine HEPATIC LS™ 14 DRY food.
OR, Hills l/d WET food. (The Hills l/d DRY isn't really recommended, I think it has pork in it).
Whether you choose the RC Dry or Hills Wet - Cooper should be eating about 5 to 6 small meals a day. This may go into the night time too. But it is important, as this is Less Stress on his Liver.
He should also be getting supplements to aid his liver:
Supplements:
* Hepatosupport (capsules)- contains milk thistle and B vitamins (substitute for Marin)
* VetriDMG liquid (substitute for Denosyl)
The above both available at
HomeVet© Natural Pet Care
If you call to place your first order and go over Coopers weight, etc.. The Vet there will write on the bottles how much Cooper should get daily. These two products are very easy to use, very easy on the dogs stomach, and pretty inexpensive.
OR
* Denamarin (Denosyl and Marin , but without the yeast and liver)
The Denamarin you have to either get from your Vet or you can get online. It is more costly than the two above, and you have to feed it whole and on an empty stomach, which can cause stomach upset.
And lastly, but VERY important...
Please join this group:
DogLiverDisease : Dog Liver Disease
This group has some much experience and knowledge with Liver Shunt Dogs it is really a blessing..They WILL help and Guide you even further to ensure you are doing the very best to help Cooper get better.
...Now for MVD...
MVD
Did they biopsy Cooper's liver when the repaired the shunt? Most surgeons will do this as well, bc a lot of times, dogs with a Liver Shunt also have MVD.
Also, dogs that have Liver Shunts repaired, then can shoot another shunt or acquire MVD down the road, that is why it is important to follow the above protocol for LS dogs, maintaining them with a special diet and supplements for the rest of their lives...
I think I have covered it all
