[107barney]

Originally Posted by Brodies Mommy

Hills faxed the holistic diet recipe to my vet. It wasn't created by her. She called the nutritionalist for hills and spoke with them. They said that he should use the L/D diet which she explained he was already on. They then recommended this. He has been on the Hills L/D diet for 6 months already and has seen no improvements.

This is what Dr. Center's from Cornell said to me : "We do not usee ameroid band constricters at Cornell, rather we tie the shunts off to the dogs individual tolerance determined in surgery. Ameroid constricters contract on their own after being placed around the shunt: some dogs cannot tolerate total ligation and they then develop multiple shunts when the ameroid constricts. To avoid that possibility, some surgeons place a "too large" ameroid that cannot totally occlude the shunt. When it contracts one hopes it optimally tied off the shunt to the dogs tolerance. As I said, we individually tie according to the dogs response, and do not use these constrictors."

As I said, we have been corresponding via email as she is in Africa.

FROM THE UT WEBSITE - seems ameroid constrictor placement still is what Dr. Tobias still recommends --

"What is the prognosis for dogs after ameroid constrictor placement around a shunt?
Survival rate from the surgery is over 95% for dogs with shunts treated by ameroid constrictor placement, and our long-term prognosis is better with this technique than with most other methods. Many dogs are clinically normal within 4-8 weeks after the surgery. Long term, about 85% of dogs with liver shunts closed with ameroid constrictors do well clinically. About 15% continue to have problems, probably because the tiny blood vessels inside the liver were also abnormal. Usually these dogs develop multiple acquired shunts and must be managed with a protein restricted diet and lactulose for life."