Hi... Kathy here. You have a problem. I have the same problem.
I also have a 4 YO female that I have been treating (per my vet) with L/D, antibiotics, Lactulose, and Denamarin, going on 2 years come this May. She's doing great, just an occasional UTI... or so I thought.
When I brought Tinkerbell home, I found out she had already been tested for liver enzymes. Her results showed a need for further testing, so a BAT was scheduled. Her numbers came in slightly (40/126) elevated, but were indicative of Liver Shunt (anything over 100 post = shunt per U of Tenn). My vet said to try her on the low protein food (not prescription) and meds (Lactulose and Denamarin). After 6 months, she had H.E. and was brought out of it with the Lactulose, then was put on a prescription diet, L/D. All else was kept the same.
So now another year has come and gone, and Tink is acting great. Hyper, playful, you-would-never-know-she-has-a-shunt, normal. No more H.E. Nothing except 1 or 2 UTIs. So I try to help others on here and I meet LittleLilly. And I see she has LS and Kidney Stones. They do not show up on xray, but do show up on Ultrasound. I thought it was best to wait and do the U/S at the same time I was going to schedule her surgery, but that was wrong. I needed to find out what shape her kidneys were in. So we did, and she has Kidney stones. Now I know.
This is what happens to dogs with Liver Shunt:
They eat food. Their liver cannot process the amonia and other waste products left over from the digestion process, so it gets passed on to the kidneys. The amonia changes the environment in the dog's kidneys making it able to produce kidney stones (amonium urates in LS dogs). Lactulose helps to bind the amonia in the intestines so they poop it out without going through the kidneys, but some still gets through, so it only slows down the process. They will still produce kidney stones eventually.
Once the Liver Shunt is repaired, the process of excess amonia stops, and the kidneys stop producing stones. Whatever damage was done to the liver goes away because the liver can regenerate itself once the bloodflow is restored. I don't know if kidneys regenerate or repair themselves. So the trick is, the shunt has to be fixed before the kidneys become permanently damaged.
Quote:
Originally Posted by Becca1  Received Lexie's BAT results and they were kind of shocking, especially since she is showing no symptoms. - Pre: 159 and Post: 380. My vet and I discussed this at length and basically our plan is to do nothing at this time. Does that seem crazy??? I talked to him about her being on Prednisolone prior to drawing her blood (but I didn't have her on this therapy but for about a week before at 1/2 tab every other day); he didn't think that amount would make these numbers high. I had read that it could. |
Yes, you need to get an ultrasound to see if she has stones, to find the shunt, and get her on Lactulose immediately, if she's not on it now.
Quote:
Originally Posted by Becca1 Thanks for your ideas; however, she's eating well, has put on great weight, plays, sleeps and is comfortable, I think I can get on it if things change. We will recheck her numbers; my vet and I discussed getting her to a specialist if something changes. Has anyone else out there gone further just because numbers were high - or has there been extinuating circumstances such as how the dog is feeling and acting? |
Yes...ME!
Tink had another BAT in Aug/Sept 2010. 267.5 pre/ 297.9 post. The BAT tests the actual Liver function. No change at all in her bahavior. Still bouncing off the walls. Dogs' livers can still function even if only 25% or less of the entire liver is actually working. And it will regenerate itself.
Tink recently had another UTI, and after reading LittleLilly's story I began to worry about kidney stones, so I immediately scheduled an Ultrasound to see how she was really doing. As I said, she does have stones, and as these can cause problems, I need to get her LS taken care of STAT,
before her kidneys go....
So... you need to move on this... get her on the Lactulose, get the Ultrasound, and schedule the surgery. Lactulose first, though.
Here's my thread:
http://www.yorkietalk.com/forums/sic...g-results.html
I hope this helps and wish you the best....Kathy