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Originally Posted by NatalieE  My 9 year old, Cami, has been having liver problems on and off since I've adopted her almost 6 yrs. ago. Unfortunately, the problems are getting worse and happening more frequently. Recently, I have taken her to a specialist and a surgeon who recommends exploratory surgery. Her bile acids test is extremely high suggesting she may have a portal shunt. However, there is no guarantee that is the problem. She may have microvascular dysplasia. If there is a shunt and they put on a constrictor, again, there is no guarantee. Especially if the liver has a lot of scar tissue (won't know until biopsy results), it will cause the liver enzymes to increase and it will kill her. The protocol for now is Denamarin 90 mg. 1 x a day; Amoxitabs 50 mg. 2 x a day; Lactulose 2 mls. 2 x day; Pepcid AC 10 mg. 1/4 tab 1 x day. Her diet is Hill's L/D canned. She still has bouts of vomiting, diarrhea, and not wanting to eat. I have to force feed her when she gets like that. However I should mention, too, she is a very picky eater and always has been. If she doesn't eat, the stomach pains (gurgling sounds), vomiting and sometimes diarrhea starts. Then we end up at the vets getting fluids.   I don't know whether to go through with the surgery or not. My heart tells me no because she will be in pain and without me for 3 - 4 days. If she was 3 or 4 years old, I wouldn't have a problem with this, but she is 9 years old! She was a rescue and since I've had her, I have babied her. She gets separation anxiety if I'm not with her for more than 1 day. I can visit her in the hospital at 15 minute intervals. Also, there is no guarantee and she may die sooner than later. Logic tells me if she gets the surgery, we will know what is wrong with her liver. Today I consulted her regular vet and he, too, thought it would be best if she gets the surgery. I just don't know. I feel like I'm damned, if I do and damned, if I don't! 
What would you do? |
what I would do is consult with Dr Tobias at Univ of Tennessee. They do liver shunt surgeries and pre surgery consults all day every day.
I don't want to make assumptions, but I thought a scintography is the tool to use to clearly understand if you are dealing with a portal shunt, or something else wrong with the liver.
You are facing a multi-faceted decision area. There are no right answers or easy as pie kind of decisions.
For me, if I was to break this down into a decision tree I would:
a) find out "for sure" if there is a liver shunt ... and by the best specialists around.
b) consult with these experts as to the success rate of liver shunt surgery with a girl of her age and health record.
c) Consult with self same experts to see if no surgery; what can be done to manage the condition and her quality of life?
c) then decide if the risks of surgery, the anticipated benefits(ie quality of life issues), the costs, and other factors personal to you point you in the direction of which way to go.
My heart goes out to you and Cami. You will both be in my prayers and positive thoughts.