[Rescuemomma]

Originally Posted by kionini

If I had a couple of weeks to do my research, then I would have a better grip on how to tackle this LS, but do I have that time?

So far this is what I'm dealing with:

~Need to find out if LS is 'congenital' or 'acquired.' (not only to determine surgery(s) or life time sustainment/management, but also insurance coverage)

~Need to know if it's Extrahepatic (outside) or Intrahepatic (outside) of the liver to determine if it's operable.

~Need to choose best way to diagnose with the least possible invasion and/or risks to my baby:

.......Scintigraphy: Pros; Relatively safe & quick.
Confirms if LS is present or not
Cons; Requires sedation or anesthesia
Requires hospitalization for at least 1 night.
Cannot tell if it's inside or outside of liver.
Cannot tell if it's congenital or acquired

........Portogram: Pros; Usually safe & able to provide a picture (snapshot) of the shunt so it's easier to see where it is and if there are more than 1.
Cons; more invasive than the above method and requires anesthesia

........Ultrasound: Pros; safer
Cons; Requires a ultrasonographer with lots of experience and a specialized machine "Doppler." If person is not experienced, the shunts can be missed

Transcolonic Portal Scintigraphy: Pros; Noninvasive, doesn't require sedation or anesthesia and takes just a few minutes "currently the most accurate and safest way available."
Cons; Doesn't say if it will confirm where shunt is or if congenital. In my experience if they don't talk about it, then it's not there

The problem is that not all this options are available to me where I am. I may have to go to NJ or NY or farther in PA to find proper diagnosis and treatment

(((HUGS))) Sounds like you've got a really good grip on the basics. If you can find a hospital - I agree that the transcolonic portal scintigraphy is the best option, but if not - A VERY skilled internal medicine specialist doing an ultrasound may be able to find where it is. It's hard, especially if your Yorkie is a very small Yorkie, to see them on ultrasound sometime, and it takes a very experienced and skilled specialist to find them with ultrasound, but it can be done. Alot of people say ultrasound isn't worth it because the vets that are skilled enough to diagnose a liver shunt with ultrasound are few and far between, and it's very easy to miss it with ultrasound. Will keep you both in my thoughts and prayers!