how young is too young to test for liver shunt??

[lulababy]

Okay I really dont know what to do. Let me just throw ALL the information out there because I see a lot being suggested that has already been done/attempted. Sorry if this is really long

When i first got him last friday I took him to Pebbles vet in the afternoon. She did a wellness check up on him. She did not notice anything wrong except he did not eat since 9am or so that morning and it was the afternoon--4:30pm. She did not watch him walk, and neither had I at that point really. He had been sleeping. She fed him some Hills precription diet a/d and gave me some cans to take home. She told me to feed something to him every 2hours and to slowly wean him onto the food I wanted to feed him by mixing it with the a/d. Offering him the a/d all weekend and sometimes trying to give him some of his old hard food (yes it is ground up very small).. it seemed he did not like his old food. I tried giving him, then, ground up lifes abundance which he took a few bites of then did not care for anymore. I also tried eukanuba small breed puppy ground up finely and innova evo ground up. ( I had basically all these left over foods because pebbles was a very picky eater as a young puppy and I tried A LOT). I even tried evangers soft food. He did not like anything and would only eat the a/d occasionally. By monday he would not eat the a/d either. I gave him karo monday morning because he had started to shake.. say around 11am. By 1pm he was still shaking his whole body and refusing food. Kind of shaking his head away and avoiding the food when I offered it to him like no no no!! So then, I decided to try the nutra-cal. After 30 minutes and he was still shaking i called the vet again and my normal vet was on her off day. So the other vet said to bring him in asap and he will look at him. By the time I got there he had stopped shaking. Those stupid vet techs took him back to parade around with him and I was liek look he is sick, please only do what you need to do. I really hate those girls. He is not some stuffed animal to show around. Anyway, I think they aer ignorant because I have to remind them everytime to take off the collar before they do the weigh as with the small ones this can make a difference!! On friday he was 1.2 pounds without a collar on when the vet weighed him. Monday the vet techs said he was 1.3--when the vet told me this i did NOTbelieve it as i knew he had not been eating and it didnt make any sense to me. SO the vet didnt think there was anything really wrong wiith him because "he was still gaining weight" (turns out later i find out the vet techs weighed him with his collar on--idiots). He checked the blood sugar and it was normal (probably due to the nutra-cal he said). I told him about the rubbing up against the furniture and walking funny. he put him on the ground to see him walk but bam bam only took a few steps and started jumping up to be picked up. i said he has to run for you to see it, then it is obvious. He was concerned about the furniture rubbing. I said I hope he is just marking and the doctor got a weird look on his face like he didnt want to scare me. Like something just hit him. He said "we can treat this conservatively or aggressively. At the moment I do not think he has liver shunt because he seems so robust, normally liver shunt puppies are way skinnier than this guy is. He is really small but he is compact and is not skinny." He then said, "I can do a full-blood panel but it might hurt one so little and I dont feel it is necessary at this point." He said if I had to bring him in again he would do the full blood panel. He sent me home with some more a/d and told me to feed bam bam some nutracal every 2 hours and then offer him some food 30 minutes after. He also said to try taking off his collar for two days, even though the bells were really lightweight, to see if that was making him walk funny. He told me his right back knee seemed a little soft, not yet anything to worry about, too young to tell but it might or might not end up being a luxating patellea and why he is walking funny. So I went home and I tried his reccomendations, but he was still walking/running to the side and wasnt eating the food always, 30 minutes later. The vet called to check up on Wednesday but I missed the call. On thursday I checked his weight again and he was 18.5 ounces. I fed him some chicken in a last attempt and he ate it 3 times that day. yesterday he ate it about 1.5 times. The week I got him, week 12, the breeder told me he was 1 pound 4.4 ounces. This morning he was throwing up. I weighed him again on an empty stomach and he was 17.5 ounces and only up to 18 after I syringe fed him some a/d with a little water.

I just dont know what to think. They checked his ears both visits and said they looked fine? I dont think he has an ear infection. I read about testing small babies for livershunt and it killing them. Being that there arent any outright livershunt symptoms that cant be explained away by something else[ I kinda do not want to force this test on him. I am VERY alarmed by his sudden weight loss. I have been keeping track of his weight since he was 5 weeks and he has not weighed this little since he was 10 weeks old- he was 17.6 ounces then. He is going on 14 weeks old on tues. I am getting this feeling if wr do a bloodpanel that nothing will come up. He is just too young for anything to really show up I think. Also, he is running around and playing, chasing pebbles, etc, when he is not asleep or lethargic. Other than his weight loss and sometimes shaking/lethargy he seems normal to me. The nutracal does seem to help when he seems weak. I just dont get why, after more than a week with me, when he seems so at home, why he isnt eating and drinking regularly. I am putting aside his potty training for now as I do not want to stress him out.

I just dont know what to do. I have people on one hand telling me get a bile acid asap and others telling me, like my mother, and others, that i am being paranoid/working myself up and he is fine, just "adjusting."

[Ladymom]

Originally Posted by MyFairLacy

I'm really confused why some of you would recommend a Blood Panel over a Bile Acid Test Both involve a blood draw...one is not any riskier than the other, and honestly, the risk of complications from a blood draw is very low. A blood draw is a common, routine procedure and the amount of blood they need for a blood panel or BAT is small.

Someone said if the breeder doesn't think he has a shunt don't test...please don't only trust your breeder. I know first hand that breeders will lie about having liver shunt problems in the past. If you and your vet think liver shunt is a posibility from the symptoms he is exhibiting, get that baby tested. The sooner he is tested, the sooner he can be treated if it is a shunt. Otherwise he will only get sicker.

A blood draw is a blood draw no matter what test you do on it afterwards. It makes no sense to say one is safer than the other.

A routine CBC often won't detect a problem with the liver until it is 70% damaged. I know of two Maltese puppies on another forum who had a bloodpanel which was completely normal and a bile acid test that revealed MVD.

If you suspect a liver shunt, the only accurate way to diagnose is first with a BAT, then a Protein C test, and possibly scintigraphy.

[Yorkieluv]

I think I shared this with you in your other thread...Weight loss, Shaking, lethargy, wobbliness, walking funny, vomiting, dark urine, head pressing, etc. are all symptoms of liver problems. This is easy to rule out with a BAT. If it comes back normal, that's great! But at least you've ruled that out. It runs anywhere from ($45-$100) depending on your area. They take a small amount of blood for this test.
If he does in fact have a liver problem, the a/d is one of the worst foods that could be given to him.
My yorkie is 11 lbs and he has a liver problem. Just because generally speaking, dogs with liver problems are smaller, my yorkie was not a tiny yorkie, and he does have liver problems.

[Yorkieluv]

Ultimately, only you and your vet can make this decision. We can all tell you what we think you should do or shouldn't do, but you are the one who has to make the call. We are all just sharing our experiences and opinions.

[gardenyorkies]

First of all..relax...Take a deep breath and lets think about this...

You have only had this pup for a week...I would recommend you call your breeder and suggest she take him back for a while...She can see if she can keep him and get him eating again...Once he is stable you could pick him back up...

Low blood sugar will cause a pup to stagger and fall over..If he is just eating protein (chicken) he is not getting enough sugar...Puppies run off their sugar and calories quickly...He is small and he does need to eat every 2-3 hours...Remember he is tiny and has a small stomach so he will probably only eat about a Tablespoon of food or two...Your vet gave you SD canned food to feed which I don't see any added sugar in it..

Ingredients for Science Diet...AD

Water, Pork Liver, Poultry Liver, Chicken, Corn Flour, Pork Protein Isolate, Fish Oil, Chicken Liver Flavor, Calcium Carbonate, Sodium Tripolyphosphate, Guar Gum, Potassium Chloride, Taurine, Choline Chloride, Vitamin E Supplement, Magnesium Oxide, Ascorbic Acid (source of Vitamin C), Zinc Oxide, Ferrous Sulfate, Thiamine Mononitrate, Beta Carotene, Manganous Oxide, Copper Sulfate, Niacin, Calcium Pantothenate, Vitamin B12 Supplement, Pyridoxine Hydrochloride, Riboflavin, Vitamin D3 Supplement, Biotin, Calcium Iodate, Sodium Selenite, Folic Acid.

Right now I think you need to get your puppy on a schedule of eating, sleeping and playing....He needs to be kept warm and get enough rest...Do not take him everywhere with you right now...Keep him home, feed him, let him play for about 20 mins and then put him to bed for a nap...Tiny puppies require more rest..

I would not jump the gun and assume he has liver shunt at this point...I also would not have a blood draw done right now...He is stable and you have some time IMO...If you decide to have a blood draw done right now they will have a difficult time getting it from a 1 pound puppy...Their veins are small and their blood supply is also small...I would not do a BA test and would do a hepatic blood panel at the most...The BA test will require twice as much blood and could be done once you get more weight on him and he is a little older...

You can also opt to have a liver ultrasound done and that is far less invasive...

I would suggest the following:

* Give about an inch of Nutri-Cal morning & evening
* Make a bowl of fresh water with a small amount of Karo in it and a bowl of
plain fresh water available at all times...You will eventually be able to omit
the bowl with karo...
* Feed puppy soft food every 2 hours...after several days you should be able
to cut back to 3 hours...
* Limit activity...Make sure he gets rest!


IF he will not eat then you can always syringe feed him the AD....

He needs to eat...If he doesn't eat he will lose weight...He doesn't have much weight to lose!...If he doesn't eat his sugar levels drop and he doesn't have the desire to eat...

I wish you the best with your puppy...Hope this little guy comes around for you!

[Woogie Man]

I'll say first off that I have no experience with a liver shunt puppy. However, if the vets do in your area like they do here, you won't get any results for days from a BAT. Here, they send out the blood to an outside lab for analysis. In the meantime, you have a tiny puppy that needs to eat. Overall, I would agree with Gardenyorkies on what to do now. With your pup being 13 weeks, he most likely has had a recent vaccination which could skew any test result. Plus, he seems to be in a weakened condition now so drawing blood will only weaken him further, if only for a bit. No one here can tell you for sure what is best for your puppy, that should be between you and your vet. If it were my dog, I would hold off on drawing blood until he had gained some strength (is eating better) unless the vet gave me a compelling reason to do otherwise. I would concentrate on getting that baby to eat, keeping him warm and making sure he doesn't over-exert himself for now.

[bjh]

I agree with Laura that returning the puppy to the owner might be the best option for now if it is possible. The puppy has to be stabilized and if you keep switching foods around the puppy will never get stable. The only reason I would recommend a blood panel is because it will most likely let you know if the liver is compromised. If the liver is compromised then the puppy would need to be on a special diet like l/d until further testing can be done. This all could just be due to recent vaccinations. Do you know what vaccinations the puppy had? Did he have a lepto shot? All these things are very important to know when it comes to knowing what is wrong with your puppy. The l/d is a liver cleansing diet and might be helpful to him if he recently had vaccinations or has a compromised liver.

[milliesmom]

hi i think it is about 18 weeks but you can check on livershunt.com they have their own web site and ask mary elizabeth she can tell you everything you need to know about shunts and procedures , but in the meantime to help your little one to not have further symptoms feed him a meat protien free diet get him on some vegetables and rice my livershunt pup only ever showed symptoms if she was fed meat you can also give baby rice puddings they love that but try had feeding him too it would be best to take him to the vet though he might be able to give you some hepatic puppy food good luck im praying he will be ok

[Ladymom]

Originally Posted by milliesmom

hi i think it is about 18 weeks but you can check on livershunt.com they have their own web site and ask mary elizabeth she can tell you everything you need to know about shunts and procedures , but in the meantime to help your little one to not have further symptoms feed him a meat protien free diet get him on some vegetables and rice my livershunt pup only ever showed symptoms if she was fed meat you can also give baby rice puddings they love that but try had feeding him too it would be best to take him to the vet though he might be able to give you some hepatic puppy food good luck im praying he will be ok

Yes, Dr. Center has just revised her protocol from sixteen weeks to eighteen weeks for a BAT. She has determined that giving the liver a few more weeks to develop gives a more accurate result.

[lulababy]

Originally Posted by gardenyorkies

First of all..relax...Take a deep breath and lets think about this...

You have only had this pup for a week...I would recommend you call your breeder and suggest she take him back for a while...She can see if she can keep him and get him eating again...Once he is stable you could pick him back up...

Low blood sugar will cause a pup to stagger and fall over..If he is just eating protein (chicken) he is not getting enough sugar...Puppies run off their sugar and calories quickly...He is small and he does need to eat every 2-3 hours...Remember he is tiny and has a small stomach so he will probably only eat about a Tablespoon of food or two...Your vet gave you SD canned food to feed which I don't see any added sugar in it..

Ingredients for Science Diet...AD

Water, Pork Liver, Poultry Liver, Chicken, Corn Flour, Pork Protein Isolate, Fish Oil, Chicken Liver Flavor, Calcium Carbonate, Sodium Tripolyphosphate, Guar Gum, Potassium Chloride, Taurine, Choline Chloride, Vitamin E Supplement, Magnesium Oxide, Ascorbic Acid (source of Vitamin C), Zinc Oxide, Ferrous Sulfate, Thiamine Mononitrate, Beta Carotene, Manganous Oxide, Copper Sulfate, Niacin, Calcium Pantothenate, Vitamin B12 Supplement, Pyridoxine Hydrochloride, Riboflavin, Vitamin D3 Supplement, Biotin, Calcium Iodate, Sodium Selenite, Folic Acid.

Right now I think you need to get your puppy on a schedule of eating, sleeping and playing....He needs to be kept warm and get enough rest...Do not take him everywhere with you right now...Keep him home, feed him, let him play for about 20 mins and then put him to bed for a nap...Tiny puppies require more rest..

I would not jump the gun and assume he has liver shunt at this point...I also would not have a blood draw done right now...He is stable and you have some time IMO...If you decide to have a blood draw done right now they will have a difficult time getting it from a 1 pound puppy...Their veins are small and their blood supply is also small...I would not do a BA test and would do a hepatic blood panel at the most...The BA test will require twice as much blood and could be done once you get more weight on him and he is a little older...

You can also opt to have a liver ultrasound done and that is far less invasive...

I would suggest the following:

* Give about an inch of Nutri-Cal morning & evening
* Make a bowl of fresh water with a small amount of Karo in it and a bowl of
plain fresh water available at all times...You will eventually be able to omit
the bowl with karo...
* Feed puppy soft food every 2 hours...after several days you should be able
to cut back to 3 hours...
* Limit activity...Make sure he gets rest!


IF he will not eat then you can always syringe feed him the AD....

He needs to eat...If he doesn't eat he will lose weight...He doesn't have much weight to lose!...If he doesn't eat his sugar levels drop and he doesn't have the desire to eat...

I wish you the best with your puppy...Hope this little guy comes around for you!

I am going to do all of this thank you. I will try to stick with this for the next few days and watch his weight to see if he improves

[Amazing Yorkies]

Originally Posted by Woogie Man

I'll say first off that I have no experience with a liver shunt puppy. However, if the vets do in your area like they do here, you won't get any results for days from a BAT. Here, they send out the blood to an outside lab for analysis. In the meantime, you have a tiny puppy that needs to eat. Overall, I would agree with Gardenyorkies on what to do now. With your pup being 13 weeks, he most likely has had a recent vaccination which could skew any test result. Plus, he seems to be in a weakened condition now so drawing blood will only weaken him further, if only for a bit. No one here can tell you for sure what is best for your puppy, that should be between you and your vet. If it were my dog, I would hold off on drawing blood until he had gained some strength (is eating better) unless the vet gave me a compelling reason to do otherwise. I would concentrate on getting that baby to eat, keeping him warm and making sure he doesn't over-exert himself for now.

Praying all goes well with your little guy!

[missj2007]

I am so sorry Bam Bam is going through so much. I wish I knew what to tell you but you are getting great advice from everyone on here. God Bless I will keep him in my prayers. I am so sorry

[Susan123]

Originally Posted by Yorkieluv

If by any chance, it is liver shunt a/d will cause more symptoms. It's very, very high in protein (on a dry matter basis)...Somewhere around 40% and contains all the wrong kinds of protein.

IF it's a liver shunt there will be more symptoms soon, get a blood chemistry panel done and stop feeding it anything other than what the vet recommends after the panel. Doesn't take a genius.

[bjh]

Originally Posted by lulababy

I am going to do all of this thank you. I will try to stick with this for the next few days and watch his weight to see if he improves

How is the baby doing this morning? I hope he is doing better.

[Cookie2]

Originally Posted by gardenyorkies

First of all..relax...Take a deep breath and lets think about this...

You have only had this pup for a week...I would recommend you call your breeder and suggest she take him back for a while...She can see if she can keep him and get him eating again...Once he is stable you could pick him back up...

Low blood sugar will cause a pup to stagger and fall over..If he is just eating protein (chicken) he is not getting enough sugar...Puppies run off their sugar and calories quickly...He is small and he does need to eat every 2-3 hours...Remember he is tiny and has a small stomach so he will probably only eat about a Tablespoon of food or two...Your vet gave you SD canned food to feed which I don't see any added sugar in it..

Ingredients for Science Diet...AD

Water, Pork Liver, Poultry Liver, Chicken, Corn Flour, Pork Protein Isolate, Fish Oil, Chicken Liver Flavor, Calcium Carbonate, Sodium Tripolyphosphate, Guar Gum, Potassium Chloride, Taurine, Choline Chloride, Vitamin E Supplement, Magnesium Oxide, Ascorbic Acid (source of Vitamin C), Zinc Oxide, Ferrous Sulfate, Thiamine Mononitrate, Beta Carotene, Manganous Oxide, Copper Sulfate, Niacin, Calcium Pantothenate, Vitamin B12 Supplement, Pyridoxine Hydrochloride, Riboflavin, Vitamin D3 Supplement, Biotin, Calcium Iodate, Sodium Selenite, Folic Acid.

Right now I think you need to get your puppy on a schedule of eating, sleeping and playing....He needs to be kept warm and get enough rest...Do not take him everywhere with you right now...Keep him home, feed him, let him play for about 20 mins and then put him to bed for a nap...Tiny puppies require more rest..

I would not jump the gun and assume he has liver shunt at this point...I also would not have a blood draw done right now...He is stable and you have some time IMO...If you decide to have a blood draw done right now they will have a difficult time getting it from a 1 pound puppy...Their veins are small and their blood supply is also small...I would not do a BA test and would do a hepatic blood panel at the most...The BA test will require twice as much blood and could be done once you get more weight on him and he is a little older...

You can also opt to have a liver ultrasound done and that is far less invasive...

I would suggest the following:

* Give about an inch of Nutri-Cal morning & evening
* Make a bowl of fresh water with a small amount of Karo in it and a bowl of
plain fresh water available at all times...You will eventually be able to omit
the bowl with karo...
* Feed puppy soft food every 2 hours...after several days you should be able
to cut back to 3 hours...
* Limit activity...Make sure he gets rest!


IF he will not eat then you can always syringe feed him the AD....

He needs to eat...If he doesn't eat he will lose weight...He doesn't have much weight to lose!...If he doesn't eat his sugar levels drop and he doesn't have the desire to eat...

I wish you the best with your puppy...Hope this little guy comes around for you!

Extremely well said! I've had this issue before and it's true,if they have no food in their belly theywill be very weak.I kept getting the same advice over and over....Syringe forcefeed .I gave about 1tsp-2tsp every few hrs also.The puppy faught me the whole time.So I used to make a pretty big mess.I felt he would never eat on his own because I was forcing the syringe feedings.I had friends hovering over me while I forcefed and they kept telling asking me why I was doing this to him! Finally I would mix a tiny amount of canned food with water,brought the syringe with me to a bedroom and LOCKED the door. I would sit on the floor with him and feed him. It would take sometimes 30 minutes to feed and my butt and back was killing me from sitting on the floor!
With more weight on him you can deffinately ask for the BAT test. I think everyone agrees that a BAT should be done but the difference is the TIMING and the WEIGHT is a big issue and very,very important. A BAT does require a pretty big amount of blood from such a tiny dog.My dog was about 2 lbs and he had a HUGE bruise in his neck when they gave him back to me.The vet felt terrible and apoligzed but she needed enough blood and it was not so easy to get it from him.PLEASE keep syringe feeding at least 1-2 tsp in a syringe every few hrs. It will be worth it. For me it turned out the be a bonding moment and he ended up being my favorite little guy

Genie
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