Liver Shunt and Bile Acid.
My yorkie, Matise has a liver shunt. I just had the bile acid test ran in Oct. and surgery as well. Matise showed no real clear signs until one day he started having seizures. He had 3 random un-diagnoseable vomitting episodes which has now been attributed to the liver shunt but no other clinical signs until he had the seizures. He was always quiet but I never had a yorkie so I didn't know and I thought that maybe his personality was mirroring ours. So after the third seizure we did the test and his results came back pre-meal 63.7 and post meal 212.3. So both of his results were very high. Matise was 14 months old at diagnosis, but the signs can start showing as early as 4 months.
A liver shunt is a blood vessel that carries blood around the liver instead of through it. In some cases a liver shunt is a birth defect ("congenital portosystemic shunt). This is the most common in yorkies. In other cases, multiple small shunts ("acquired portosystemic shunts") form because of severe liver disease such as cirrhosis. All mammalian fetuses have a large shunt ("ductus venosus") that carries blood quickly through the fetal liver to the heart. Since the mother's liver does the work of filtering out toxins, storing sugar, and producing protein for her unborn babies, liver function is not needed in the fetus. This ductus venosus is supposed to close down shortly before or after birth as the baby's liver begins to work. In some individuals the shunt doesn't close down; it is then called a "Patent Ductus Venosus", or an intrahepatic shunt. In other animals, a blood vessel outside of the liver develops abnormally and remains open after the ductus venosus closes. This is called a congenital extrahepatic shunt. This is the most common for yorkies.
Some red flags can include small stature, poor muscle development, behavioral abnormalities (circling, disorientation, unresponsiveness, staring into space, head pressing), seizures, and quiet demeanor. Other less common signs include drinking or urinating too much, apparent blindness, diarrhea, and vomiting. In some cases the signs are associated with eating protein. Other signs are when they take a long time recovering from anesthestics (i.e. barbiturates) or sedatives (i.e. acepromazine). Some show no signs until they are older, when they develop bladder and kidney infections and stones.
Bile acid test cost can range from $50-$100 depending on where you live. Ours cost $85 for the bile acid and the CBC $84. They often do a CBC to check the albumin concentration, blood urea nitrogen (BUN), blood glucose levels. They just draw blood so it really doesn't hurt them. What they do is, they ask you to fast your dog-NO FOOD of any kind for 12 hours before the test. Then they draw blood. Then they feed your dog a high fat food and wait 2 hours then draw blood again. They then test these 2 blood samples to see what the bile acid scores are. Normal pre-meal is <10. Normal post-meal are <15 to 20. They also consider other levels and usually do a CBC blood test to test for albumin concentration, blood urea nitrogen (BUN), blood glucose levels. Dogs with shunts have higher than normal scores both pre and post test. Matise's results came back pre-meal 63.7 and post meal 212.3. So both of his results were very high
There are different kinds of shunts but the most common in yorkies is extrahepatic portosystemic shunt. This is what Matise had and they performed surgery where they put an Ameroid Constrictor on the shunt. An ameroid constrictor is a metal band with an inner ring of casein, a protein found in milk. In the belly, the inner ring absorbs normal fluid and gradually swells, pressing on the shunt and encouraging it to scar shut.
Matise is recovering well and Dr. Moore expects him to make a full recovery it is a long process and a hard road to go down. We are very relieved and happy about the optimistic outlook. We are lucky that we had the resources to fix his shunt. I can guarantee you that I will have a bile acid test before I get my next yorkie. This has been a very difficult thing to go through and for Matise to go through. Not to mention very, very expensive. Matise had his stitches out yesterday and we go back for our 1 month re-check on the 18th then a three month re-check in Jan. and possible 1st post surgery bile acid and CBC blood work. Then again in April for 6 month re-check and blood work then again in Oct. 2006 for 1 year re-check and blood work. Now Genie (Cookie2) is going through this. It is hard. Let me know if I can offer you any other info, help or support. Check out the links in my signature they can provide you with some good info on Liver Shunts. | 