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Old 06-03-2008, 08:16 AM   #1
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Unhappy Could it get any worse? Yes, apparently it can...

Sorry... this is a long one…

I had posted about a week ago about Ruthie's liver shunt issues… So I had finally come to terms with it, and felt better about everything — from talking to people on here, as well as my vet — who recommended NOT doing surgery and bringing her in every couple months for bloodwork to keep an eye on her because she is doing SO well on the drugs and special food right now — she has virtually NO symptoms and is very energetic and happy.

Anyways, I took Ruthie AND Oscar to the vet yesterday (Ruthie for follow-up bloodwork and Oscar for his annual exam).

Ruthie's tests came back exactly the same and now they are recommending further testing (scintigraphy) to determine if it IS a shunt, how big, etc. Then, based on that, possibly surgery…

OSCAR'S results came back elevated as well. His weren't nearly as high as Ruthie's (hers was 249 pre and 231 post) — Oscar's was just a random bile acid test - not the fasted one, and his result was 51 or something... According to my vet, normal range is 1 to 10. SO, now they want to do a proper BAT test on him in the morning where they'll take values before eating and after. Based on that result, they will recommend a scintigraphy test be performed on him at the same time as Ruthie.

Sorry for the long post... I'm absolutely devastated. What are the odds that BOTH my dogs could be liver compromised??? They aren't even from the same breeder! I seriously can't take this… emotionally or financially. I feel like throwing up. Oscar has had NO symptoms - he was always a healthy puppy. I'm tempted to not bother with any further testing on him... but does that make me a jackass? I'm thinking of doing the BAT tomorrow, but even if they recommend the scint test for him, I may decline.

What would you all do? Keep in mind, I've already shelled out $4000 this year for Oscar's broken leg — plus now an additional $1500 in testing, etc. for him and Ruthie. Not to mention the $600 surgery to have Oscar's plate removed from his leg in a couple months. I have no idea how much the scint test even is.. but I dont' imagine it's cheap. Then surgery!!! Ugh, I can't even imagine doing surgery — Ruthie is only 2.5lbs for pete's sake!!! Oscar is only 3.5lbs...

I dont even know why I'm posting... i have no idea what to do... I hate having to make these decisions and it's me alone that has to make it.

Does anyone have any advice or suggestions? Has anyone's dog tested around 50ish and NOT had liver issues?

Please help... I'm losing my mind here. All I wanted was a couple dogs to love — I love animals SO much... I did the research, I found reputable breeders with great reputations — I thought I did everything right... so what's the deal... How is this possible???
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Old 06-03-2008, 08:40 AM   #2
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If its liver shunt, can the breeder you bought them from help with the costs of the surgeries?

I feel sooo bad for you... I would be exactly in your shoes too. financially its such a burden when you are going it alone.

Try to take things one day at a time. One test at a time and make decisions when you have all the info to make the next decision. Looking at the big picture can be too overwhelming to even comprehend.
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Old 06-03-2008, 08:47 AM   #3
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Sadly, it isn't surprising that there are two dogs in one family with a liver problem. This is so common in Yorkies.

I would do further testing with Ruthie if you can afford it.
If not then just do your best.

For Oscar, why did the vet do a random bile acid test?
It is important to get the results from paired samples.
Now you are stuck paying for a second test...
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Old 06-03-2008, 09:06 AM   #4
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Ruthie and Oscar came from two different breeders, so I guess I'm just having some really bad luck.

As far as the breeders helping out, Ruthie is 2 and Oscar is 2.5 — long past there health guarantees. I had such an ordeal just getting Oscar's papers from his breeder… we are no longer in contact. Ruthie's breeder has been great offering advice, etc... but I can't really expect her to help out with costs. She says Ruthie is the first of her dogs in 3 generations to be diagnosed with shunt.

It's not just the cost of surgery... it's the risk involved. They are both sooo small...
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Old 06-03-2008, 10:41 AM   #5
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Default Be careful--

Sometimes I wonder if some of this liver trouble is invented by the veterinarians as a money making gimmick. They just decided to run a BAT on the boy for what reason? Something fishy here. I would definitely not be considering surgery on either of these dogs; they are way too small. Watch what they're eating and avoid unnecessary medications and vaccinations. As for the boy testing 50ish on the bat, I'm very curious about that for my own personal reasons. Good luck, and be careful.
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Old 06-03-2008, 10:43 AM   #6
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Cali had Ba results first test 0/93 ish and second one 0/43ish and she had a liver biopsy that showed very mild MVD internal shunt and requires NO treatment. I just had her bloodwork done 2 years later and her liver values were all normal. I did not redo the BA as vet felt it wasn't necessary. I pray both your babies are ok. I know where you are coming from. I soent 8000 on Cali the first 8 months I had her and now my Pom has been sick for over a year and the vet bills are killing me. Pixie is in right now for dental and when I go pick her up I have to tae Maya in as she is really acting sick. The emotional and financial tolls are high so I really feel for you. I will keep you in my prayers
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Old 06-03-2008, 10:51 AM   #7
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I think you should do the Protein C test. It isn't too costly at all and it's a yes or no if they have it. BA's can vary from so many things..stress, foods and everything like that although Ruthie's are very high.
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Old 06-03-2008, 11:00 AM   #8
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Default Protein C--another thing I'm curious about

When a friend's Yorkie puppy recently tested 50ish on BAT I recommended the protein C but her vet gave her some fancy reason why it doesn't work. Her vet says she can see a big shunt on the ultrasound and wants to do exploratory liver surgery as part of the spay (for $4000 extra). The whole idea makes me break out in hives. Isn't a BAT of 50 inconsistent with a BIG shunt?
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Old 06-03-2008, 11:04 AM   #9
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Has either of your puppies been put under anthesia? My Gizmo had a liver shunt, and he has symptoms from the start. One of which was almost not waking up after going under anthesia. His BAT results were well over 300. If it were my babies and they were not showing any symptoms but the vet is running all these tests with the puppies not related. I would get a second opinion before even thinking about surgery.
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Old 06-03-2008, 11:26 AM   #10
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Originally Posted by Wrenee4 View Post
I think you should do the Protein C test. It isn't too costly at all and it's a yes or no if they have it. BA's can vary from so many things..stress, foods and everything like that although Ruthie's are very high.
I was told that "Protein C tests were useless", so my vet didn't recommend I go that route. That's the first time I've heard anything negative about the Protein C test, a lot of people have recommended it. I was leaning towards a scintigraphy test but found out today that it costs $1400 dollars!!! and that they have to keep her for 3 days because it causes her body temperature to rise?? I said no. At this point, we already know that she is liver compromised. A scint test isn't going to tell me how big the shunt is, how MANY shunts there are, or if it is inside or outside of the liver. I can't afford to shell out that much money for another inconclusive test. If I'm paying that much money I want to know exactly what, where, how big, etc.

I've questioned my vet about every possible thing I can think of — and I actually have great faith in him. Ruthie's tests have come back TWICE with the same results, and she was symptomatic ('small' symptoms, nothing neurological) BUT, Oscar has had ZERO symptoms, and I do wonder if there are any other factors that could cause his test to be slightly elevated like that. Tomorrow morning we will perform a BAT on him and get a better idea of what's going on.
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Old 06-03-2008, 11:32 AM   #11
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Quote:
Originally Posted by belindaY View Post
When a friend's Yorkie puppy recently tested 50ish on BAT I recommended the protein C but her vet gave her some fancy reason why it doesn't work. Her vet says she can see a big shunt on the ultrasound and wants to do exploratory liver surgery as part of the spay (for $4000 extra). The whole idea makes me break out in hives. Isn't a BAT of 50 inconsistent with a BIG shunt?
From what I've read, a BAT of less than 100 USUALLY indicates MVD and NOT a shunt, but that's not always the rule. My vet suspects ruthie has a shunt (her numbers were 249/231) and that Oscar has MVD (51). My vet also said the Protein C test was useless...
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Old 06-03-2008, 11:36 AM   #12
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Quote:
Originally Posted by SassyAnn101 View Post
Has either of your puppies been put under anthesia? My Gizmo had a liver shunt, and he has symptoms from the start. One of which was almost not waking up after going under anthesia. His BAT results were well over 300. If it were my babies and they were not showing any symptoms but the vet is running all these tests with the puppies not related. I would get a second opinion before even thinking about surgery.
That's the thing — Oscar has been through FOUR surgeries in his life already with ZERO complications! One was for his neuter, the other 3 were on his leg for when he broke it - and one of those surgeries was only 3 months ago. I'm really hoping his results were a mistake and that some other factor caused his numbers to be elevated. I will definitely NOT be doing surgery on Oscar, and at this point, I'm even thinking no surgery for Ruthie either. She's doing so well with no symptoms right now - none for over a month now, and I just can't justify putting her through the trauma of surgery... or worse, risking her life.
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Old 06-03-2008, 11:40 AM   #13
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Each individual has to determine at what point they have reached their financial limit in caring for their pet(s). It's a PERSONAL decision, and no one should judge you for whatever you decide. You are not obligated to continue pursuing all kinds of tests. Deciding to either re-home or stop testing does not make you a bad person!
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Old 06-03-2008, 11:41 AM   #14
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Quote:
Originally Posted by Patti View Post
Cali had Ba results first test 0/93 ish and second one 0/43ish and she had a liver biopsy that showed very mild MVD internal shunt and requires NO treatment. I just had her bloodwork done 2 years later and her liver values were all normal. I did not redo the BA as vet felt it wasn't necessary. I pray both your babies are ok. I know where you are coming from. I soent 8000 on Cali the first 8 months I had her and now my Pom has been sick for over a year and the vet bills are killing me. Pixie is in right now for dental and when I go pick her up I have to tae Maya in as she is really acting sick. The emotional and financial tolls are high so I really feel for you. I will keep you in my prayers
Thanks Patti I'm really hoping that worst case scenario he has a mild case of MVD. I really don't think he has a shunt, and his numbers weren't THAT high. I can look back with Ruthie and think "okay, maybe she did have symptoms", but with Oscar, I can't think of anything. He's always been happy and healthy.

I hope Maya is okay
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Old 06-03-2008, 11:42 AM   #15
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Quote:
Originally Posted by Oscar's Mummy View Post
I was told that "Protein C tests were useless", so my vet didn't recommend I go that route. That's the first time I've heard anything negative about the Protein C test, a lot of people have recommended it. I was leaning towards a scintigraphy test but found out today that it costs $1400 dollars!!! and that they have to keep her for 3 days because it causes her body temperature to rise?? I said no. At this point, we already know that she is liver compromised. A scint test isn't going to tell me how big the shunt is, how MANY shunts there are, or if it is inside or outside of the liver. I can't afford to shell out that much money for another inconclusive test. If I'm paying that much money I want to know exactly what, where, how big, etc.

I've questioned my vet about every possible thing I can think of — and I actually have great faith in him. Ruthie's tests have come back TWICE with the same results, and she was symptomatic ('small' symptoms, nothing neurological) BUT, Oscar has had ZERO symptoms, and I do wonder if there are any other factors that could cause his test to be slightly elevated like that. Tomorrow morning we will perform a BAT on him and get a better idea of what's going on.
I've done a lot of reading on this topic because Logan is being tested for liver shunt. I read that a high protein diet can cause the results to be higher than normal.
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