My Yorkie needs 3 operations....
 

Hi,

I am facing a very difficult decision and I'm hoping conversing with other Yorkie owners will help me thru this.

In May of 2008 we adopted 2 male Yorkies (brothers). Moxie is larger and stronger of the two, very active and very loving. Eli is less active but also very loving. Moxie, the parents and siblings are all heathy.

Approximately two months ago we noticed Eli developed a limp and his rear legs were gradually becoming weaker and unstable. A month ago the vet did an x-ray and determined Eli may have early stages of hip dysplasia. It was decided to bring him back in one month for more x-rays.

Yesterday when I came home from work and took the dogs outside, I noticed Eli was struggling to pee. After several attempts all he could produce was a slow drip. Shortly after we were on our way to the vet.

The vet suspected bladder stones but could not see them in an x-ray. An x-ray of Eli's hips did verify hip dysplasia. The vet instructed me to take Eli to the emergency hospital immediately.

At the emergency hospital they gave Eli a mild sedative and inserted a catheter to drain his bladder. An ultra sound verified bladder stones. Although the stones will need to be analyzed, a blood test leads the vet to believe Eli has a liver shunt. The vet gave me my options, I held Eli for a short time, paid a deposit and then drove home to discuss the situation with my wife.

At 1:00 my wife had a long talk with the vet and we decided to go ahead with surgery to remove the stones to buy us time to make other decisions. Because Eli will need surgery for hip dysplasia and for a possible liver shunt we asked the vet what he would do if he were us. We understand Yorkies can have difficulties with anesthesia. The vet felt 3 major operations may be too much for Eli and there are no guarantees he'll survive. He basically said he wouldn't do it and we should consider the alternatives.

I hate to make a decision on Eli's life because of money. But there are no guarantees that he will live a happy and healthy life after all of this or will survive the operations. We are looking at $1300 for last nights surgery, $3-5000 for liver shunt (more if 2 operations are required) and $1000+ for hip operation.

I'm hoping you all can provide information and help me with very hard decision. What would you do?

Sorry for such a depressing message. Thanks to all who respond.

Moxie and Eli's dad.

I'm sorry I am no help I just wanted to say welcome to Yorkie Talk and I'm sure tehre is someone on here who can help you through this.

Bless your heart. I am so sorry that you and your family are having to go through this, and of course poor little Eli.

I would certainly seek a second opinion. I think it's good you did the bladder stone surgery. You can know get some diagnostics done to address the liver problems. Your vet would start with comprehensive bloodwork (I am assuming they did some blood work last night??) and a bile acid test, which is done before and after fasting.

There are several things that could be going on there, ranging from mild to severe. If it is something like a mild case of MVD, you can usually manage that with diet and supplements.

By hip dysplasia, do you mean Leggs-Perthes Disease? I have several friends on here whose babies have been diagnosed and treated, by surgery, and are doing extremely well.

Please don't be discouraged just yet. I hope you can get a second opinion by a vet who is a little more positive. How old is your baby and what is his size? Does he present with any symptoms aside from lethargy that might indicate liver problems? Some of these include (but not limited) to head pressing, turning circles, picky eater, vomitting, etc. Anything like that?

amandawash -
 

Yes - they did blood work last night - the results led the vet to believe Eli has a liver shunt.

Yes - by hip dysplasia, I mean Leggs-Perthes Disease. The vet did tell me they have very good results with the hip operation.

Eli is 8 months and approximately 9 lbs. He certainly has a big appetite as he's on the heavy side so he's not a picky eater. He presents no liver shunt symptoms. He's not as active as Moxie and sleeps more but I would say it's because of hip pain.

There were 5 stones in his bladder. Around noon he pulled out his catheter so they left it out because he was peeing on his own. If he's eating by tomorrow we can pick him up otherwise he has to stay until he eats.

I'm hoping because he doesn't shown any liver shunt symptoms, maybe it's a mild case that can be treated without surgery.

Thank you for the responses.

Hey! Well that all sounds like pretty good news!! I understand the vet did bloodwork, but I beleive (I have no experience myself w/ liver shunts but I am sure someone else who does will chime in and correct me if I'm wrong) that bile acid test is really the only way to determine the extent of liver problems without ultrasound, biopsy, etc. The bile acid is done by fasting for a certain amount of time, taking a blood sample, feeding, and then testing again. Since your situation sounds like it was quite an emergency, I doubt that test was done.

Do you have the test results? If so, could you post some of the numbers? Many on here have extensive experience with this stuff.

He has several things in his favor, and one of those being his size. I think it would be a much worse prognosis if he was 2lbs. You can go visit Delisa2850 and Robin, Mxkids. Both of them have recently had LP surgeries done on their kiddos, and they are doing GREAT!!

Did you vet provide you with any other information about treating/diagnosing the liver problems?

OMG I'm so sorry you and your little Eli are going through so much!!! I definately agree with Amanda you should get a second opinion before you choose not to go ahead with any necessary surgeries!!!!

Sounds like you have gotten some good news lately!!!! YAY!!!

Please keep us up on what's going on with your furbaby!!!

I would get him tested the liver problems could be something not as serious like MVD which I have heard can be controlled with the proper diet

So Sorry. Will pray for you.

Just got a call from the vet and Eli is ready to come home. Just waiting for my daughter and we're on our way to get him. The vet says he's doing great and they have all fallen in love with him!

I will post information as to where we go from here later.

Thanks to all who answered!

So happy he is coming home!! My Cali has very mild MVD Internal liver shunt) thay has needed no treatment so hopefully that will be the case with your baby.

I'm sorry about little Eli. :(

If this were my dog and there was any way possible that I could afford it, I'd be doing all that is possible.

Liver disease is not a death sentence.
The stones are most likely secondary to it.
If you take care of the stones he has now and take care of the liver, maybe the stones issues will go away. The vet cannot possible tell you it is liver shunt by one blood test. If they say they can, I think I'd find a new vet. A pre and post meal bile acids test sent to a lab is a good clue but diagnostic imaging needs to be done or a Protein C test. MVD (small shunting throughout the liver) can be managed by diet and supplements. Intrahepatic shunts (shunts inside the liver) are hard to get to and probably can't be fixed. These dogs would be managed also. Extrahepatic (outside the liver) shunts can usually be repaired but problems can develop after surgery. In a young dog, it is most definately worth a try.

Why doesn't a Yorkie have a good chance of making it through three major surgeries? IF the right anesthesia is used and the right pain meds (absolutely no NSAIDs), they can do very well with liver disease and surgery...

Don't know much about hip problems but I think I'd consult with an internist about the liver issues and see when this surgery should be done.

University of Tennessee (best place to have liver shunt surgery done) is probably the cheapest (under $2000). Corness is another excellent place and may be cheaper than $3-5000. That is waaaay too much in my opinion.

Hope everything works out for you. :)

Welcome
 

You sure have your hands full.:rolleyes: You will be happy you found this site. There are alot of people on here that know there stuff.:thumbup: I've got to agree with prior posts. Get all the data and get a second oppinion,if you feel you need to. Never second guess your heart. These vet bills can be overwhelming. Take it on step at a time. Make the decisions that are best for you and your little one. He's blessed to be with a family that cares enough to adopt two pups at once. Hang in there and post us the lab info, and anymore questions and support you need. Good luck and hugs and kisses to your little man.

I am pretty sure the reason your vet is so certain that your baby has a liver shunt is because of the stones...The type of stones that liver shunt dogs produce are ammonium urate and are NOT seen on x-ray and are ONLY seen on ultrasound....Of course, liver shunt can't be diagnosed only from that, but like I said, that's a VERY good indicator...
The only dogs that produce ammonium urate stones are Dalmations and dogs with liver shunt/disease...
Many times, these stones are the only symptom of liver disease...Does your baby exhibit any symptoms other than the bladder stone issues?
Picky eating? falling over? acting drunk? drooling? vomiting? etc?

Do you have any lab values? You should get copies of all of that from your vet.

Liver disease is not a death sentence, and many liver compromised dogs have had surgery. My yorkie has had a total of 3 surgeries (I think...), and he is still alive :) You just have to provide maximum liver support and make sure they use the RIGHT anesthesia and be very, very careful with pain meds...

Eli has been home for 15 hours and is doing well. He has no bladder control and pees red but that's normal for now. He has been walking a lot, even went after the cat (he loves our cat) a few times and he is eating VERY well. Overall he seems to be in good spirits.

Yorkieluv - Eli exhibits none of the symptoms you listed. The vet that operated was at the emergency hospital - not Eli's vet. We were told to take him back to Eli's vet along with the stones for further testing so we don't have any lab values. They did say when they called to say he was ready to come home that his tests look promising - wish I had asked for more info.

Tomorrow I will get in touch with Eli's vet and see where we go from here.

Thanks to everyone for the information - it will certainly help me make sure he gets the proper testing.

Moxie and Eli's dad

Here are the latest news on Eli. He has healed well and is back to his normal self. Last Friday he went in to have his staples removed and for his bile acid test. We received the results today - not good!:(
His Pre Meal Bile Acid was 94 - Post Meal was 196.1

We haven't heard our options yet and he still needs hip surgery.

He is 8 months now, 9.5 lbs. What baffles me is he shows NO signs of liver shunt other than the bladder stones we had removed. He eats very well - very playful but tires easily - seems very happy despite his deteriorating hips.

I would appreciate anyone to tell me how serious the numbers are. Also, any advice on what should be done next. I want to make sure I'm somewhat educated for the next specialist visit.

Many thanks to all replies. Moxie and Eli's dad.

Having dealt with bladder stones and heart issues in my yorkies, in my opinions it is best to go to a veterinary teaching hospital for any serious case.

The closest one to you that I know of is Cornell University in New York, but there is also Angell Memorial in Boston which I've heard good things about. I suggest you make an appt. with them and let them help you work through this case.

Also if your yorkie has any bladder stones in the future if they are caught when small enough they can do a procedure called eurohydropulsion which expresses the stones out the urethra and no incisions are required.

If surgery is still required it can also be done laparoscopically, our dog has had a cystotomy (bladder stone surgery) 3 times and one of those was laporoscopically and he recovered much much quicker.

Liver Shunt Group
 

You may want to go to this link and check out this Liver Shunt Support Group on Yahoo. My Yorkie doesn't have a liver shunt but she had high Liver Levels as a result of medication she was on and this group was great at giving me advice.

Liver_Shunt_And_MVD_Support : Liver Shunt & MVD/HMD Support

Almost everyone in this group has gone through similar issues with their furbabies.

Hope this helps.

Lee Ann

did you get them from a breeder? If so did they have a health contract?

They came from a forever home breeder. the only thing in the contract is they will replace the dog within a year if anything happens to Eli. That doesn't help us...

I have joined the support group - they have been a big help. On Monday we are meeting with the vet and specialist to decide what to do next. At this point I'm leaning towards taking Eli to UT.

I am so sorry to hear of his health problems. i have not experience with this but would like to add that their are organizations to help with health costs. their are prerequisites and I dont know what they are, but the option of making payments could ease the financial burden. Hopefully someone here can point you in the right direction as to the web site addresses. prayers for you...

Bumpin' this up.

have you tried contacting the breeder to let her know many she will help.

I will make my story short, but, my son bought a golden retriever pup 3 years ago. Our son moved back home with us for a year, in between renting and buying his first house. When he moved out, the dog stayed, as I had boughten a german shepherd and the 2 dogs were so close to one another, we didn't want them separated. We noticed one day the golden wasn't getting up as easy, etc etc. So, took her in to the vet. She did an xray, and the golden had the worst case of hip dysplasia she had ever seen in such a young dog. she did say the surgery was an option, but, very expensive. We decided we were going to try the meds. So, she's on a pain pill( 1 1/2 pills twice a day) and they had her on rimadyl(for arthritis), Well, the one pill for pain, I get filled at walmart(3 mos supply under $20) and the rimadyl was closer to $400 for every 4 mos. So, I started cutting back on the rimadyl, and started giving her glucosamine tablets from petsmart. They had also given her glucosamine shots for 8 weeks straight, and said most likely she would have to have another shot every 2-4 weeks the rest of her life(that was back the last weekend in August). We had to take her back in about 4 weeks ago, to make sure her liver etc was still fine, and they were amazed with her. She's gaining back some muscle, and she's actually running fast again, and is able to put her paws up on the fence and us, and the trees(which she wasn't able to do for awhile). We decided against the surgery, it was so expensive, and the vet said there was no gurantee with it. If you would like the name of the pain pill so you can ask your vet about it, just pm me and I'll send you the informataion. I feel so bad for you, I know where you're coming from, but, as I said, when the vet said there was no gurantee with the surgery, we opted to go the less expensive way, and it's working great. We're usually always home, so the meds twice a day is no problem for us, and if we do go away, our son swings by and gives her her pills.
Good luck on whatever you decide!

Liver Shunt
 

DJ was around 6 when he had biopsies done and had no problem with the anesthesia. Just make sure the vet/s use the proper dosage and right kind of anesthesia. While under the vet surgeron found an external type shunt and closed it off with a ameriid(?) type constricter and DJ did ok. Glourmerii disease, where protein is not retained by the kidneys and put back in the body and is lost, and chronic renal failure (CRF) were his down fall late jan 08. 4 biopsies and shunt surgery cost 2,800. There is a credit card called Care Credit that is very helpful in financing pet surgeries (also some people dental offices). The Yahoo group is very good for info and support. I am very sad that you and your wife are being faced with these surgeries. We went through the same with DJ. PM me if you would like more info such as web links. Bob

Thanks to all for the responses.

Yes - I have contacted the breeder to see if any of the siblings or parents have had any problems. She said no that this would be the 1st. My wife noticed the breeder's website suddenly has been removed.... I'm not trying to blame them for any of this - I just hope they don't try to ignore us and be honest with any questions we have.

Other than Eli's hips, you would never know there are problems. He loves to play and eat. This weekend he was running thru the house alot but his stride is more of a hop. He loves the cat and is constantly aggravating him.

Today we are hoping to meet with the vet and specialist is discuss the options - we're just waiting for the vet to call to set up a meeting. Wish me luck.

This situation sucks :( ...

At 9 months old, he can still live a long, happy life. If he were older or the prognosis dire, then it would be a less difficult decision.

I would definitely be all over the breeder ... as in calling every day. Re-read the contract if you have one, most have a health guarantee for the first year.

Liver shunt is often treatable.
Hip dysplasia is treatable.

The cost is what is so hard to fight with. It's tough because we don't want to back down if it is something that we could have helped with. At the same time, at some point the $ becomes too great of a factor.

Sending good vibes ...

Here's a long overdue update. It's been a hectic winter with the snow raising havoc with the power system ( I work for the power company) and kids sports.

In January I drove Eli to University of Tennesee. It was confirmed he has a liver shunt, he was operated on the next day and 2 days after the operation we were on our way back to Maine. He recovered rapidly - has become more active and even grew more shortly after the operation. In a coupe more weeks we'll be taking him in for his BAT's. If everything is OK, he will be scheduled for his hip operation and then - hopefully, he'll have a normal healthy life.

MoxieEli

I am so happy for you!! What a good dad you are driving from Maine to Tennessee!! Eli is lucky to have you. My Joey is recovering from liver shunt surgery. He also had no symptoms except for the abnormal bloodwork and stones. He is slowly healing, but the poor thing is exhausted. I wish all the best for you and Eli.

Thanks for the update. I hope so he will have a great healthy life, thank you for doing so much for him.