Liver Shunt Sticky
 

I think we should get a liver shunt sticky due to so many yorkies having this -is there a way we can make one of these up?

That's a great idea. It seems like every day we get a new thread asking about liver disease/shunts. It would be great to have all the links to information and resources pinned in one place.

Not sure how we would do it but definitely would be helpful for reference

If everyone can post what they know and recommend for liver shunt so we can make a sticky as this is coming up alot in this breed and we can reference it to knew owners of liver shunt or mvd babies

If no symptoms but bloodwork shows post biles below 100 but over 25 then protein should be limited to 22% in diet and if showing symptoms but less than 100 then 18% protein.

AVMI- Portal Scintigraphy

Gallbladder can contract when doing bile acids thus causing higher numbers

Protein C test and liver biopsy while being spayed or neutered will help determine if mvd or liver shunt.

Usually numbers over 100 post tend to be indicative of liver shunt and below tend to be mvd.

The best person for surgery is dr. Tobias

Here are my favorite links:

Hepatic Vascular Disorders - WSAVA 2006 Congress

Portosystemic Shunts FAQ

Comparative Coagulation -- NYS Animal Health Diagnostic Center

PSVA and MVD Research Summary

http://www.yorkiefoundation.org/purina1.pdf

http://www.idexx.com/animalhealth/an...r0905final.pdf

I too have a number of Liver Shunt related links from my web searches for DJ that I would like to offer up.

Here is a starter from the Yahoo Groups:

Liver_Shunt_And_MVD_Support : Liver Shunt & MVD/HMD Support

Dr. Karen M. Tobias at the U of Tenn. is doing a lot of liver shunt reseach.

I had thought about this and think it's a great idea but whoever puts it together may have a difficult time. When talking about LS and MVD, there are different opinions. For instance, one person might think feeding K/D is the greatest thing and another would disagree because it contains the wrong kind of protein. Some vets go for ultrasound right away and that is thought to be best by some people while others would do Protein C. One vet says Marin, one says Hepatosupport..... The list goes on. So while I think links are great and having all info in one place would be very helpful, it might be a bit tricky to put it together. The same would go for a sticky on vaccines.:)

All the links I posted were from Dr. Center or Dr. Tobias, the experts on liver disease and shunts. Most vets just don't see enough cases of liver disease to be aware of the results of the research being done at Cornell and U of T.

I think it's important not to let people waste their money on outdated tests like ultrasounds, for instance, since they can be as low as 60% reliable according to Dr. Center. The current protocol calls for a Protein C test after a high BAT, then scintigraphy, so we need to get the proper information out there.

I agree, it would seem difficult to make a "one size fits all" sticky. Each case is slightly different, although there is much in common. But, it would be nice to have some sort of starting point. Encouraging members to use the search function on this forum would be good, however it is more common to just blurt out the problem in a new thread.

I think the idea is to give as much info on this thread so someone with liver shunt can get all points of view and consult with vet as to best option for that specific dog as there are alot of consistent information being given. Also to save time and money for some with limited funds in getting the best info from those of us having experience with this quickly like not wasting money on an ultrasound when protein c is more accurate, etc as i know when my dex had pancreatitis some of the tests i wasted a ton of money and did nothing for him and my money could have been better spent on more accurate tests. I wish i would have known about cpli and tli prior to doing ultrasounds and spending $1200 on them and they really did not help much at all and the amylase and lipase blood test is not accurate either vets and specialists are finding so by knowing this you can be more educated and spend your money wisely - especially in california where costs will be going up due to new tax so we need to really try to narrow things down faster with our vet - I think sometimes these vets think we have an endless supply of money to keep doing all these different things and i prefer to get to the most accurate now after spending 20k in vet bills not knowing the things i do now and why i try to help others and join the groups as i was extremely frustrated about all this - I have a yorkie that has mvd, hypothyroid and atopic dermatitis and a yorkie that almost died of pancreatitis and has ibd and a maltese with periodontal disease so i have had my hands full and want to help others with what i have learned and learn more to help my 3

Exactly. A sticky is a great idea as a starting place but in order not to mislead, it would either just need to have a few links or endless information.

As for ultrasound, yes it is best to get a Protein C test and then move to scintography for "most" dogs, but in Ellie's case her bladder was in question (possible stones secondary to liver issues), so she had to have the U/S. This may be more common than what people would think... Yes, it is best to skip liver biopsy "unless" the dog is opened for spay already... Low protein is advisable but may be increased if the dog is asymptomatic... There are just so many variables. So all of this needs to be explained IMO.:)

endless info sounds good to me as many people do not know how to do the searches and I think the more info we can give them fast the better as many vets are not very familiar with it so i think it is very important for this breed

I find myself posting the same links I posted above almost daily. Having them pinned in a sticky would be a helpful reference, a starting point.

Being able to get the basic accurate information out there such as the best age to do a BAT test would save people time and money. Same thing with the Protein C test. Many vets have never heard of it. All the information plus where to send it is in one of the those links. One of the links explains how a blood sample should be collected (courtesy of Dr. Center). That can prevent inaccurate results and unnecessary worry.

Of course, we could continue the discussion based on the individual dog in another thread.

Symptoms to watch for and that have been observed in liver compromised dogs (only one or only some may be observed):

-Picky eating
-Occassional lethargy
-Reactions to vaccinations
-Sensitivity to light/blinking
-UTI/dark or smelly urine
-Bladder crystals/stones
-Vomiting
-Head pressing
-Acting funny/strange a couple-few hours after meal
-Not responding to nutri-cal/karo/etc. within a couple of minutes during hypoglycemic episode
-Head bobbing
-Circling
-Seizures