hepatic shunt

[DAB]

My little 6 lb yorkie girl will be seen soon at Tufts University Foster Hospital for Small Animals, located near Boston in Grafton, MA., to confirm my vet's possible diagnosis of Hepatic liver shunt. She was sick with loose bloody stools and vomiting yellow bile 2x between Thanksgiving and Xmas. She is currently on Metronidazole ( 1 ml ) and Peptid AC 2x a day with meals to neutralize the acid in her stomach and stem the toxic breakdown of food to ammonia since her liver is not functioning properly.

Long story short is that I have seen on this forum that the University of Tenn is a leader ( Dr. Karen Tobias) in the field of shunt surgery. Does anyone have info about/experience with the Tufts University Foster Hospital? Has anyone had this surgery done successfully on their yorkies? Has anyone just been advised to treat the condition w. diet and meds but not surgery. What is the survival rate with surgery and or without surgery and just meds? At Tufts, what are the ballpark costs for the diagnostic testing before treatment, surgery costs, and post op costs for follow up hospital visits?

I want the best for my little girl yorkie and I know that Tufts is a top rated university and their Vet School is top notch as well. I live in MA so Tufts is a convenient choice of place to bring my yorkie. However, I need to know if anyone on this forum has had the shunt surgery done there and what were the results? Is your yorkie thriving? What was your experience there like?

Thanks. Please keep my yorkie in your prayers. She is such a sweetheart. I am trying to keep calm but I know this is a serious life threatening condition. Also, I have read online that often times yorkies only on meds may progress to worsening conditions in the months after a positive diagnosis. Surgery is the only fix but is complicated and intense which may also lead to blood pressure problems, etc.

Your comments are appreciated.

[bchgirl]

There are many dogs who've had surgery for shunts and done quite well.

Good luck...and I'm bumping your thread for you.

[Julie1760]

I don't have anything to offer, but you'll be in my prayers!!!

[MauiGirl]

Welcome to Yorkie Talk. I am so sorry that it is a Yorkie health crisis that brings you here, but want to assure you that you will find lots of information, friends and support here.

I cannot answer your question about Tufts, but am sure you will soon be getting more help from members who know.

My Yorkie Tiki (9 months old), is "liver challenged" too, although we believe she most likely has microvascular dysplasia (MVD) rather than a shunt. The members here with years of experience in dealing with liver disease have been incredibly helpful in leading me thru the diagnosis process, and in selecting the best diet and supplements for her case. If you search under "Liver Disease" you will see my thread, and many others who are dealing with the same.

What is your puppy's name and age? You will both be in my prayers.

[Ellie May]

I haven't heard of any reports of it being done at Tufts, so I don't know their success rate. I thought I had read that the University of TN had the best record for no seizures after surgery which is directly related to death from surgery. It would be my first choice if my dog needed LS surgery and that is taking into considerationt that we have Michigan State University here. My second choice would be Cornell. Now any vet school could've easily moved up past UT in success rate without me knowing, so you might want to call and talk to each school about it.

If there is no diagnosis yet, maybe you don't even have to worry about this part of it. It could still be MVD...

From what I have read, it is safer to go ahead with the surgery in a young dog with an extrahepatic shunt. Medical management is second best. Those complications are very real though. I'm sorry you have to deal with this.

[ltret0294]

Welcome to YorkieTalk,
I can not add anymore to the previous two/three posts but you and your little one are in my prayers and thoughts. I had a 6+ year old yorkie who had an external shunt closed off at an Animal Speciality Hospital in the area and the Vet Surgeon did a good job. DJ had more complications than just a shunt. The only other comment I would have is to ask any yorkie or other small dog rescue groups in your area if they know of Tufts work with small dogs. Bob

[magicgenie]

There's a lot of good information on here to help you. I know of at least one case that was incorrectly diagnosed and that puppy came perilously close to being subjected to this big, horrible, expensive operation. It was actually Tufts that determined the original vet was wrong, but I think a lot depends on who you get at Tufts too, so be careful. PM me and I'll tell you more. Good luck.

[DAB]

Good Morning and thank you to everyone who replied to my first post ever yesterday. I am so new to this site that I am not sure how to forward threads, etc.

My yorkie girl is Emma Angel. She is the sweetest little girl and so much fun. Her older "sister", Zofia, is 4 years old and they are best friends. The 3rd member is their 3 year old brother, Bright Eyes, who is a cat! The 3 are like 3 peas in a pod....always playing and even sleeping together. Emma is chasing the cat (about 3x her size), around the house now.

I will call Tufts Foster Hospital as soon as it opens this morning. Because of the holidays, I could not make an appointment last week...Emma's blood work test results were not available to me until the Dec. 26th and the clinic was closed until today. I will be CERTAIN to ask about the shunt surgery success rate, how many shunt surgeries have they done and whether or not the surgeon vets are students.

I spent most of the afternoon yesterday researching liver shunts online and I printed down an extensive amount of info from the University of Tenn. I also read about Dr. Karen Tobias, inventor of the ameroid costrictor used in the shunt surgery. Vets, not pet owners, may contact her via email or by phone. The site at the University of Tenn College of veterinary Medicine ( liver) has wonderful information. There is a page of commonly asked questions and answers, testing and diagnosis, diet, and management suggestions, inheritability of the disease ( per Dr. Tobias), etc.

I am quite anxious. Emma's gums are white. The meds make her appear OK but I know she is not. I will keep everyone posted. Thank you so much for your prayers.

[MauiGirl]

Originally Posted by DAB

Good Morning and thank you to everyone who replied to my first post ever yesterday. I am so new to this site that I am not sure how to forward threads, etc.

My yorkie girl is Emma Angel. She is the sweetest little girl and so much fun. Her older "sister", Zofia, is 4 years old and they are best friends. The 3rd member is their 3 year old brother, Bright Eyes, who is a cat! The 3 are like 3 peas in a pod....always playing and even sleeping together. Emma is chasing the cat (about 3x her size), around the house now.

I will call Tufts Foster Hospital as soon as it opens this morning. Because of the holidays, I could not make an appointment last week...Emma's blood work test results were not available to me until the Dec. 26th and the clinic was closed until today. I will be CERTAIN to ask about the shunt surgery success rate, how many shunt surgeries have they done and whether or not the surgeon vets are students.

I spent most of the afternoon yesterday researching liver shunts online and I printed down an extensive amount of info from the University of Tenn. I also read about Dr. Karen Tobias, inventor of the ameroid costrictor used in the shunt surgery. Vets, not pet owners, may contact her via email or by phone. The site at the University of Tenn College of veterinary Medicine ( liver) has wonderful information. There is a page of commonly asked questions and answers, testing and diagnosis, diet, and management suggestions, inheritability of the disease ( per Dr. Tobias), etc.

I am quite anxious. Emma's gums are white. The meds make her appear OK but I know she is not. I will keep everyone posted. Thank you so much for your prayers.

There is so much to learn it can be overwhelming. I'm still wondering Emma's age, and what tests were done to get the diagnosis? Bile Acid test, Protein C test, ultrasound, are some of the common diagnostics; and what were the results.

I am by no means an expert, and am learning just like you are. I have gotten thru the panic stage with Tiki and am happily on a course that is appropriate for her case. Your case may be different if there is a definite shunt, but still, don't panic.

Here is a link to the thread about Tiki, if you want to see the progression of our diagnosis etc. It's quite long, but filled with valuable information for any liver challenged dog. I'm going to be gone all day, but will check in this evening, so please keep asking questions, and we'll try to help.
http://www.yorkietalk.com/forums/yor...r-disease.html

Thoughts and prayers are going your way.

[DAB]

Hi!
I am having a difficult time figuring out how to post a new thread so I just have to keep "replying." Sorry.

Emma's appointment at Tufts University, Foster Hospital for Small Animals is Wednesday afternoon, January 7. I have read and printed all sorts of info on shunts from many different sites. The University of Michigan has a high success rate with shunt surgery but seems to use a different procedure than Dr. Tobias at the Univ. of Tenn. I wish Tufts had their info online as well but they do not.

She seems fine and runs around playing when she and her "sister" yorkie and "brother" kitty are not sleeping. I guess I only need to wait and see. There is not much I can do until her ultrasound test next week and conversations with the doctors at the hospital. Thank you for the link on liver disease. I am all set to go and picked up all her pertinent medical records and proof of rabies vaccine today.

Thanks to every one for keeping my little girl in your prayers. She is such a sweetheart.I will keep you posted on this site.

Happy New Year to everyone.

[MauiGirl]

Glad to hear you are getting everyting in line, copies of tests, etc., and are moving forward. As you will see in my thread on Liver Disease, ultrasound does not always see shunts, even if one is there. Has your vet done the Protein C test? Many vets aren't even aware of it, yet it is very valuable in determining if it is a shunt or not; and in some cases could save you from doing the more expensive ultrasound.

Not trying to second guess your vet, just wondering how the diagnosis was made. That's how we all learn.

Good luck. And the Reply button is the correct way to respond or update everything that has to do with this case/topic. If you wish to post about a different topic, start on the section that it best fits in and at the top click on button "New Thread"

[DAB]

Thanks for your reply. I do not think the protein C test was given. Emma did have blood work done but I can barely read what the vet wrote. Doctor's penmanship! Some "people" doctors are now being required to type their notes and prescriptions. which I believe is a great idea. Maybe all those involved with patient care whether they treat people or animals will one day be required to do the same.

I inquired about the ultrasound. It is the least invasive procedure. I feel that this is going to be a process as I am sure that if nothing is clearly seen on the ultrasound then another test will have to be scheduled. The issue will be time. When I called, Tufts only has an opening to do the ultrasound test next week. I may have to wait until the following week to schedule another test because they only schedule appointments on Mon., Tues., and Wed. However, since Emma will have had her first visit, maybe they can move up the 2nd test date if needed. I will definitely ask them to do a blood test for the Protein C while I am there next week.

Thank you so much for your help in navigating this site. I appreciate your thoughts. Happy New Year Blessings.

[MauiGirl]

Protein C is a blood test that is sent to Cornell; here are 2 links about it:
http://www.diaglab.vet.cornell.edu/c...t/proteinC.asp

http://www.vin.com/proceedings/Proce...2675&O=Generic
(see under Liver function test toward the end of paragraph)

Is your dog having symptoms associated with liver disease, or did you just discover it thru routine bloodwork (like I did)?

Good luck, and do keep us posted.

[DAB]

Emma was throwing up yellow bile and had bloody stools. The vet put her on meds to coat her stomach and also did blood work to determine: whether or not she had any parasites (she does not) and to check for the bile acid. The reading was high.

We go to Tufts on Wednesday, January 7th. Hope we get a very good
ultrasound tech. Again, I will ask for the Protein C test be given. Thanks for all your info and the links to Cornell University. Wednesday can't come fast enough for me!