Liver Shunts
 

I am wondering if anyone else had to deal with a liver shunt in their yorkie. I looked it up and talked to the vet, but i would like some info from someone that has gone through it with their yorkie. Does the surgery always work? Do the meds help? How long do they live with or w/o surgery? Please just let me know anything you can about this problem. Also, does anyone know any groups that help out military families with their dogs? Thank you!

Also, how long is the recovery time for the surgery? luna is on the EN food right now. Is that food going to help her? We are moving soon overseas, do you guys think that she will be able to make the trip? Sorry for all the questions but my husband and i are really clueless.

I'm sorry about your girl. :(

There is an endless amount of information about liver shunt on YorkieTalk from previous threads. You can use the search function at the top of the screen or the Google search (don't forget to click search on YorkieTalk if you use this one) at the bottom of your screen for lots of good threads.

What tests has she had and how was this diagnosed?
How does the vet know that it isn't MVD (microvascular dysplasia? MVD is small shunting throughout the liver that is inoperable and has to be managed by diet and supplements.

Have you considered switching to Science Diet L/D canned or Royal Canin LS 14 dry food?

If the surgery is successful (about 85% chance), most dogs live long and happy lives. Some places have better success rates than others and there are a few different surgery methods. It appears that the University of Tennessee has the best success rate and uses the best method (closure by ameroid constrictor). This closes the shunt over time instead of all at once, so it is less like that too much pressure will build up. Dr. Tobias at UT has taught other surgeons this method.

What supplements is she on?
The correct diet, supplements and protocol is extremely important for both LS and MVD. If she has surgery, it does not guarantee that there will not be issues afterwards. For the best prognosis, a young dog with an operable shunt should have surgery.

What are her symptoms?

Thank you. I will search for that. Well she has had the bile acid test, which my vet said it was high. So she sent us to get an ultrasound done and the dr. said that she has a liver shunt. The reason she was tested was b/c she has had to major throwing up days. the vet took an xray and that's were the test came in and the ultrasound.

Has the vet talked about supplements?
Denosyl or Vetri DMG
Milk Thistle
Omegas
Vitamin E
Lactulose

Is she having an neurologic symptoms?

After surgery, I would hesitate to take her out of the area until her bile acids are normal or until you are released from the surgeon's care.

If you have any specific questions, we can try to answer them for you.
Can you post the ingredients to the EN food? Along with the protein and fat percent?

UT is the cheapest place to get the surgery done.
It can be done at time of spay for under $1800.

She is seems fine. She loves to play. If we find a place to do the surgery where we are moving too, will the plane ride effect her if she hasn't had the surgery. The vet gave us two meds, one that i have to get tomorrow (i don't know the name) and metronidazole. There hasn't been any talk about supplements. Should i bring it up to her tomorrow? and should i ask about the protien c test? We give her the EN gastroenteric from purina the wet and dry food.
The wet food says it has 6.5% crude protien, 3% crude fat,
.5% crude fiber and 74% moisture. It has water sufficient for processing beef, brewers rice, egg product, coconut oil, gum arabic, tricalcium phosphate, chline chloride, calcium carbonate, salt, potassium chloride, vit supplements (e,a,b-12,d3) there's a lot more ingredients.
I asked the vet about the SD liver and she said this food was fine. I want to switch sometime soon, bc where we are moving thats what they have. I know that surgery is the best thing for her,but how long does she have if we keep up with her meds, the right food, and get her on supplements? Will her life be ok if we do all this and not have surgery? We don't have the money for the surgery right now, but sometime this year i hope will.

I am so sorry to hear about your pup's liver shunt. Paisley is my 14 month old yorkie. She was diagnosed with a liver shunt when she was about 6 months old. The vets recommended she have the surgery by the time she was a year old. Our vet told us we had some time since she was asymptomatic.

In the meantime I got her on prescription food for liver compromised dogs. I feed her small meals through out the day.

I took her to the University of Tennessee when she was 9 months old (after we saved money) for the surgery. She did very well during the surgery and recovery. We flew home soon after her surgery with the vets approval. Paisley was back to herself within a few days. But we kept her in a large crate for several weeks (per surgeon's instructions) to restrict her activity and help with recovery.

Paisley's bile acid numbers are not back to normal, but are significantly lower. She is still on a liver shunt diet with no symptoms.

If you have any other questions feel free to ask me.
Christina

Guaranteed Analysis (Dry)
Crude Protein (Min) 23.0%
Crude Fat (Min) 10.5%
Crude Fiber (Max) 2.0%
Moisture (Max) 12.0%
Zinc (Zn) (Min) 200 mg/kg
Vitamin E (Min) 350 IU/kg
Vitamin C (Min) 100 mg/kg
Omega-6 Fatty Acids* 1.76%**
Omega-3 Fatty Acids* 0.25%**
*Not recognized as an essential nutrient by the AAFCO Dog Food Nutrient Profiles.
**Actual Analytical
Guaranteed Analysis (Canned)
Crude Protein (Min) 6.5%
Crude Fat (Min) 3.0%
Crude Fiber (Max) 0.5%
Moisture (Max) 74.0%
Zinc (Zn) (Min) 70 mg/kg
Vitamin E (Min) 140 IU/kg
Vitamin C (Min) 35 mg/kg
Omega-6 Fatty Acids* (Min) 0.30%
Omega-3 Fatty Acids* (Min) 0.03%
*Not recognized as an essential nutrient by the AAFCO Dog Food Nutrient Profiles.
Packaging
Cases of 24, 12.5-oz. cans. Bags of 8, 20 and 35 lbs.
Ingredients (Dry)

Brewers rice, corn gluten meal, whole grain corn, chicken meal, coconut oil, animal digest, animal fat preserved with mixedtocopherols (form of Vitamin E), calcium phosphate, calcium carbonate, potassium chloride, L-Lysine monohydrochloride, sodium bicarbonate, soybean oil, fish oil, salt, choline chloride, Vitamin E supplement, zinc proteinate, L-ascorbyl-2-polyphosphate (source of Vitamin C), manganese proteinate, ferrous sulfate, niacin, copper proteinate, Vitamin A supplement, calcium pantothenate, thiamine mononitrate, riboflavin supplement, Vitamin B-12 supplement, pyridoxine hydrochloride, garlic oil, folic acid, Vitamin D-3 supplement, calcium iodate, biotin, menadione sodium bisulfite complex (source of Vitamin K activity), sodium selenite.

P-4552
Ingredients (Canned)

Water sufficient for processing, beef, brewers rice, egg product, coconut oil, gum arabic, tricalcium phosphate, choline chloride, calcium carbonate, salt, potassium chloride, vitamin supplements (E, A, B-12, D-3), L-Lysine monohydrochloride, riboflavin supplement, niacin, calcium pantothenate, ascorbic acid (Vitamin C), zinc sulfate, biotin, ferrous sulfate, thiamine mononitrate, folic acid, manganese sulfate, pyridoxine hydrochloride, copper sulfate, menadione sodium bisulfite complex, calcium iodate, sodium selenite.

I-4553
Purina Veterinary Diets - EN GastroENteric - Canine



I would not feed either of these foods to a liver compromised dog.
Red meat produces the most ammonia (toxins) which builds up and can cause neurological symptoms. It is hard on the liver. Organ meat is also not good. The dry contains unnamed animal ingredients. The amount of protein is important but the type is just as important. Remember that when feeding canned it has to be converted to a dry matter basis to get actual protein content. How much protein does the vet want your pup on?

I have no idea how much protien. My vet has not told me anything. I have learned more from you and on here then her. I guess changing her food is a better. I think i should change vets. I am just annoyed now that my vet didn't tell me all this info.

I'd be annoyed too.
Most vets believe that liver compromised dogs need low protein but don't take the type into consideration. If that is the case, you may not do much better with another vet. Since this pup is symptomatic, I would probably lower the protein a bit just to see if it helps. Does she ever get shaky?

She gets slightly shaking sometimes, not everyday. Do i need to get the science diet from a vet?

That is a sign of hepatic encephalopathy (HE), especially if it happens a couple hours after eating. HE or neurological symptoms mean toxins are building up. She needs to be on a food for liver compromised dogs. Science Diet L/D wet (not dry because some of the ingredients are very questionable) or Royal Canin LS 14 dry (very palatable but RC makes lots of Yorkie itchy). She also needs to be on lactulose to push the toxins out of her system. This should be given 3x per day to produce two soft but formed bowel movements.

With shaking going on, I would have her on SAMe (Denosyl or equivalent....cheap from entirelypets.com) and milk thistle would be a good idea along with vitamin e.

She should not be free fed or fed large meals. Liver compromised dogs should be fed 4-6 small meals per day to lessen the load on the liver and to make sure that their bodies aren't be overloaded by too much protein at one time. So measure out what she should get for the day and break it up into at least 4 meals.

Thank you SO much for this info. where would i get the food and those extras?

You're Welcome.

You need a prescription for the food. There may be places online that you can get it with the script or your vet should be able to order it for you.

You can get Denosyl at EntirelyPets Discount Pet meds Pet Supplies & Flea Medicine. Vetri DMG, the precursor to Denosyl, is available online but I've never used it, so I'm not sure what site has a good deal on it. You can choose one or the other. Most vets only know about Denosyl. It is more expensive though. Denosyl cannot be crushed and has to be given at least one hour before eating.

If you have a GNC, milk thistle is available there and it is completely vegetarian. Do you know how to dose this? You should also give vitamin e. Ellie was on 400IU for awhile but that is quite high. That is probably the dose I'd go with though. There are also veterinary products with milk thistle and vitamin e combined if you want to go that way...

You need a prescription for lactulose. I've heard that Walmart's generic for this is cheap.

Did that answer your question?

If you can get your vet to write you a prescription for Royal Canin Hepatic dry food, you can take it over to any Petsmart that has a Banfield. They will have you fill out a form and then give you a prescription card so that you can purchase the food anytime. If your vet won't do this for you, you can order the prescription food from: at SouthernAgriculture.com

My vet did write a prescription for the science diet ld. I got her lactulose yesterday and the vet is looking into the amounts for the milk thistle and vit e. So hopefully it helps luna out. How much LD do i gave her? once again thank you for all your help.

MILK THISTLE
The milk thistle dose can be found here.
The adult human dose is about 400mg, so each dog's dose can be figured with the chart at the bottom of this page.

I think some people get right down to the grams of protein but what does the can say to feed?

It doesn't say what to feed. My vet is suppose to call me today. I will ask her. If she even knows. Also, is there any good treats that i could give her?

You can use seedless watermelon, peeled and cored apple bits and green beans as treats. Have you joined this group:
DogLiverDisease : Dog Liver Disease

They can help you with just about anything and will be able to tell you how much L/D to give.

I found the amount for the canned food. and i will look into the group.

My 9-year-old Yorkie, Pebbles has liver shunt. Because no large blood vessel was noted outside of the liver we are guessing it is Microvascular Dysplasia.

This was diagnosed when she was three years old--kind of late! We got her when she was 1 1/2 and there was no sign of a problem. She started becoming more quiet, going around in circles and falling over. She wasn't eating well, shaking and drooling.

I took her to 3 vets. Finally a great old-time vet in Bountiful UT took her home with him to watch her. He then decided to do a bile acid test. I think that normal is about 6-10 and hers was 183!!!!!

He told me it was better to give her Science Diet K/D than the L/D. What do you think about that, anyone? I guess it doesn't matter much, because she weighs under 3 pounds and she can't chew a kibble that big. When I tried the canned K/D she kept getting it stuck in the top of her mouth and I was afraid she would choke. The vet knows what I am feeding her and he approves. He could be wrong, though.

I'm sure I'll get some heat for this, but she eats Science Diet Adult 7+ Small Bites. It has 16% protein as compared to 13% in the dry K/D. She's not crazy about it. Sometimes I put a little bit of brown rice in it. She also likes fresh broccoli--the stalk that has been peeled and is more mild.

She definitely has hepatic encephalopathy and she is blind in her right eye. She still goes around in circles.

I give her Metronidizol and a Supplement called Marin from Nutramax. I thought it had Milk Thistle in it, but apparently it doesn't. I don't give her Lactulose all the time, because it makes her quite Loosey-goosey!! It is hard to decide on how much to give her because the same amount does not always have the same effect.

She has other problems too. The worst is Lupus. We found that out a couple of years ago. She started getting sores on her nose and in her ears. We had a biopsy done. It affects the skin.

Every 6 months or so she becomes extremely lethargic, stops eating and we think she is dying. We have blood tests that only show her glucose is a little elevated, but that can be from stress. Her last bile acid test was 15. Still too high, but it sure is better than 183.

I tried giving her Niacinimide for the Lupus but she threw up 8 times after one dose. I just can't do that to her. How much medicine can I shove down that teeny throat?

NOW she is having difficulty walking and it appears that her rt knee needs an operation. Needless to say my husband is not thrilled about spending $700-800 on knee surgery when she is in this condition. I can understand how he feels, but she is NOT his baby!!

She loves me intensely, and only tolerates my three sons. She won't go to any of my daughters.

I love this little creature. We call her a puss pocket or an abscess because she really has an attitude. She is the BOSS over Dexter, our other 9-year-old Yorkie who is such a gentleman. He only has arthritis in his back, so we think he's pretty healthy.

Sooooooooooo- what do I do? Have surgery on her leg or not? The vet said he thinks she will be okay with the anesthesia, because she has minor anesthesia when he hand scales her teeth and she had it when we did an ultrasound of her liver. He is, however, concerned that some of her difficulty walking could be neurological and not just her knees.

Her surgery is scheduled for next Friday?

This is my very first post. I'm sorry, I probably am asking too many questions and giving too much information on someone else's thread.

Some vets do recommend K/D over L/D because it is lower protein but what they don't consider is that it is the wrong kind of protein and is more likely to cause neurologic symptoms. If she is having neurologic symptoms on 16% protein, then it is probably either the wrong kind of protein or she does need lactulose. What doses have you tried? If you want to get really clinical with her, the purines in the food have to be watched too. What are the ingredients in teh Sci Diet that you are giving?

Why did she have to go under anesthesia for an ultrasound?
Did a regular vet do it?
How was a large shunt ruled out?
Is she on Denosyl?
How many times a day is she fed?
Marin contains milk thistle but dogs with extreme symptoms may react to the liver and the yeast in the Marin.
Because she would need to be under anesthesia for a very long time for knee surgery, I would talk to an internist about it.
What anesthesia is used and what does the vet plan to give as a pain med?

If she had trouble eating the K/D kibble, how about L/D canned?

Looneylinda,

I have a two year old Yorkie that has no portal vein. Is that what you were referring to when you said "no large vein"? Doctor Tobias at UT said that her shunt was keeping her alive. You said your baby is 9 years old? That's great! Dr Tobias said Grace would have 1-5 years.

Don't feel bad about the food. Grace gets Science Diet Adult can food mixed in with her LD. Doesn't seem to hurt her and we have been doing this for awhile. We keep dry KD down all the time for her and her two brothers. Sometimes we boil potatoes and mix in with the LD. Dr Tobias said nothing over 18% protein. She loves dry cereal, especially Rice Chex and Cheerios.

You have given me hope that my Gracie will live longer. I always say that she will!

Debbie

Liver compromised dogs can do okay on protein that isn't appropriate for them but it is usually not optiminal. Sticking with canned L/D may lessen the load on her liver. Do you healthy dogs get more than about 15-20% of the K/D? It is dangerously low in protein for healthy dogs...

I am sorry to hear that your girl has LS, Copper has MD (Microvascular Dysplasia.) This is a wonderful place to learn. I give him Hepto Support, it has milkthistle and other things in it to help support his liver. You can order it on line.
He was having neurological symptoms when we found out and It has been a long road to get to where we are today. I have learned that more important than the amount of protien is the type, animal proteins are harder to digest than things like yogurt and eggs and cottage cheese. Whitefish and Chicken produce less toxins than red meats and pinkfish. Another thing that helped alot for us was taking him off of the flea prevention and using a shampoo that does the same thing, he started siezures the day after he was given frontline. There are so many wonderful people here willing to help with lots of great info.:)

Being the lucky person that I am, my two other dogs (one Yorky, one Silky)are suppose to eat KD because they have kidney issues. Works out well so that their food can stay down for them to pick at when they get hungry. We sometimes keep my sister's Bichon puppies, so everyone has to eat separate then. Grace got to the point where she wasn't eating the LD, so we had to do something. It was a choice I had to make...her eating no food opposed to her having a little bit of Science Diet Adult. I chose the latter.

Liver Shunt woes
 

I started to write this and went back to see what questions were asked and there was nothing here. Hope is doesn't appear after I start over. Sorry. I am no computer genius.

An Internist did the ultrasound and she required anesthesia because she would not hold still. Some kind of gas was used.

No problem with the Portal Vein was noticed on ultrasound so we assume it is MVD. Is that always congenital or can it be acquired?

My vet told me to add cottage cheese to her diet when she goes through these cyclical "downtimes". At first she will eat it, but that doesn't last long. It is apparently common for these little dogs to go through these times. An Internist told me he thinks they may become septic and that the next time she becomes ill I should have my regular vet draw blood cultures. This must be done before an antibiotic is started or it is of no value. If the body has an overwhelming infection sometimes the dog will not have increased white blood cells to attack an infection. Therefore, when a regular CBC comes back without elevated WBC's a vet might think there is no infection when there is. He also has questioned whether they might get a "touch" of hepatitis. It is interesting that she has not been deathly ill since I have been giving her the Marin supplement.

The Science Diet Mature Adult food has chicken as its base. It's probably not the best I could do. She has some food down all the time. She doesn't eat much at a time.

There is an exceptional Interist that I will talk to before she has the surgery.

I fiddled around with dosages and have decided that .7ml is a pretty good dose of Lactulose for her daily. Maybe I should decrease that to .5 and give it every day.

I hate to see anyone else going throug the trauma of Liver Shunt. I will keep all our little friends in my prayers.

Can you use Royal Canin LS 14 kibble and crush it?
It may cause allergies though. :(
Then there is Natural Balance Vegetarian that might be an acceptable replacement.

I tried crushing the kibble on the K/D. I had to use a hammer. Since she hated the taste I didn't do that for very long. I also mixed the canned with the crushed kibble. Then I just did the canned until she kept getting it stuck in the top of her mouth. We have been dealing with this for 6 years and I have tried lots of things.

One vet told me to put some corn oil on her food. I haven't done that for a long time. Why would that help?

No idea why that would help.
With an already balanced commercial food, I'd hesitate to add too much oil because of the pancreatitis risk in Yorkies that eat excessive fat.

My dog's postprandial bile acids were 106 at last check and she has had acute pancreatitis, so we go through a lot of misery with food too. I homecook though and we can change ingredients around.