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Old 06-09-2009, 09:58 AM   #1
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Default Protein C Test Results: where do we do from here?

Here's an update if you haven't heard Lacy's story so far. She turned three in February, and last year was sort of unofficially diagnosed with a liver shunt and possible MVD due to elevated bile acids. We never knew if it was both or just MVD, but a veterinary internist advised us not to seek surgery due to Lacy's tiny four-pound stature. For a year we have managed her dietarily, and she has never once displayed any symptoms. She has been perfectly happy and healthy. Recently, we took her in for her checkup, and a new vet wanted to get some more information. They did a urinalysis and did find a moderate level of crystals. It got us thinking about all this stuff from last year all over again, and got us worried and pondering the surgery we had rejected because we could lose Lacy on the table, when she is living a perfectly happy and healthy life as far as she knows.

I also suggested a Protein C test, which just came back this morning. Lacy got a 55% capacity, and the normal range is 75 to 135%. Our local vets have been so kind to us, but they're a little baffled as to what they should be comparing the numbers. Lacy is in the shunt range, but is a really "low" number in the fifties, or the tens? How bad is she? I guess we'll have to look into getting the scintigraphy done next to see if surgery is an option. Anybody else know any specifics about Protein C testing and how accurate it is? I don't even know if the vet did the test right, but that's probably just wishful thinking.
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Old 06-09-2009, 10:12 AM   #2
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Im not even going to attempt to tell you I know about the numbers but did you say your vet did the Protein C Test? Did they send it to Cornell Uni. because I do know that is where the test should be sent and they do the results not your vet. Scintigraphy should be the next step and thats were they inject dye into the spean watching it flow thru the liver and can tell if there is a shunt. This is not very invasive and not that expensive. My Manolo was under about 10 min and his liver functioned well but was diagnosed with MVD. I know others will answer the Protein C test question in more detail. Wishing you well..
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Old 06-09-2009, 10:14 AM   #3
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If that is an accurate Protein C % result ~ than YES 55% is in Liver Shunt range.

I would go onto the Scintigraphy.

4 lbs is not too small for LS surgery BTW ~ if that is what she needs

Have you joined the LS group yet?
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Old 06-09-2009, 10:17 AM   #4
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Protein C test can not give you a *real* difference between Healthy and MVD ~ BUT I do believe it is a Good indicator of Liver Shunt.

My Roxy's Protein C was 165% ~ mild MVD what was I was told

Keep us posted.
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Old 06-09-2009, 10:22 AM   #5
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That is shunt territory and yes, the next step is a scintography.
Even if it is just asymptomatic MVD (not likely because of the Protein C number), while not necessary, SAMe could definitely be given and can only help things. Omegas, vitamin e and milk thistle can be given also.

I suppose the question is, if she has a shunt, are you going to correct it?
If not then the scint. would be pointless.
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Old 06-09-2009, 10:28 AM   #6
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There is a baby here that had a Protein C test and I *think* the results were 78% (approx. right around that %) and YES he had a shunt, he was about 8 months old and about 3 lbs ~ He is doing well now after he had surgery. Him too, no real symptoms, just abnormal pre-neuter bloodwork. And I think he had stones too
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Old 06-09-2009, 12:01 PM   #7
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My baby girl Lola had liver shunt surgery in March of this year. We did not do the Protein C test. Her bile acid test numbers came back so high that I took her straight to Dr. Tobias at University of TN where they specialize in doing this surgery on these tiny babies. They did the Scintigraphy there and it showed a large shunt. Lola was in the hospitsl there for 2 nights and she is doing super now - no complications whatsoever. They have special, heated beds that sort of "inflate" around these little ones so they don't get chilled during surgery and their aftercare is excellent. The have grants and gifts that make the scintigraphy and surgery very affordable. I can't say enough wonderful things about out experience there. Lola is like a different dog today - so full of energy. She had no other symptoms either - only a picky eater and she was very small. Please ask questions - someone out there or on Liver_Shunt_And_MVD_Support : Liver Shunt & MVD/HMD Support
knows the answer. Good luck - sending Yorkie hugs your way!
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Old 06-12-2009, 02:37 AM   #8
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Originally Posted by iwannalollipop2 View Post
Here's an update if you haven't heard Lacy's story so far. She turned three in February, and last year was sort of unofficially diagnosed with a liver shunt and possible MVD due to elevated bile acids. We never knew if it was both or just MVD, but a veterinary internist advised us not to seek surgery due to Lacy's tiny four-pound stature. For a year we have managed her dietarily, and she has never once displayed any symptoms. She has been perfectly happy and healthy. Recently, we took her in for her checkup, and a new vet wanted to get some more information. They did a urinalysis and did find a moderate level of crystals. It got us thinking about all this stuff from last year all over again, and got us worried and pondering the surgery we had rejected because we could lose Lacy on the table, when she is living a perfectly happy and healthy life as far as she knows.

I also suggested a Protein C test, which just came back this morning. Lacy got a 55% capacity, and the normal range is 75 to 135%. Our local vets have been so kind to us, but they're a little baffled as to what they should be comparing the numbers. Lacy is in the shunt range, but is a really "low" number in the fifties, or the tens? How bad is she? I guess we'll have to look into getting the scintigraphy done next to see if surgery is an option. Anybody else know any specifics about Protein C testing and how accurate it is? I don't even know if the vet did the test right, but that's probably just wishful thinking.
are you in beverly hills , california?
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Old 06-12-2009, 02:43 AM   #9
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My baby girl Lola had liver shunt surgery in March of this year. We did not do the Protein C test. Her bile acid test numbers came back so high that I took her straight to Dr. Tobias at University of TN where they specialize in doing this surgery on these tiny babies. They did the Scintigraphy there and it showed a large shunt. Lola was in the hospitsl there for 2 nights and she is doing super now - no complications whatsoever. They have special, heated beds that sort of "inflate" around these little ones so they don't get chilled during surgery and their aftercare is excellent. The have grants and gifts that make the scintigraphy and surgery very affordable. I can't say enough wonderful things about out experience there. Lola is like a different dog today - so full of energy. She had no other symptoms either - only a picky eater and she was very small. Please ask questions - someone out there or on Liver_Shunt_And_MVD_Support : Liver Shunt & MVD/HMD Support
knows the answer. Good luck - sending Yorkie hugs your way!
yes join this group immediately and i would not let anyone do this surgery but dr tobias PERIOD especially if you are in california -- i would fly to tennessee and have dr tobias do all the testing and surgery

is your dog having symptoms - seizures, head pressing, spaced out after eating, vomitting, picky eater? If not having any symptoms then my belief is treat the dog not the blood work. If having symptoms then pursue further

if you are in california in los angeles and tustin dr broome does the scintigraphy - below is his website but i would not do this test unless my dog was having symptoms as i live in california and my girl had post biles of 73, 54 and 26 on low protein diet and they wanted me to do this test and i said no way as she has no symptoms and she is below 100 on post biles so i put her on low protein diet and she is still doing fine

AVMI- Portal Scintigraphy
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Old 06-13-2009, 09:21 PM   #10
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Sorry, no we're actually in Maryland, not CA. I meant to change that a while ago, someone else set up the account for me who just picked a random city. We're about an 8 hour drive out of Tennessee, so it's do-able. I asked our vet to call Dr. Tobias, but haven't heard back from her. I think I'd also like to have them do another BAT, because they only did one in her history, and that was more than a year ago. We asked if they wanted to do another one the last time she was there and they just shrugged us off and said the numbers would be high anyway, so it wouldn't matter. Should have said something. The numbers were astronomical when they did it a year ago, however--I think 150 and 220 pre and post-prandial. I don't even see how those kinds of numbers are possible: Lacy is totally asymptomatic. We've never seen a single behavior associated with a liver shunt in her, EVER.

How good is Dr. Tobias at getting back to vets who contact her, and how long can we expect to wait for the surgery? Also, I should probably start another group for this, but does anyone know how much just the surgery costs? Lacy has already been spayed and had her baby teeth removed, so she should need just the surgery. That's another thing--when she was little, before we knew about this, she went through anesthesia just fine. The vets said she was totally normal.
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Old 06-14-2009, 05:05 AM   #11
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Quote:
Originally Posted by iwannalollipop2 View Post
Sorry, no we're actually in Maryland, not CA. I meant to change that a while ago, someone else set up the account for me who just picked a random city. We're about an 8 hour drive out of Tennessee, so it's do-able. I asked our vet to call Dr. Tobias, but haven't heard back from her. I think I'd also like to have them do another BAT, because they only did one in her history, and that was more than a year ago. We asked if they wanted to do another one the last time she was there and they just shrugged us off and said the numbers would be high anyway, so it wouldn't matter. Should have said something. The numbers were astronomical when they did it a year ago, however--I think 150 and 220 pre and post-prandial. I don't even see how those kinds of numbers are possible: Lacy is totally asymptomatic. We've never seen a single behavior associated with a liver shunt in her, EVER.

How good is Dr. Tobias at getting back to vets who contact her, and how long can we expect to wait for the surgery? Also, I should probably start another group for this, but does anyone know how much just the surgery costs? Lacy has already been spayed and had her baby teeth removed, so she should need just the surgery. That's another thing--when she was little, before we knew about this, she went through anesthesia just fine. The vets said she was totally normal.
U of Tenn is an EXCELLENT idea. I advise you to do what ever you need to do the get this moving with your Vet and Dr. Tobias this week.

From reading other stories here about U of Tenn, surgery can happen rather quickly. U of Tenn will do ALL the required testing, etc....and surgery. Don't quote me, but I think it would be around $1300 - $1500 ~ which is way better than quotes I have seen from Specialty Hospitals. Plus you will be getting one of the BEST surgeons!
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Old 06-14-2009, 05:21 AM   #12
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Originally Posted by iwannalollipop2 View Post
Sorry, no we're actually in Maryland, not CA. I meant to change that a while ago, someone else set up the account for me who just picked a random city. We're about an 8 hour drive out of Tennessee, so it's do-able. I asked our vet to call Dr. Tobias, but haven't heard back from her. I think I'd also like to have them do another BAT, because they only did one in her history, and that was more than a year ago. We asked if they wanted to do another one the last time she was there and they just shrugged us off and said the numbers would be high anyway, so it wouldn't matter. Should have said something. The numbers were astronomical when they did it a year ago, however--I think 150 and 220 pre and post-prandial. I don't even see how those kinds of numbers are possible: Lacy is totally asymptomatic. We've never seen a single behavior associated with a liver shunt in her, EVER.

How good is Dr. Tobias at getting back to vets who contact her, and how long can we expect to wait for the surgery? Also, I should probably start another group for this, but does anyone know how much just the surgery costs? Lacy has already been spayed and had her baby teeth removed, so she should need just the surgery. That's another thing--when she was little, before we knew about this, she went through anesthesia just fine. The vets said she was totally normal.
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Old 06-14-2009, 05:31 AM   #13
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U of Tenn is an EXCELLENT idea. I advise you to do what ever you need to do the get this moving with your Vet and Dr. Tobias this week.

From reading other stories here about U of Tenn, surgery can happen rather quickly. U of Tenn will do ALL the required testing, etc....and surgery. Don't quote me, but I think it would be around $1300 - $1500 ~ which is way better than quotes I have seen from Specialty Hospitals. Plus you will be getting one of the BEST surgeons!
100% agree dr tobias is where i would fly from anywhere to have her do the surgery - she is the best surgeon on liver shunt and dr center at cornell university is best internal medicine specialist for this disease
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Old 06-14-2009, 05:34 AM   #14
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Sorry, no we're actually in Maryland, not CA. I meant to change that a while ago, someone else set up the account for me who just picked a random city. We're about an 8 hour drive out of Tennessee, so it's do-able. I asked our vet to call Dr. Tobias, but haven't heard back from her. I think I'd also like to have them do another BAT, because they only did one in her history, and that was more than a year ago. We asked if they wanted to do another one the last time she was there and they just shrugged us off and said the numbers would be high anyway, so it wouldn't matter. Should have said something. The numbers were astronomical when they did it a year ago, however--I think 150 and 220 pre and post-prandial. I don't even see how those kinds of numbers are possible: Lacy is totally asymptomatic. We've never seen a single behavior associated with a liver shunt in her, EVER.

How good is Dr. Tobias at getting back to vets who contact her, and how long can we expect to wait for the surgery? Also, I should probably start another group for this, but does anyone know how much just the surgery costs? Lacy has already been spayed and had her baby teeth removed, so she should need just the surgery. That's another thing--when she was little, before we knew about this, she went through anesthesia just fine. The vets said she was totally normal.
wait no symptoms of liver shunt ? The bile acids could be high due to gall bladder contraction during blood work. If my dog were not having any symptoms at all i would not push for surgery if it were me -- i would just lower protein to 22% - my dog is mvd -usually shunt is indicative in numbers post bile over 100 but not always - maybe do protein c test but i would not rush to surgery on a dog that is not seizing, not picky eater, not head pressing, not spaced out after eating JMHO
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Old 06-14-2009, 05:36 AM   #15
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Have you joined Liver_Shunt_And_MVD_Support@yahoogroups.com this group will enlighten you alot they did for me

also did they do bile acids after or before spay if before why did they not biopsy liver to see if mvd?
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