Liver Shunt/Vaccines - Issue?

[twilson28]

Hi everyone,

I put up a thread a couple weeks ago when we started having issues with my 2 yr. old Lhasapoo, after blood tests, urine tests, and bile acid tests, we think, about 99.9% its a shunt, probably one Chewy has had from birth. Oddly, my Vet was unable to see it on the ultrasound though...so looks like we'll be going into NYC to the amazing Animal Medical Center to get their radiology department and surgery wing involved.

But -- I've been reading up on this problem to prepare for what's ahead and I keep hearing that if you have a doggy with liver shunt, you should not give them heartworm prevetative or flea/tick preventative. I have given Chewy Heartgard and Frontline since he was 3 months when I first got him. I don't over vaccinate, we just do rabies, distemper, the usual, and the only "extra" I get is the Bordatella cause my dogs go to the groomer once a month and I don't trust how others care for their pets. I don't do the Lyme/Tick one and I don't do the Leptospirosis because I have little doggies and they don't go out in the woods or live in a very urban environment, so I don't feel they are necessary....

Anyway have info on this? Should I really stop the heartgard and flea/tick preventative? Also -- my little Yorkie is only 5 months, seems SUPER healthy...but I now know Yorkie have a bit of a predisposition to this problem...should I be watching for the same symptoms that I saw in Chewy?

Thanks in advance for all your help!
Mom to Chewy and Sparky

[Ellie May]

I wouldn't stop giving heartworm preventatives too quickly.
If my dog had a shunt and was stable, I personally would give it.
You may be able to give it less often though (like every 42 days), so that's something to talk with your vet about. Flea preventative is a bit more optional unless you are worried about ticks and lymes.

Vaccines are a hard area.
Has he had all of his puppy vaccines?
If yes, then I wouldn't worry about it until you get a diagnosis.
they should not be given yearly either.

If you are in NY and are going to a specialty hospital, Cornell is one of the best with shunts.

Ultrasound is only 60-80% accurate at detecting shunts, so it isn't surprising that the vet didn't see anything. Was a Protein C test done?

All Yorkies over 20 weeks really should be bile acids tested since the problem is so bad in the breed. Then you wouldn't have to wonder either...

[twilson28]

Thank you so much! I really appreciate your response. I'm going to talk to my Vet about it too, I just wanted to see what other people have done/experienced. Chewy had all his puppy vaccines, I was very on top of that, and he's two now and this is the first time he's due for Bordatella since his puppy vaccines.

They only did ultrasound and bile acid and the results on the bile acid were so clear (super super high, like 245 before and 332 afterwards) that they're convinced this is the issue and they want to move as quickly as possible.

When we go to the place in NYC, we were going to plan to get the radiograph test or scintagraphy (don't think that's spelled right) done. Right now, I'm just praying it portosystemic, from birth, and that it's only one because I'm fearful of the outcome if there are multiple....

Really, only symptoms are general depression and laziness, sleeping all the time, orange urine, he vomits at least once a month, and he drools like crazy when he goes outside (weird i know, but I just learned this is also a sign). I feel so horrible I didn't pick up on this sooner...thank goodness he pees on wee wee pads otherwise Inever would have noticed the orange urine...

I'll definately plan on getting the bile acid test on my little Yorkie man at 12 weeks to be sure he doesn't have the same problem. But I have notice no sign of health issues in him at all, he seems to be a super hungry, healthy, fiesty little man...

Thanks again!
Chewy and Sparky's Mom

[twilson28]

Meant 20 weeks, not 12....

Everyone just say a prayer that my little man can get the surgery to get better...he's the bestest little boy in the world! I just want him to be himself again...and play and run and enjoy his days....

[dwerten]

Originally Posted by twilson28

Hi everyone,

I put up a thread a couple weeks ago when we started having issues with my 2 yr. old Lhasapoo, after blood tests, urine tests, and bile acid tests, we think, about 99.9% its a shunt, probably one Chewy has had from birth. Oddly, my Vet was unable to see it on the ultrasound though...so looks like we'll be going into NYC to the amazing Animal Medical Center to get their radiology department and surgery wing involved.

But -- I've been reading up on this problem to prepare for what's ahead and I keep hearing that if you have a doggy with liver shunt, you should not give them heartworm prevetative or flea/tick preventative. I have given Chewy Heartgard and Frontline since he was 3 months when I first got him. I don't over vaccinate, we just do rabies, distemper, the usual, and the only "extra" I get is the Bordatella cause my dogs go to the groomer once a month and I don't trust how others care for their pets. I don't do the Lyme/Tick one and I don't do the Leptospirosis because I have little doggies and they don't go out in the woods or live in a very urban environment, so I don't feel they are necessary....

Anyway have info on this? Should I really stop the heartgard and flea/tick preventative? Also -- my little Yorkie is only 5 months, seems SUPER healthy...but I now know Yorkie have a bit of a predisposition to this problem...should I be watching for the same symptoms that I saw in Chewy?

Thanks in advance for all your help!
Mom to Chewy and Sparky

join this liver shunt mvd group on yahoogroups.com as they know a ton on this

if cornell is near you then dr centers is great and she is internal medicine specialists or if surgery is needed university of tennessee dr tobias is who i would go to .

How did they determine shunt through bile acid tests? Protein c is not 100% accurate as a dog on here had a negative protein c and had 4 shunts when tobias opened him up but it was picked up with a scintigraphy at uoft and they thought just one but turned out to be 4 so it was inoperable

If the bile acids were not over 100 I personally would not do further testing unless my dog was having alot of symptoms and i would put on protein of 22% if my dog was having symptoms i would put on 18% protein and if still having symptoms would do scintigraphy as ultrasound is a waste of money many times as it is really hard to detect one unless the person is really good at detecting them and both scintigraphy and ultrasound her in california are $400 so if bile acids over 100 most likely a shunt and i would just go straight to scintigraphy and save yourself $400 on ultrasound as most likely if shunt after they do ultrasound they will have you do scintigraphy then anyway the ultrasound will show if stones and if liver is small both of which are signs of shunts as well

let us know the pre and post bile acids as that will give us a better indicator whether mvd or liver shunt

[dwerten]

Originally Posted by twilson28

Thank you so much! I really appreciate your response. I'm going to talk to my Vet about it too, I just wanted to see what other people have done/experienced. Chewy had all his puppy vaccines, I was very on top of that, and he's two now and this is the first time he's due for Bordatella since his puppy vaccines.

They only did ultrasound and bile acid and the results on the bile acid were so clear (super super high, like 245 before and 332 afterwards) that they're convinced this is the issue and they want to move as quickly as possible.

When we go to the place in NYC, we were going to plan to get the radiograph test or scintagraphy (don't think that's spelled right) done. Right now, I'm just praying it portosystemic, from birth, and that it's only one because I'm fearful of the outcome if there are multiple....

Really, only symptoms are general depression and laziness, sleeping all the time, orange urine, he vomits at least once a month, and he drools like crazy when he goes outside (weird i know, but I just learned this is also a sign). I feel so horrible I didn't pick up on this sooner...thank goodness he pees on wee wee pads otherwise Inever would have noticed the orange urine...

I'll definately plan on getting the bile acid test on my little Yorkie man at 12 weeks to be sure he doesn't have the same problem. But I have notice no sign of health issues in him at all, he seems to be a super hungry, healthy, fiesty little man...

Thanks again!
Chewy and Sparky's Mom

i am not a big fan of bordatella as it does not cover all strains and kennel cough can be treated with antibiotics so i would not do it personally

also vaccines and titers are good for 3 years so i personally would titer as i do with my dog and try to get a health waiver for rabies as rabies vaccine says in healthy dogs only and your dog is not healthy

I think it is a shunt too I hope not multiple like this other yorkie owner i just helped Personally if this were my dog i would go to dr tobias at university of tennessee as she is the BEST surgeon for this and she does a ton of these and it is MUCH CHEAPER than anyone else only $1200 for the shunt surgery and most charge 4-6k so it is worth the trip and she is THE BEST in my opinion. My friend flew from california to have her do her yorkies surgery and she was so thankful she did. If this were my dog i would call dr tobias have all records sent to her and get to her asap and have her do scintigraphy and surgery as the guy i just helped on here did it and he said they were awesome with his dog but unfortunately he had 4 shunts and he was 3 when discovered. What happens is if they have one at birth if not found which your vet should have found before neuter or spay if they did blood work- were the ALT high as i do not think all vets do blood work before spay and neuters which is not good in toy breeds. If caught early there is less chance of multiples but if caught later more likely multiples as what happens is the blood does not flow properly through the liver and the heart pushes it back thus causing more shunts and those cannot be operated on but there are many dogs that have lived long lives with multiple shunts on a diet of low protein, denamarin, juiced zucchini which cleanses the liver, and lactulose. So do not panic if it is multiple shunts as it is not a death sentence. The liver is a very forgiving organ and can repair damage to itself but obviously not repair shunts

[twilson28]

Bile Acid Test
Pre 245
Post 332

Oddly, Chewy has never had diarrhea, is always hungry and drinks a normal amount of water.

Only symptoms that started appearing over past year and gradually increased are as follows:

(1) Constant drooling when outside
(2) ALWAYS sleeping
(3) Almost comatose/sleepy after he would eat dinner - like totally out of it (I was feeding very high protein diet)
(4) Orange urine
(5) Upset stomach...seems to fake throw-up, like heave once a month -- often in middle of night, like acid reflux (that's what I thought it was)
(6) Lately, used to love other dogs and now seems to be fearful and agressive

Otherwise, no fever, no outright vomiting, no diarrhea, no excessive drinking, no seizures, no other signs...

All along, until the bile acid, my husband was convinced I was over-reacting and said "He's always just been a lazy sleepy puppy"

If only I knew...I just hope the time it took for me to find out doesn't worsen the outlook....I can't imagine life without this little man...he's only been with us 2 years and I planning on him being with us 12+++ I never expected something like this, and I feel helpless...

Thank god almighty for ASPCA health insurance....

[twilson28]

ALT and another liver enzyme were high with blood test -- Vet did do blood work before he was neutered and everything was completely normal...

[dwerten]

signs of liver shunt are spaced out after eating, seizures, picky eater, hypoglycemic -- usually the problems occur after eating as the protein affects the liver so this was a big sign

join this group there is a ton of awesome people going through what you are and they helped me with my dee dee as she is mvd and her bile acids were below 100

Liver_Shunt_And_MVD_Support : Liver Shunt & MVD/HMD Support

[dwerten]

Originally Posted by twilson28

ALT and another liver enzyme were high with blood test -- Vet did do blood work before he was neutered and everything was completely normal...

wow then probably acquired shunt as that is possible as well and with that breed not being yorkie or maltese there was probably not much cause for concern but it is in the shih tzu breed as well as others so sorry but sounds like acquired shunting may be the culprit

[dwerten]

Originally Posted by twilson28

ALT and another liver enzyme were high with blood test -- Vet did do blood work before he was neutered and everything was completely normal...

ALT being high is a sign of liver disease

[dwerten]

Originally Posted by twilson28

ALT and another liver enzyme were high with blood test -- Vet did do blood work before he was neutered and everything was completely normal...

Symptoms and Diagnosis of Liver Disorders in Dogs

did they do urinalysis and was their crystals in urine ?

[bellbuzz07]

good luck with this.. i have been in your shoes, it was almost too late for my girl. but she had her surgery more than a year ago and all symptoms have passed and she has more energy than ever.. i would definetly do the scintography, it is the best. i too had the ultrasound.. waste of money. i was also on the group that someone mentioned. the people on there are VERY helpful and they will help you get through this.. as far as your babies symptoms, those are pretty serious. my girl was the same and one day, she was completely out of it.. had to be rushed to the hospital and had her life saved.. she actually died and was brought back to us, followed by an hour of seizures.

anyways, i'd get your baby help asap. i wouldn't give him any chemicals, etc.. and very low protein.. again, livershunt/MVD group can help you with ALL your questions, concerns.. once the surgery is done, you will not believe the difference it will make. you will think you have a new dog

good luck, prayers for you guys!!

[twilson28]

But -- strangest of all...the liver looked totally normal according to my Vet -- not reduced in size, no hardered or any signs that usually show with liver disease. Also - no tumors, bumps or anything indicating cancer.

I asked over and over, the liver was good size? The live didn't look small (malnourished and unhealthy) and she said no, structurally it looked good...

It's SO weird....I joined that Yahoo site,though I'm a bit confused and overwhelmed with it, Ijust keep getting tons of e-mails and there aren't alot of files on the website -- well, not as many as I expected. But I'll read more into it this weekend when sitting with my little man on the couch.

[dwerten]

please tell me your vet is only vaccinating every 3 years for parvo distemper after the one year shots? Does your vet recommend titering as there is a blood test to test for antibodies for the disease as i have been titering for 4 years and all 3 of mine still have enough antibodies to fight off disease