Really scared for Brodie high enzymes please help

[Brodies Mommy]

Brodie required the surgery to get the large stone out of his bladder as it kept obstructing and they would have to take a needle and dislodge it twice a day. The stone is being sent in for testing - not at my vets office. They told me Saturday they would have the results in 5 business days (I'm guessing after Christmas??). After they find out the results of the stone type they are going to decide what to do from there. They said it could either be he has a genetic condition where he doesn't metabolize food properly or he has a liver problem. I am really, really hoping it is something that can be treated with a diet change or medication as I can't afford much more! It cost me $3700 to have him at the vets this past week and remove the one bladder stone! I also don't want the poor little guy to have to go under again. Brodie only weighs 3lbs 9oz, which is a problem - when we purchased him we were told he was a toy, not a tea cup and would grow to 7-10lbs. I have been told this could be a sign of a liver shunt, but it could also just be that he is small. He is leaking small amounts of urine so I have him in a tiny area of the house. He is hating it and wants to come be with his mommy. I'm so worried picking him up because of all the stitches. He also has bruising (red under his skin) on his belly opposite the stitches. Is it dangerous handling him a lot when he had his bladder and belly cut open? I've been feeding him little bits at a time and he keeps cleaning up the bowl. I feel bad because he seems super hungry but the vet told me not to let him eat a lot all at once. Currently I am only feeding him his Wellness wet puppy food about 1-2tbsp at a time.

[JERSEY BOY]

Oh little Brodie I am so sorry you are not feeling well. Hope you and Mommy get some rest and feel better

[Patti]

Poor baby, he has been through a lot and Mom too. Do you have a crate you can put in your bedroom and keep him in there until he heals. I will keep him in my prayers.

[dwerten]

Originally Posted by Brodies Mommy

Brodie required the surgery to get the large stone out of his bladder as it kept obstructing and they would have to take a needle and dislodge it twice a day. The stone is being sent in for testing - not at my vets office. They told me Saturday they would have the results in 5 business days (I'm guessing after Christmas??). After they find out the results of the stone type they are going to decide what to do from there. They said it could either be he has a genetic condition where he doesn't metabolize food properly or he has a liver problem. I am really, really hoping it is something that can be treated with a diet change or medication as I can't afford much more! It cost me $3700 to have him at the vets this past week and remove the one bladder stone! I also don't want the poor little guy to have to go under again. Brodie only weighs 3lbs 9oz, which is a problem - when we purchased him we were told he was a toy, not a tea cup and would grow to 7-10lbs. I have been told this could be a sign of a liver shunt, but it could also just be that he is small. He is leaking small amounts of urine so I have him in a tiny area of the house. He is hating it and wants to come be with his mommy. I'm so worried picking him up because of all the stitches. He also has bruising (red under his skin) on his belly opposite the stitches. Is it dangerous handling him a lot when he had his bladder and belly cut open? I've been feeding him little bits at a time and he keeps cleaning up the bowl. I feel bad because he seems super hungry but the vet told me not to let him eat a lot all at once. Currently I am only feeding him his Wellness wet puppy food about 1-2tbsp at a time.

i recommend if stones is an issue and not liver shunt related the natural balance vegetarian diet as high protein causes stones usually. Were they not able to see if he had a shunt while under for the bladder stone? If the stone is urate and not struvite then it is probably tied to liver shunt. The liver shunt surgery is not too costly if you can get to university of tennessee to dr tobias. Being a smaller yorkie they are more susceptible to liver shunt as stunted growth is part of it

[Brodies Mommy]

Brodies stones were urate. The vet said this was due to a congenital issue. He wants to do more blood work on Monday because he is concerned his liver may be too small tho he said it looked fine on the ultrasound. He is consulting a nutritionist bc brodie is so small and young. I'm so worried. Brodie has peed a few drops what seems like hundreds of times today. I have now payed $4500 and really can't afford much more. I don't want to lose my baby! What can I do?

[dwerten]

urate is tied to liver shunt are you near cornell university as dr centers is a good source for liver shunt and if surgery university of tennessee dr tobias will be the cheapest route. So sorry Did they run bile acid tests ? I would recommend hill's L/D as your dog needs to be on a low protein diet 18% or below. If your dog is not having seizures you may want to just do natural balance vegetarian as that is low in protein and i know a yorkie on this after having stones

[Brodies Mommy]

I know you keep telling me all these things are connected to liver shunts, but my vet seems to have ruled this out. He says Brodie doesn't present any of the characteristics other than being small and having kidney stones which can be caused by many other things. He also says he saw nothing wrong with the liver when he did the ultrasound (or when the specialist looked at it). After Brodie had been on IV for several days they reran his tests and everything came back the way it should have. He had proper enzymes and function in both his kidney and liver. He also cut open his bladder, I would think when he did that he would have checked to see if there was a liver shunt even if he was doing nothing about it? I will ask tomorrow. He is concerned Brodie's liver is too small and not able to keep up with him. He is running more blood tests to check for his liver efficiency. Is that a possibility anyone has heard of before?
My vet told me Brodie would not require more surgery unless he got more stones. He saw nothing wrong with any of his organs that could be fixed with surgery. The test was being run to see what was going on with his liver and to change his diet or give him medicine accordingly. Do you guys think my vet is actually wrong and just didn't see the shunt? And the specialist didn't either? I want to believe them but all I've heard from everyone on YT is that he has a shunt and that is making me very worried that perhaps my vet isn't doing a good job. HELP!? I care very much about my baby and want this to all be over.

Also, I live no where near Tennessee. It would cost me quite a bit of money to get him there (probably like $1000).

[dwerten]

when you say specialist are you seeing an internal medicine specialist? What tests is your vet running? Did he run pre and post bile acid tests? A regular blood test does not ALWAYS show signs of liver shunt my dogs did not but when pre and post biles were done she has a liver issue. Are you near cornell university as dr center is excellent with this. So what is his reasoning for a small liver? For urate stones? Does he know urate stones are tied to liver shunt? Sadly many vets are not familiar with liver shunt - i went to 3 vets and no one mentioned liver shunt in my dog with mvd and finally on vet 4 he asked if she was ever bile acid tested and i asked what was that and he said all yorkies and maltese should be bile acid tested as it runs so prevalent so the fact that your dog has a small liver and urate stones really concerns me but maybe we are wrong as we are not vets it just sounds like it and i would make sure you take all your blood work and test results and have it reviewed with dr centers as to why your dog has urate stones - what diet is the vet putting your dog on ? Is it a low protein diet? what meds is he referring to ?

[Brodies Mommy]

Brodie and I are from NYC area. My vet sees tons of small dogs every day as that is what the majority of people have. An ultrasound specialist looked over the ultrasound as the technician that took it said everything looked fine but since Brodie is such a small dog he wanted to be certain. My vet had Brodie fast overnight and this morning is running a pre and post Bile acid test. He told me I could pick Brodie up in aprx 3 hours. He said that livers that are too small are common in this kind of animal, but the test would also tell if there was a shunt - though if there is it should be controllable with diet and medication as it was not large enough to be detected on the ultrasound. After the test results come back (how long does this take??), my vet told me he was going to meet with a nutritionist to decide Brodie's diet.

[dwerten]

Originally Posted by Brodies Mommy

Brodie and I are from NYC area. My vet sees tons of small dogs every day as that is what the majority of people have. An ultrasound specialist looked over the ultrasound as the technician that took it said everything looked fine but since Brodie is such a small dog he wanted to be certain. My vet had Brodie fast overnight and this morning is running a pre and post Bile acid test. He told me I could pick Brodie up in aprx 3 hours. He said that livers that are too small are common in this kind of animal, but the test would also tell if there was a shunt - though if there is it should be controllable with diet and medication as it was not large enough to be detected on the ultrasound. After the test results come back (how long does this take??), my vet told me he was going to meet with a nutritionist to decide Brodie's diet.

The test should be back in 24-48hrs tops and then you will know how the liver is functioning - if there is a shunt I would have it fixed and by dr tobias at ut as if you have it done there it will be more expensive than flying to ut or driving. I would at least get an estimate. It may just be mvd so wait for the results but if the pre or post are over 100 I would do scintigraphy next. What can happen if you do not fix a single shunt early on is it can blow more shunts and then it can never be repaired. Diet alone will not stop symptoms if the dog has a shunt. If it is mvd then yes diet helps a low protein diet of fish, vegetarian, soy works. My dog has mvd and her pre and post biles were below 100

[BanditSocks2]

Wow, poor little Brodie. Hopefully when all the tests come back they can provide an appropriate treatment, even if it's just a strict diet. You both are in my thoughts.

[Brodies Mommy]

Brodie update:

Bile acid test results:
Pre meal - 290
Post meal - 366

He has no external liver shunts so they believe it is an internal liver shunt that is causing him the issues. The only way they could find this is to do a liver biopsy which is very dangerous and costly. My vet has recommended Hills LD and has ordered me a bag of dry and a case of wet food as well. He is going to monitor Brodie's urine and blood once every 3 months. He said Brodie could have lots of complications down the road but right now he is playful and healthy and he sees no reason to do a very dangerous surgery that could kill a 3lb dog if it can be controlled by diet and constant regulation. He said Brodie could have Hepatic micro dysplasia. :'(

What to do now?

[dwerten]

Originally Posted by Brodies Mommy

Brodie update:

Bile acid test results:
Pre meal - 290
Post meal - 366

He has no external liver shunts so they believe it is an internal liver shunt that is causing him the issues. The only way they could find this is to do a liver biopsy which is very dangerous and costly. My vet has recommended Hills LD and has ordered me a bag of dry and a case of wet food as well. He is going to monitor Brodie's urine and blood once every 3 months. He said Brodie could have lots of complications down the road but right now he is playful and healthy and he sees no reason to do a very dangerous surgery that could kill a 3lb dog if it can be controlled by diet and constant regulation. He said Brodie could have Hepatic micro dysplasia. :'(

What to do now?

sorry but not real thrilled with vet just being honest anything over 100 is usually an external shunt in a yorkie not an internal. Internal shunts happen is large dogs not small dogs so i really have a red flag up about this vet and have since your first post as i knew this was liver shunt related. Mvd or hmd is what my dog has and that is usually when a dog is asymptomatic meaning no signs and bile acids are below 100 anytime it is above 100 usually is a shunt and one is easy to correct if your dog blows more shunts due to one shunt not being corrected then you will not have surgery as an option. The next thing i recommend is a scintigraphy as that is more precise in determining if shunt or not NOT AN ULTRASOUND. These dogs are tiny and shunts are almost impossible to see on an ultrasound. The scintigraphy cost about $390 and only certain specialists can do it as it is radioactive dye- if this were my dog I would have the scintigraphy done next and i would go to ut because if it is a shunt and shows up in scintigraphy i would want dr tobias to do the surgery immediately so my dog could live a normal life. Have you joined this group as they can help you alot as they helped me out alot when dd was diagnosed with mvd.

Liver_Shunt_And_MVD_Support : Liver Shunt & MVD/HMD Support

here is what a scintigraphy is

Portal Scintigraphy in Veterinary Medicine

basically they put a dye capsule in your dogs butt and it travels through the body and they take hundreds of pics to see if it bypasses the liver if it does then there is a shunt if it does not then no shunt. It is the only true test for liver shunt that is accurate. Protein c is a blood test for it but a dog with 3 shunts showed negative for a shunt so i do not think that test is so accurate anymore. The dog does not have to be sedated if calm and you have to leave for entire day as all dye has to be out of them before they can come home.

[dwerten]

mvd

MVD

liver shunt

Do all dogs with high bile acids have shunts?

Bile acids can be increased with any liver disease. Bile acids can also be mildly increased in normal dogs, particularly in some breeds (such as Maltese) where chemicals in their blood interfere with the test. Most dogs with liver shunts have fed bile acids over 100 (normal <15-20). If the bile acids are only mildly increased or the animal seems normal, many veterinarians will simply rerun the test in 3-4 weeks.

Congenital Portosystemic Shunts

[dwerten]

this is a very good site

Portosystemic shunts - liver shunts