Really scared for Brodie high enzymes please help

[dwerten]

here is info stating internal shunts are in big dogs external are in small dogs

Portosystemic shunt - Wikipedia, the free encyclopedia

[Brodies Mommy]

Are you a vet? Or just a person with experience with their dog? I would imagine the fact that my dog was physically cut open and had his kidney and bladder squished, squeezed and cut open would have given my vet an opportunity to look for an external liver shunt? Unless he is a complete idiot (which I rather not believe considering all that surgery was done) why would he not look? He has done many liver shunt surgeries himself (which he has told me) and said it would be a costly operation. Since he is so familiar with liver shunts I assume (maybe I'm dumb?) while he had poor Brodie open he would have looked?? Otherwise why would he so confidently rule out an external shunt???
I don't really know what else to do. I already paid $4,200, not to mention my vet informed me he went ahead and ordered me a case of Hills LD wet dog food and dry (as they only sell by the case). I can't wait for that bill! Maybe this makes me a bad dog owner, but I've had him for 4 months and didn't anticipate him costing so much in such a short period of time. I really can't afford more surgery, or a $300 flight to TN, plus taxis, plus hotel stay, plus food, and time off work... I don't mean to offend but I am not a millionaire or a stay at home doggy mom. I want the best for my little guy but I'm now in debt and my vet seems to think he shouldn't have surgery so I am not sure I should go put another couple thousand on my credit card and rush him into surgery again.

[Brodies Mommy]

ALSO to quote from what you sent me to read - Symptoms of congenital PSS usually appear by six months of age[1] and include failure to gain weight, vomiting, and signs of hepatic encephalopathy (a condition where toxins normally removed by the liver accumulate in the blood and impair the function of brain cells) such as seizures, depression, tremors, drooling, and head pressing.

Brodie has none of this at all... this is why my vet didn't think it was a shunt at all. He also had no symptoms appear until he was 8 months of age and the only symptom being one stone that was in his bladder and much to large for him to pass that happened to be urate. He had no crystals and did not have concentrated urine.

The article also states - Surgery definitively shows the shunt if it is extrahepatic.
Brodie already had surgery, he is just recovering. My vet didn't tell me he saw any external shunts and has suggested he thinks it is an internal one.

And this is the exact reasoning my vet gave for concluding he didn't want to operate on Brodie - Intrahepatic shunts are much more difficult to surgically correct than extrahepatic shunts due to their hidden nature, large vessel size, and greater tendency toward portal hypertension when completely closed.


Am I being really stupid? I really don't understand how my vet could be wrong about it being internal. I also don't understand why Brodie lacks all signs of a liver shunt? I am glad, but it makes no sense to me. In your opinion I should go into my vets office and demand he perform another test because I don't believe he didn't see an external shunt? Then demand I take my dog to Tennessee for a surgery my vet has told me is too dangerous for my baby?

[Brodies Mommy]

I want to note - I am not trying to be mean at all. I'm so upset about my baby and more upset that I am not sure I can afford more surgery to fix him! I am a responsible person, but I just don't have the ability to pay off a credit card with much more debt

Do you have information on how much the surgery would cost at Cornell? That is drivable for me.

[dwerten]

Originally Posted by Brodies Mommy

Are you a vet? Or just a person with experience with their dog? I would imagine the fact that my dog was physically cut open and had his kidney and bladder squished, squeezed and cut open would have given my vet an opportunity to look for an external liver shunt? Unless he is a complete idiot (which I rather not believe considering all that surgery was done) why would he not look? He has done many liver shunt surgeries himself (which he has told me) and said it would be a costly operation. Since he is so familiar with liver shunts I assume (maybe I'm dumb?) while he had poor Brodie open he would have looked?? Otherwise why would he so confidently rule out an external shunt???
I don't really know what else to do. I already paid $4,200, not to mention my vet informed me he went ahead and ordered me a case of Hills LD wet dog food and dry (as they only sell by the case). I can't wait for that bill! Maybe this makes me a bad dog owner, but I've had him for 4 months and didn't anticipate him costing so much in such a short period of time. I really can't afford more surgery, or a $300 flight to TN, plus taxis, plus hotel stay, plus food, and time off work... I don't mean to offend but I am not a millionaire or a stay at home doggy mom. I want the best for my little guy but I'm now in debt and my vet seems to think he shouldn't have surgery so I am not sure I should go put another couple thousand on my credit card and rush him into surgery again.

not a vet but a VERY WELL INFORMED DOG OWNER. And sadly i think your vet is MILKING YOU. Ask your vet if he looked during surgery to see the shunt? Does your dog have a long scar on belly? If not he did not cut him up far enough to see the liver is my guess. Those numbers are really high on bile acids. I hope your vet is right and knows his stuff but with numbers that high I would have to question him. I was only trying to help you as i have read on liver shunt for 5 years and am a member of liver shunt groups. Did you ever join that group i recommended to you as they know alot about this probably more than many vets so i STRONGLY recommend this group. I know you are upset trust me I spent 10k on pancreatitis over the course of the year and am out over 25k now with 3 dogs in 5 years. It is very costly to own a sick dog and why i do so much research myself and try to help others with what i know as sorry but very disappointed in the vet profession from what i have seen. And in your state and my state it is VERY EXPENSIVE for vet care as what you are seeing. Sadly had you gone to ut it would have cost you about 2k and that includes all diagnostics and surgery so now like myself you are out all this money and still do not have a difinitive answer as to if your dog has mvd or liver shunt and mvd (hmd) those numbers are high for that as everything i sent you shows numbers less than 100 for mvd (hmd) and over 100 most likely shunt - a dog i helped had NO SYMPTOMS but stones and had 3 shunts so dogs do not have to have all the symptoms. Join the group and educate yourself further it will save you money in the long run. I never put 100% of my trust in anyone anymore as they are only human and why i mostly deal with specialists when it is something more serious.

[dwerten]

Originally Posted by Brodies Mommy

I want to note - I am not trying to be mean at all. I'm so upset about my baby and more upset that I am not sure I can afford more surgery to fix him! I am a responsible person, but I just don't have the ability to pay off a credit card with much more debt

Do you have information on how much the surgery would cost at Cornell? That is drivable for me.

if you are close to cornell then take all diagnostics to dr centers as she is very familiar with this along with dr tobias they are the top two in this field and they are constantly doing studies on it. Dr centers is an internal medicine specialist and dr tobias is a surgeon. Dr centers is able to treat without surgery in some cases so i would take everything to her get copies of all reports from your vet and do a consult with her and have her check everything. Ask your doctor if he knows dr centers or dr tobias if he doesn't then he is not real up on the subject as those two are well known around the country for their works. Follow dr centers advice and JOIN THAT GROUP

[dwerten]

Originally Posted by Brodies Mommy

ALSO to quote from what you sent me to read - Symptoms of congenital PSS usually appear by six months of age[1] and include failure to gain weight, vomiting, and signs of hepatic encephalopathy (a condition where toxins normally removed by the liver accumulate in the blood and impair the function of brain cells) such as seizures, depression, tremors, drooling, and head pressing.

Brodie has none of this at all... this is why my vet didn't think it was a shunt at all. He also had no symptoms appear until he was 8 months of age and the only symptom being one stone that was in his bladder and much to large for him to pass that happened to be urate. He had no crystals and did not have concentrated urine.

The article also states - Surgery definitively shows the shunt if it is extrahepatic.
Brodie already had surgery, he is just recovering. My vet didn't tell me he saw any external shunts and has suggested he thinks it is an internal one.

And this is the exact reasoning my vet gave for concluding he didn't want to operate on Brodie - Intrahepatic shunts are much more difficult to surgically correct than extrahepatic shunts due to their hidden nature, large vessel size, and greater tendency toward portal hypertension when completely closed.


Am I being really stupid? I really don't understand how my vet could be wrong about it being internal. I also don't understand why Brodie lacks all signs of a liver shunt? I am glad, but it makes no sense to me. In your opinion I should go into my vets office and demand he perform another test because I don't believe he didn't see an external shunt? Then demand I take my dog to Tennessee for a surgery my vet has told me is too dangerous for my baby?

i am telling you your vet is not real familiar as the odds of a yorkie having an internal shunt is a LONG SHOT. They have external internal run in BIG dogs and yes i am asking you to question this vet. I helped a dog that was older than yours had NO SYMPTOMS FOR YEARS had stones like your dog and whamo 3 shunts when dr tobias opened him up and she closed him up and could do nothing - now had shunt been repaired when a pup then 3 shunts would not have occured. Multiple shunts are acquired due to one shunt not being repaired early enough the dogs body throws more shunts to adapt to shunt and if a dog has multiple ones no repair can be done. I have friends with shunt dogs where the symptoms do not appear until 2 years of age so it is not unlikely but your dog is showing a symptom - urate stone is a symptom of liver disease, the bile acids are very high too another symptom. Unless your vet did the test wrong or gall bladder contracted but even so the numbers would still not be that high.

[Brodies Mommy]

I had a question about Dr. Centers. How do I go about getting in touch with her? I don't just drive my dog up there do I? It is a very far drive for us both (8 hours), so we don't want to get there and then be told that she doesn't see animals like that. Brodie has been very lethargic and isn't his perky self at all since his surgery. He sleeps most of the day and can't hold his bladder (he pees every 15mins or so, at least tries to - it is usually only a tiny bit). I can't have him upstairs with me anymore because he can't make it back to his wee pad and will just stop and go. He seems incredibly unhappy and unhealthy. I want to get him the medical attention immediately.

I already joined that group you referred me too. I filled out the spreadsheet and forwarded it back to the group.

Thanks!

[dwerten]

so sorry he is not doing well You can make an appointment with her at cornell university and let them know you are driving 8 hrs to see her as i know someone else that did that and ended up having to stay an extra day as she had an emergency situation so be prepared it is a university hospital so plan a couple days if you can - here is the number and it is dr sharon center internal medicine

Cornell University Hospital for Animals

keep in mind they usually are not feeling well after a surgery so give it a bit of time with that- that group will help you ALOT and be a great support for you as well so hang in there i know it is not fun having a sick one as i have an ongoing one myself and my other one was sick for a year

[Brodies Mommy]

thank you so much for all of your help! I am going to call!

[Brodies Mommy]

I am so confused now!

I called Dr Centers at Cornell and she was incredibly nice and explained the entire process to me. She will be in the vet hospital in a week and a half and said she would be more than glad to see Brodie. She asked me to bring him in on a Monday so that we could get the testing out of the way to see if he was even a candidate for surgery. I was very happy with this - yes, I'd have to take time off work, but at least Brodie would be getting looked at and hopefully fixed!

THEN, the group you had me join on yahoo informed me that Dr Centers was a very bad choice, that they would not take their dogs there as she was inexperienced and that just pretests alone with her would cost me $3500. They told me the only good choice was Dr. Tobias. Now, I understand Dr Tobias may be the best, but I live no where near UT. I'd have to take a plane, rent a car, get a hotel, take off work, hope I could get Brodie on the plane, be alone in TN (I'm a young female, I feel so unsafe doing that), and then hope that Brodie was a candidate for surgery or I'd have wasted my time. Is Dr Centers really that expensive? I thought she too was under $2000 for the full surgery and pre-op work? Is she really a bad choice?

[dwerten]

she is not the surgeon so for surgery no i would not have her do surgery - dr tobias is a surgeon and dr centers is an internal medicine specialist. you would only be going to dr centers as a consult to review all the tests you have already done to discuss his case. Call her back ask if they do the scintigraphy there and ask her the cost and tell her you have all these tests done already and do not want them duplicated you just want her to review the tests and get back with you and maybe you can even do over the phone as a phone consult as i think your vet can overnight the ultrasound, and you or vet can send all records for her to review this may save you the trip - I do agree dr tobias is the best for surgery and cheapest - are you near new jersey? I know someone else on a yorkie group that is very pleased with her surgeon that did the shunt surgery and could get you her info as she could not make the trip either - The group has a list of hotels, etc over there and it is very safe i believe as my friend flew from california stayed a week and had everything done there as it was very expensive to have it done here and the surgeon had not done alot of them here so she was more comfortable going to ut and flight hotel, surgery all was cheaper than surgery here

[kr1mzn]

Hey I was just checking to see how Brodie was doing?? I hope all went well or if not I am soo soo sorry! I have been following your posts and could find no further post . Thanks Cindy and Crimson in Alabama

[Brodies Mommy]

Brodie was doing well, he had gained weight and was acting much more like a "normal" puppy! Unfortunately, Brodie looks like he needs another trip to the vet! He has been straining to go to the bathroom and I am not sure if it is another stone or what could be wrong. He looks like he is trying to poo and when he does go it is in little tiny bits. Because he is straining to poo so much he has peed all over himself. He is drooling excessively and otherwise in pain. I'm completely distressed and am waiting for my vets office to open so I can bring the little guy in... again. I hate this so much

[kjc]

Did you have a consult with Dr. Centers or Dr. Tobias? I'm seeing this thread for the first time... just wondering if anything had changed? Hope it's something simple at the vet's today. I'll keep you and Brodie in my prayers....