Liver Question- Please help!
 

Does anyone have experience with Liver Shunts or other liver disease?
Chewy had a bile acid test done...
Pre food should be under 10- Came back 58
Post food should be under 20- Came back 37

We are going for more and more testing this week but I would like to hear from anyone who has experience with this first...

The Dr said true liver shunt should be in the 200's but this could be many small shunts. They want to do a biopsy to determine.

She has been really sick the last week or so and i'm terrified of anesthesia!

Anyone have a baby with something silmilar?

Do a search, and you will see tons of threads on LS.

I did somre searches and see a lot on shunts.. but i'm looking more for specific results.. on the numbers. I guess to me they dont seem that high that a biopsy is necessary. Maybe a change in food or medication...

Sorry! I don't know anything about shunts. I was hoping my post would bump this up for you so someone who does know can see it. I hope you get the answers you're looking for.

Thank You!
We're going in to see the neurologist tomorrow so I was hoping to get some opinions before then. I know I'll wind up doing whatever tests they suggest but i'm curious if the results are bad enough to require a biopsy. She is soo weak.. I dont want to keep putting her through all these tests if they arent necessary.

A neurologist for liver shunt? Is your baby showing other symptoms as well?

She fell down the stairs about a week and a half ago. She possibly had a seizure and shes acting drunk so they want to rule out neurological issues before doing the biopsy.

Ah poor baby! I hope she's fine!

Hi! unfortunately there are lots of people here with liver problem dogs. My dog has MVD, but she is asymptomatic. Her latest BATs were pre 8 and post 70. she shows no signs of anything being wrong. i have her on a moderate protein diet (20-25%) and am starting Denamarin soon. she is 4 years old and i've known about this since she was about 2 i think. previous BATs had higher pre values (25 and 45) and relatively similar post values (66 and 67). I have not done a biopsy of her liver but we did do an ultrasound for the heck of it (i worked at the vet hospital so we just threw a probe on her to see what was going on, at no cost to me). the ultrasound showed everything looked good but there was a little sludge in her gall bladder. what that means, i have no idea. it could have been nothing or it could be liver related.

Since your pup is showing possible neurological symptoms i'd definitely take her in to the specialist. I hope there is an internal medicine vet in the same office as the neurologist. They will most likely need to work together. And if surgery is required they should have a board certified surgeon there as well. Usually all these specialists are in the same building.

Sending prayers for your little one. I know how hard it is when they are sick and we don't have the answers.

I have two dogs with MVD... the numbers your dog is showing are highly indicative of MVD (which is the smaller shunting your vet alluded to).

How old is your dog? I recommend waiting until spay to do the biopsy, that is what I did with my dog.

What food are you currently feeding? Did your vet recommend you putting her on a low protein diet until you determine what is wrong?

Hepatic Encephalopathy
 

Hi,
First allow me to say that I am sorry you are dealing with this. The fear of the unknown is intimidating. My yorkie, Coco was recently diagnosed through biopsy with having microvascular dysplasia. Her bile acid tests were done last July and came back around 25, October and results were around 22, and this April just under 70. This last test was the first time her pre test came back abnormal. Without pulling the paperwork it was under 20....16, 17? She was otherwise asymptomatic. She was taken to U Penn for a consult, all lab there was "normal", blood and urine. They did not repeat the BATs. Was told to resume normal diet, she was fine that sometimes a number is just a number is just a number. Regular diet upset her stomach, so I spoke to my vet and she was already scheduled for a few teeth extractions (puppy teeth) and we decided to do the biopsy.

The seizures and acting drunk can be symptoms of Hepatic Encephalopathy. Check this page, www.petplace.com/dogs/hepatic-encephalopathy-in-dogs/page1.aspx.
The clinical manifestations of HE can range from mild (unusual behavior) to severe (coma).


Hysteria
Unpredictable bouts of aggression
Staggering
Pacing
Compulsive circling
Pressing the head against a wall
Sudden apparent blindness
Tremors
Seizures
Coma-like state

These unusual behavior changes are often more pronounced a short time after a meal.

Also watch for:

Anorexia
Lethargy
Weight loss
Drinking a lot or urinating a lot
Nausea or hypersalivation (drooling)
Vomiting
Diarrhea

As far as being nervous about anethesia...discuss these concerns with the vet. Ask questions...will the drug be tailored toward your furbaby with suspected liver issues? What will they use to monitor your furbaby while under anethesia?

There are a few groups on yahoo that are dedicated to liver issues in furbabies.
DogLiverDisease : Dog Liver Disease
Liver_Shunt_And_MVD_Support : Liver Shunt & MVD/HMD Support

I am a complete novice, but I found help and advise here and the 2 previously mentioned groups. Experience is a wonderful knowledge to share. Good luck with your everything. Ask questions, be your furbaby's advocate. It has been my experience that my vet has neverminded me asking why? how? when?. If she doesn't know, she will find out for me. The 2 of you are a team and tackling issues together will warrant the best results for your furbaby. Good luck with everything!! :D

Thank You for the replies.

She is 4 yrs 2 months. Spayed as a puppy.

I'm going to look up MVD right now... I'm just trying to see if there is anything I could do to control/lower the BAT numbers.. redoing the BAT test in some time to check if this had any effect.

Tomorrow is the neurologist and Wednesday I can call in and speak to the internal specialist. It is an ER/Specialist hospital but they all have such different schedules!!!

Is the low protien food by prescription only? She has been eating natural balance for about 2 yrs. Will do some low protien food searches now too.
Thanks

There are prescription foods available but many with MVD dogs just feed a normal low protein food, for example, I feed Natural Balance Organic food, the protein level is 22% I believe.

There is a lot of differing opinions on what food is the best to feed, personally me and my vet felt that a vegetarian diet or one TOO low in protein was not right for my dogs who are very young (1 and 3). So this is why I chose the food I did, everyone has to do what they are most comfortable with. Which natural balance are you feeding? protein source is more important then protein content. For example, Duck and beef are BAD sources of protein for liver compromised dogs, I stick with chicken.

The best way to control BAT numbers is with a low protein food.

I also use hepato support a supplement that has milk thistle in it. Many use denamarin, but my dogs could not tolerate it.

I did a biopsy on my youngest when she was spayed. My oldest had already been neutered when his high BAT's were found and I chose not to biopsy him. I did not think it was worth it to put him under since it wouldnt make a difference in treatment and therefore the benefits didnt outweigh the risks for me.

Are you using a hospital in NYC?

We went to VERG- Veterinary Emergency Referral Group in Brooklyn because I live close to there and have been there to see the dermatologist before.
She is eating Venison and Fish Natural Balance... those were chosen for allergy reasons but then I discovered that more likely her allergies are environmental rather than food related. She liked the food though (rare for her) so I kept her on it this whole time. I guess I will talk to them tomorrow about switching to a low protein food and these supplements you guys are talking about.

Can you please help me with the dry kibble? How does your furbabies tolerate the Natural Balance Organic? What is the highest protein level you would try? I have expressed to my vet that I want to try different food. She hasn't treated many LS or MVD furbutts and I doubt the ones she has dealt with, the "parents" have been quite as neurotic as I am. Coco isn't on lactulose, my vet doesn't feel her case warrants that presently. So I want to educate myself better about the nutritional aspect of it to approach not necessarily using a prescription kibble if it is not needed. Thanks. :)

Mine are not on lactulose either, my vet also said that it should only be used in more advanced cases and that mine didnt warrant it. My vet did recommend the Denamarin but mine threw it up everyday, so the vet recommended we take them off, she said not all dogs can tolerate it.

The usual recommendation you see, is nothing higher than 18% with symptoms and nothing higher than 22% otherwise. However, my vet and I agreed that with my dogs being so young and healthy (besides the high BAT's), such a low protein food was not necessary for them if I wanted to do something higher.

My dogs were on a 24% protein food (Innova small bites) and they did fine, I switched only because of a problem with the company (Natura) nothing else. Mine are doing very well on the Natural Balance Organic, I also add some chicken and potato canned food because one of my little brats is picky and won't eat only dry food :rolleyes: This does increase the protein level though.

Honestly, my one dog was on a food that is close to 40% protein before I found out and he had zero issues or symptoms on it. I wouldn't stick with it now that I know about the MVD though.

Basically, I focus most importantly on the TYPE of protein, I stick with chicken and fish based foods, and will add other proteins like cottage cheese or egg on my own sometimes.

I was not happy with the ingredients in any of the prescription foods which is why I chose to find something else.

My Cali has MVD diagnosed by a liver biopsy after 2 Bile Acid tests. Her first Bile Acid results were 0 pre and in the high 80's post o close to that. The second one was 0 pre and post was near 50. We did an ultrasound and then a liver biopsy when she was spayed at 8 months old. The liver biopsy came back with her having very mild MVD with no treatment needed. Cali just turned 5 last week and is doing well. She has allergies that are under control with medicine too. I have yearly blood work done and her liver values are great. I have not redone the Bile Acids as vets didn't think it was necessary.
I hope your little one has a similar outcome. Keep us posted.

My Cali has MVD diagnosed by a liver biopsy after 2 Bile Acid tests. Her first Bile Acid results were 0 pre and in the high 80's post o close to that. The second one was 0 pre and post was near 50. We did an ultrasound and then a liver biopsy when she was spayed at 8 months old. The liver biopsy came back with her having very mild MVD with no treatment needed. Cali just turned 5 last week and is doing well. She has allergies that are under control with medicine too. I have yearly blood work done and her liver values are great. I have not redone the Bile Acids as vets didn't think it was necessary.
I hope your little one has a similar outcome. Keep us posted.

I had feed them Orijen 6 fish before the diagnosis, my concern is Pickles (the youngest) always wants what Coco is eating. Pickles is healthy and I don't want her not receiving proper levels for her growth and development. So I would like to find a common ground that is good for both of them. The one issue that my vet and I have had is the "oh that low protein diet won't hurt Pickles". We are currently debating this. She is very tolerant of me and I love that about her. Sometimes I worry that she will feel I am stepping on her toes, but I think she understands I just want the best for my "brats". :D

This also brings up another issue for me. My vet did strongly suggest against pre-made raw diet though and that disappoints me. I see such a difference in my 9 yr old, non-yorkie, Belle. And with Stella & Chewy's frozen pre-made I am still not sure why....their Beef is 13.0% min protein per serving, the chicken is somewhere around there. I am confused why I am advised against using these once a day (1 and a half or 2 patties) if the protein content is so low and dry kibble the rest of the day? Merely a question from a nonvice, please be kind with your replies. :D

Raw (and canned) food appear to have a lower protein value but when converted to dry matter (moisture removed) the protein level goes WAY up.

However, I did consider Raw for a short time and I know there are others who feed Raw with MVD dogs, I chose not to because the risk of bacteria did concern me since liver compromised dogs can be pre disposed to a suppressed immune system.

If you are comfortable you could try it and see how your baby does on it, but I would stick with the chicken formula.

Thank you. I will probably just homecook for them for awhile. But I am definitely going to check out the Natural Balance Organic kibble.

When i first tested morgan she was eating nature's variety raw. after that i *think* i switched her to a regular kibble (wellness, solid gold, or nature's variety) but not a low protein one. i retested 3 months later and the results were similar. so diet really wasn't having much of an effect on her. during the next two years she was on a variety of foods including NV raw, NV instinct, wellness core, solid gold, wellness small breed, and innova small breed. she was on innova small breed for a few months when i decided to test again because she possibly needed knee surgery. those results had the lowest pre she's ever had (8) and a similar post to previous tests (70).

I was going to keep her on the innova small breed but then P&G bought out the company so i wanted to switch. I tried Acana and at the same time i did that Morgan got a bad UTI (which we're still treating). So in my paranoid mind i connect the two, even though it could just have been a coincidence. So NOW she is eating natural balance ultra small breed. And wouldn't you know it, not 3 days after i switched her over NB had a recall. it wasn't the same food i was feeding but i still don't like it. I think i'm gonna put her on Taste of the Wild salmon. its 25% protein and grain free. i think she should do fine on that.

Finding a food your comfortable with is such a pain in the butt. i don't' want to put morgan on a really low protein diet if its not necessary yet. i feel like she needs meat protein in her diet because she is a dog and dogs eat meat. i just don't feel comfortable feeding her a vegetarian or low meat protein diet unless all other things fail.

It is good you are seeing a Neuro Specialist. To me those numbers are extremely low and if it were my dogs numbers, I wouldn't do a biopsy unless she needed to be spayed and they were going in anyway. My Roxy was about 3.5 y/o when we did her first BAT, which was pre 43 and post 100.9 - since she was spayed and really lacked the 'classic symptoms' I chose not to do a biopsy. We did numerous other tests, blood, urine, clotting, protein C and about 6 more BATs over the next few years. With diet change and supplements, her pre has come down to normal, but her post stays in the 60 to 80 range.

Again, glad you are seeing a Neuro, bc she may have some other going on besides MVD.

that's what i was thinking too. hopefully its nothing serious and her condition can be treated with meds and diet change alone.

This is exactly what im thinking/ HOPING will work. Can you tell me what supplements and food you used?

Hello. I too have an MVD dog -- Daisy is now almost 10.

Her numbers were over 100 when she was diagnosed.
We put her on Hill's L/D and her post number dropped to 33. She did not tolerate the diet very well and was always starving.
We went on a home cooked vegetarian diet (15% protein) that is also high in fiber to help her with her IBD and severe allergies.
Her numbers now are post 13.

So diet can improve this condition in some dogs.