lol thanks I did not read further down. Yep then I would go to surgery then as that is indicative of shunt and with symptoms I would skip scintigraphy

Liver shunt dogs can lead a normal great life after surgery so I would go for it and keep us posted and join the liver shunt groups for support too :)

Fudge is still not better and the Vet is now cutting out the possibility of a shunt. They will however to a scintigraphy and CT scan tomorrow. What if it's not a liver shunt? Is this a "death notice" for my little baby??

Is your baby still wobbly ?

Have they done any X-Rays of the neck ? to rule out AAI. Also I'm concerned about Chiari as it can have same symptoms as shunt and can cause liver enzymes to be off.

He is very off-balance and pacing on the same spot the whole time.... No X-ray of the neck was done yet. I am worried that this might be something wrong with his brain and they can't do anything for him!!!

Well I can't see him but it does sound like he may have hydrocephalus. This can be caused by a few diff things, most of witch are treatable but he needs MRI & Spinal tap to diagnose them. I would get him in for a neck X-Ray 1st thing to rule out AAI as if he has this , one wrong move could kill him. Are you happy with the vet you have now ? Does he know about the things yorkies are prone to ? If this were my dog I would see a neurologist ASAP.

Not in that order. I would not let your regular vet do neck X-Ray as they can kill him if they are not familiar with AAI , when they stretch his neck for X-Ray. You just need to get him to a neurologist immediately, I'm talking like last week.

Carina,

His Bile Acid Test was pre 148 and post 182 - That is HIGH and the chances of him having a Liver Shunt are EXTREMELY HIGH. I would bet he has a Liver Shunt OR a severe case of Microvascular Displasia (MVD). Not ruling out anything else, but you are under Vet care and I am sure you will get him better.

It is good the Vet is going to do a Scintigraphy. You read about that here:
Portal Scintigraphy in Veterinary Medicine
Liver Shunt Research

His off-balance and pacing or circling, acting drunk, walking along the walls while his head is off to the side pressing are all Classic symptoms of Hepatic Encephalopathy (a condition where toxins normally removed by the liver accumulate in the blood and impair the function of brain cells). In order to control the Hepatic Encephalopathy (HE for short), low protein diet such as ROYAL CANIN Veterinary Diet® canine HEPATIC LS™ 14 (Dry Kibble) Hill's L/D (wet/canned), and drugs such as Lactulose AND Antibotics Such as metronidazole are given daily to prevent production and absorption of ammonia and other intestinal toxins.

Lactulose, a disaccharide sugar containing galactose and fructose, is used
for the treatment of hepatic encephalopathy in veterinary medicine. The
active ingredient, lactulose, works by reducing the ammonia build up in the
blood. The large number of resident bacteria in the intestine consumes the
unabsorbed lactose as their food and release lactic, acetic, and formic acid
and carbon dioxide gas. These acids draw fluid into the colon, softening the
stool. The acidification of the bowel contents draws ammonia from the
bloodstream and locks it there to be emitted with the stool. This action
aids the prevention of a form of dementia called hepatic encephalopathy.

HEPATIC LS | Royal Canin Veterinary Diet

Please keep us posted. When is he having the Scintigraphy?

i agree it sounds like a shunt to me too with those bats

deb they need to rule out the liver shunt first as these are all signs of liver shunt so once that is ruled out then I agree neurological testing needs to be done but first step is scintigraphy as those bats are high and my guess is liver shunt causing all the symptoms :(

many vets have no clue about liver shunt sadly :( with bats like that you have to first rule it out completely and scintigraphy will do this

Many vet's have no clue about allot of things. I agree about the liver and maybe I misunderstood but I thought I read the vet said they now don't think it is Liver so next step should be Neuro. My worry is they seem to be wasting too much time getting a diagnosis.

You are correct, but what I am gathering is, they did a U/S (which is only about 60% accurate in seeing a shunt), and they changed his diet to low protein. I do not think he is on Antib's or Lactulose. And unfortunately, in most cases, just switching to low protein diet just is NOT enough to control Hepatic Encephalopathy. Also, not sure what the low protein food is, it might be still to high in protein OR he could be eating too much of it at one time. LS or MVD dogs that are really bad, need to be feed small amounts of low protein food approx. 5 to 6 times a day, this way it is not a protein overload on the liver...

The Scintigraphy should shed some insight :)

I agree. Is the regular vet diong this , or specialist? as at this point I don't feel comfortable with this vet . I don't understand what's taking this vet so long to get on the rite track and get the ball rollin. This baby is very sick, how long does vet think he has to play games.

since dealing with radioactive dye it is very specialized as only about 2 places in california that are authorized to do it so I would assume the same there