liver disease - YorkieTalk.com Forums

khloe0926 · 09-22-2010, 06:12 AM

Hi everyone. I am new to this forum but I am in need of some information and support. I have an 11 month old yorkie, khloe. She is the love of my life. Recently, she became ill. She wouldn't eat or drink and was very lethargic, which is not like her, she is very active. I have taken her to the vet and the emergency vet and she has had extensive tests done. Her bile acids were elevated and they suspected a shunt, but after the test yesterday they found out that isn't the case. Now they have done a liver biopsy to see if it is microvascular dysplasia. I am really frustrated because I feel like we are on a wild goose chase. She is eating now and acting more like herself, but they are concerned that it is some sort of liver disease because of her bile levels. Has anyone else had any experience with this? I want to do everything I can to help my baby. I have spent a lot of money so far and want to make sure I am doing all I can and make sure they are the right things. They said if the biopsy doesn't show anything then exploratory surgery would be next. Could it be possible that nothing is wrong? Could something else be causing her bile levels to be elevated? I just feel that she is so young and don't want to lose her to something like liver failure. Please help! Any information or advice would be greatly appreciated! Thank you all!

Jill

cally930 · 09-22-2010, 07:21 AM

I, unfortunately, do not have any advice for you. I do know that there are a lot of informative people on here that will respond. I just wanted to bump this up for you so that it won't fall through the cracks. In case they don't respond go through some old threads - there are a lot of links to some sites that will help you. I hope all goes well for you and your little puppy. Also, I hope you received a health guarantee from the breeder you got the puppy from - and contact them if you already haven't. The breeder should be responsible for all of this in some form or another - as this is a hereditary condition. Good luck to you and I pray all goes well.

Ladymom · 09-22-2010, 07:36 AM

You need to get a referral to an internal medicine vet or a vet school if you have one close enough. Most general practice vets don't see enough cases to have the experience and training to diagnose and treat liver shunts/disease.

How close are you to Ohio State? They have an excellent vet school.

You can waste a lot of time and money trying to get answers from a general practice vet. A specialist or vet school will repeat all the tests anyway.

I am very concerned that they did a biopsy. That is a very invasive test and should be done as a last resort. There are many less invasive and more accurate tests that should be done before a biopsy like a Protein C test, scintigraphy, etc.

Ultrasounds can be low as 60% reliable at detecting shunts, especially in small dogs. Is that how they ruled out a shunt?

khloe0926 · 09-22-2010, 01:43 PM

My general vet did refer us to MedVet which is where I took her for the ultrasound, which they ended up doing twice. They were unable to see a shunt either time. Its funny because they said ultrasounds catch shunts most of the time but my research and what you told me show that's not true. That makes me wonder if they are just taking me for my money. They also did a splenoportogram (not sure the spelling) which was basically injecting dye into her spleen to see if there was a shunt that way and that turned out negative. It was then that they did a biopsy in order to look for other liver diseases. The biopsy was just a needle biopsy and they said depending on the results they may have to actually go in to get a bigger portion for a biopsy. I thought about going to OSU but since I'm already taking her to MedVet I didnt want to have to repeat things and spend more money. The biopsy results come back in 3-5 days and then we will see from there. Right now they have her on Lactulose and Neomyicin 3 times a day. I just feel like after all the tests that we have done, there should be some answers and I would hate to do exploratory surgery for no reason. Khloe seems better but has bad diarrhea from the lactulose, but the doctor said we have to keep her on it until we know whats going on. I am very frustrated and want to make this as easy on my baby as possible. She has been through a lot the past couple weeks and it breaks my heart. Thank you for responding so quickly. I don't know where else to turn. And thank you Cally930 for your support. It is greatly appreciated! I will keep you updated.

Ringo1 · 09-22-2010, 04:13 PM

What were the BAT results? Did they tell you the numbers? I've not heard of doing a needle biopsy to detect a liver shunt; but then there is a lot that I haven't heard of!

khloe0926 · 09-23-2010, 02:48 AM

Her BAT levels were 40 pre and in the 80s post. They did the biopsy to see if she has microvascular dysplasia since they seem to believe there is no shunt because of the previous test results.

Ladymom · 09-23-2010, 07:46 AM

Quote:

Originally Posted by khloe0926

Her BAT levels were 40 pre and in the 80s post. They did the biopsy to see if she has microvascular dysplasia since they seem to believe there is no shunt because of the previous test results.

Generally, BAT levels under 100 suggest MVD, not a shunt.

I personally cannot imagine doing an invasive procedure like a biopsy on a dog with BAT results like that.

Most vets seem to be pretty conservative with those numbers. They will usually retest first. Lots of things, including how the blood is collected, can skew the results.

PSVA and MVD Research Summary

What do you feed her?

Lolasmom1211 · 09-23-2010, 10:19 AM

My Lola had a shunt and has MVD. My suggestion to you is DO NOT let them do exploratory surgery. Take a deep breath, do some research and figure out what you need to do next. The greatest help to me was to join the Yahoo group for liver disease -
Liver_Shunt_And_MVD_Support : Liver Shunt & MVD/HMD Support
they are a wealth of information and can give you numerous resources that may be helpful. I took Lola to University of TN to have her shunt repaired and she is now like a different dog. I was told a Portogram and the Ultrasound was not always conclusive. We did the scintigraphy and repair at UT for the same amount of money it would have been to have all of the tests run at my local vet. I'm not saying don't run the tests, just make sure you need to have them done. The lactulose should not cause diarrhea - only soft stools. I would cut back on the lactulose...the above group will be a great help to you - they were much more help to me than my local vet. Good luck!

Ringo1 · 09-23-2010, 04:51 PM

Lucy's numbers were not quite that high - but hers were elevated as well. We elected to alter her diet (slightly) and re-test in 30 days. The numbers were still slightly elevated and my vet diagnosed MVD based on the elevated numbers in two separate tests. We adjusted the protein in her diet accordingly and . . so far . . so good.

I agree with the above poster to take a deep breath and do some research; move forward from there. I also joined the group mentioned above.

Keep us posted!

09-22-2010, 06:12 AM	#1
khloe0926 Yorkie Talker Join Date: Sep 2010 Location: Dublin, OH USA Posts: 14	liver disease Hi everyone. I am new to this forum but I am in need of some information and support. I have an 11 month old yorkie, khloe. She is the love of my life. Recently, she became ill. She wouldn't eat or drink and was very lethargic, which is not like her, she is very active. I have taken her to the vet and the emergency vet and she has had extensive tests done. Her bile acids were elevated and they suspected a shunt, but after the test yesterday they found out that isn't the case. Now they have done a liver biopsy to see if it is microvascular dysplasia. I am really frustrated because I feel like we are on a wild goose chase. She is eating now and acting more like herself, but they are concerned that it is some sort of liver disease because of her bile levels. Has anyone else had any experience with this? I want to do everything I can to help my baby. I have spent a lot of money so far and want to make sure I am doing all I can and make sure they are the right things. They said if the biopsy doesn't show anything then exploratory surgery would be next. Could it be possible that nothing is wrong? Could something else be causing her bile levels to be elevated? I just feel that she is so young and don't want to lose her to something like liver failure. Please help! Any information or advice would be greatly appreciated! Thank you all! Jill

09-22-2010, 07:36 AM	#3
Ladymom Donating YT 2000 Club Member Join Date: Sep 2007 Location: North Carolina Posts: 8,317	You need to get a referral to an internal medicine vet or a vet school if you have one close enough. Most general practice vets don't see enough cases to have the experience and training to diagnose and treat liver shunts/disease. How close are you to Ohio State? They have an excellent vet school. You can waste a lot of time and money trying to get answers from a general practice vet. A specialist or vet school will repeat all the tests anyway. I am very concerned that they did a biopsy. That is a very invasive test and should be done as a last resort. There are many less invasive and more accurate tests that should be done before a biopsy like a Protein C test, scintigraphy, etc. Ultrasounds can be low as 60% reliable at detecting shunts, especially in small dogs. Is that how they ruled out a shunt? __________________ http://www.myladysdogbows.com/ http://www.facebook.com/home.php?ref...6213341?ref=nf

09-22-2010, 04:13 PM	#5
Ringo1 Ringo (1) and Lucy too! Donating Member Join Date: Sep 2009 Location: On the Edge of Glory Posts: 3,447	What were the BAT results? Did they tell you the numbers? I've not heard of doing a needle biopsy to detect a liver shunt; but then there is a lot that I haven't heard of! __________________ Mommy to Lucy, Ringo, and Matthew

09-23-2010, 04:51 PM	#9
Ringo1 Ringo (1) and Lucy too! Donating Member Join Date: Sep 2009 Location: On the Edge of Glory Posts: 3,447	Lucy's numbers were not quite that high - but hers were elevated as well. We elected to alter her diet (slightly) and re-test in 30 days. The numbers were still slightly elevated and my vet diagnosed MVD based on the elevated numbers in two separate tests. We adjusted the protein in her diet accordingly and . . so far . . so good. I agree with the above poster to take a deep breath and do some research; move forward from there. I also joined the group mentioned above. Keep us posted! __________________ Mommy to Lucy, Ringo, and Matthew

09-22-2010, 07:21 AM	#2
cally930 Donating YT 500 Club Member Join Date: Jul 2010 Location: Mt. Sinai, New York Posts: 910	I, unfortunately, do not have any advice for you. I do know that there are a lot of informative people on here that will respond. I just wanted to bump this up for you so that it won't fall through the cracks. In case they don't respond go through some old threads - there are a lot of links to some sites that will help you. I hope all goes well for you and your little puppy. Also, I hope you received a health guarantee from the breeder you got the puppy from - and contact them if you already haven't. The breeder should be responsible for all of this in some form or another - as this is a hereditary condition. Good luck to you and I pray all goes well.

09-22-2010, 01:43 PM	#4
khloe0926 Yorkie Talker Join Date: Sep 2010 Location: Dublin, OH USA Posts: 14	My general vet did refer us to MedVet which is where I took her for the ultrasound, which they ended up doing twice. They were unable to see a shunt either time. Its funny because they said ultrasounds catch shunts most of the time but my research and what you told me show that's not true. That makes me wonder if they are just taking me for my money. They also did a splenoportogram (not sure the spelling) which was basically injecting dye into her spleen to see if there was a shunt that way and that turned out negative. It was then that they did a biopsy in order to look for other liver diseases. The biopsy was just a needle biopsy and they said depending on the results they may have to actually go in to get a bigger portion for a biopsy. I thought about going to OSU but since I'm already taking her to MedVet I didnt want to have to repeat things and spend more money. The biopsy results come back in 3-5 days and then we will see from there. Right now they have her on Lactulose and Neomyicin 3 times a day. I just feel like after all the tests that we have done, there should be some answers and I would hate to do exploratory surgery for no reason. Khloe seems better but has bad diarrhea from the lactulose, but the doctor said we have to keep her on it until we know whats going on. I am very frustrated and want to make this as easy on my baby as possible. She has been through a lot the past couple weeks and it breaks my heart. Thank you for responding so quickly. I don't know where else to turn. And thank you Cally930 for your support. It is greatly appreciated! I will keep you updated.

09-23-2010, 02:48 AM	#6
khloe0926 Yorkie Talker Join Date: Sep 2010 Location: Dublin, OH USA Posts: 14	Her BAT levels were 40 pre and in the 80s post. They did the biopsy to see if she has microvascular dysplasia since they seem to believe there is no shunt because of the previous test results.

09-23-2010, 10:19 AM	#8
Lolasmom1211 Donating YT 500 Club Member Join Date: Apr 2008 Location: Texas Posts: 664	My Lola had a shunt and has MVD. My suggestion to you is DO NOT let them do exploratory surgery. Take a deep breath, do some research and figure out what you need to do next. The greatest help to me was to join the Yahoo group for liver disease - Liver_Shunt_And_MVD_Support : Liver Shunt & MVD/HMD Support they are a wealth of information and can give you numerous resources that may be helpful. I took Lola to University of TN to have her shunt repaired and she is now like a different dog. I was told a Portogram and the Ultrasound was not always conclusive. We did the scintigraphy and repair at UT for the same amount of money it would have been to have all of the tests run at my local vet. I'm not saying don't run the tests, just make sure you need to have them done. The lactulose should not cause diarrhea - only soft stools. I would cut back on the lactulose...the above group will be a great help to you - they were much more help to me than my local vet. Good luck!