Possible Shunt/Liver Disease

[Patti]

I am sorry the results weren't better. Cali had 2 BA tests here results were 0/90 and 0/47 or close to that. We did the ultrasound, no external shunt and then did a liver biopsy. The biopsy showed a very mild case of MVD. I just keep her on a low protein diet, including treats and 5 1/2 years later she is doing great. Her recent blood work was great. I am hoping that Lucy will continue to do just fine.

[Ringo1]

Lucy had mildly high BAT's after testing and re-testing. The vet did not think they were high enough to be indicative of a shunt. but pointed more toward MVD. We proceeded with that diagnosis and skipped the biopsy. Your Lucy's numbers are a bit higher thouth.

We treated her with diet and she has had no further symptoms.

I hope that this is all YOUR Lucy will require; anxious to see what your Vet has to say.

[aproctor]

Originally Posted by Patti

I am sorry the results weren't better. Cali had 2 BA tests here results were 0/90 and 0/47 or close to that. We did the ultrasound, no external shunt and then did a liver biopsy. The biopsy showed a very mild case of MVD. I just keep her on a low protein diet, including treats and 5 1/2 years later she is doing great. Her recent blood work was great. I am hoping that Lucy will continue to do just fine.

Thank you!! I am hoping too!! Lucy's blood work was so good I was really hoping that the BAT would have come out better too. I am waiting on the Vet to call and I hope he does tomorrow!

[aproctor]

Originally Posted by Ringo1

Lucy had mildly high BAT's after testing and re-testing. The vet did not think they were high enough to be indicative of a shunt. but pointed more toward MVD. We proceeded with that diagnosis and skipped the biopsy. Your Lucy's numbers are a bit higher thouth.

We treated her with diet and she has had no further symptoms.

I hope that this is all YOUR Lucy will require; anxious to see what your Vet has to say.

Thank you!! I am hoping that is all she will require too. She is only 6 pounds so it worries me to think she may need surgery. I am hoping that a low protein diet and maybe a supplement or something will be the answer since her blood work/liver enzymes came back so good.

I will be calling the Vet tomorrow if I don't hear from him by 9am!!!

[107barney]

Originally Posted by aproctor

Thank you!! I am hoping that is all she will require too. She is only 6 pounds so it worries me to think she may need surgery. I am hoping that a low protein diet and maybe a supplement or something will be the answer since her blood work/liver enzymes came back so good.

I will be calling the Vet tomorrow if I don't hear from him by 9am!!!

Any news?

[aproctor]

Originally Posted by 107barney

Any news?

I called but the Dr was in with a patient so I am waiting for him to call me back!!! If he tells me the DR at BP hasn't called him yet then I am going to call there because I can't WAIT any longer!!!!!!! I am getting frustrated!!!

The good news is that it was actually bearable to go outside this morning so we actually got to take a walk...YaY....we have been cooped up way too long inside trying to stay away from the HEAT!

[kjc]

Hoping no news is good news... praying harder that you get good answers! Hang in there!

[aproctor]

My Vet here said he sent it to Dr Myers Monday but I think he meant Tuesday because he was supposedly out on Monday and then Dr Myers was out on Wednesday but she is supposed to review it TODAY and he should be able to call me later today to talk about it.
Blah Blah Blah Blah................I am tempted to call BP and ask them to talk to Dr Myers myself and tell her this needs to be done TODAY!!!!!!!

It is sooo frustrating and I wonder if they just don't think this is important but then I remember that we humans go through the same thing. My dad had an important Dr appt. yesterday and the Dr called in sick so the nurse that called told my mom...."I will call you to reschedule" I told my mom she needs to call her because you may wait forever!!! All Dr's seem to be the same I think!

[107barney]

Originally Posted by aproctor

My Vet here said he sent it to Dr Myers Monday but I think he meant Tuesday because he was supposedly out on Monday and then Dr Myers was out on Wednesday but she is supposed to review it TODAY and he should be able to call me later today to talk about it.
Blah Blah Blah Blah................I am tempted to call BP and ask them to talk to Dr Myers myself and tell her this needs to be done TODAY!!!!!!!

It is sooo frustrating and I wonder if they just don't think this is important but then I remember that we humans go through the same thing. My dad had an important Dr appt. yesterday and the Dr called in sick so the nurse that called told my mom...."I will call you to reschedule" I told my mom she needs to call her because you may wait forever!!! All Dr's seem to be the same I think!

I personally would call them. I don't have the patience to wait around. Didn't Dr. Myers do the first and second BAT?

[Ellie May]

Because it has been weeks since the last blood draw and the enzymes aren't as high as they had been originally, this wouldn't be considered very urgent. An extra day or two isn't going to make any difference because it has already been about 30 days.

Vets are so busy at times and sometimes get really frustrated when clients call to rush things along (if it needed to be rushed, your vet would rush it if they are any good). You know they have the results and that the called the specialist, so I'd hold off on calling until Monday afternoon. JMO. I highly doubt Lucy will get any worse waiting another few days, it's in your vet's hands, and I'm sure the IMS will get to it asap.

Now if you didn't hear from them about results, that would be different because things can get lost, etc.

[107barney]

Originally Posted by Ellie May

Because it has been weeks since the last blood draw and the enzymes aren't as high as they had been originally, this wouldn't be considered very urgent. An extra day or two isn't going to make any difference because it has already been about 30 days.

Vets are so busy at times and sometimes get really frustrated when clients call to rush things along (if it needed to be rushed, your vet would rush it if they are any good). You know they have the results and that the called the specialist, so I'd hold off on calling until Monday afternoon. JMO. I highly doubt Lucy will get any worse waiting another few days, it's in your vet's hands, and I'm sure the IMS will get to it asap.

Now if you didn't hear from them about results, that would be different because things can get lost, etc.

Thank you for saying this Ellie May. I felt there was a hidden message in there for your friends

[Ellie May]

Originally Posted by 107barney

Thank you for saying this Ellie May. I felt there was a hidden message in there for your friends

You mean for you? LOL. Well, I'm sure your vet is used to being rushed by you just as mine is used to being rushed by me. ha. But why traumatize more vets when it's okay to wait?

A few years back I couldn't stand waiting even 24 hours for itching to stop after a steroid infection. Poor dogtor. I'm surprised she still speaks to me.

[aproctor]

I did call to make sure Dr Myers was there and the tech I spoke to was very nice and she understood my anxiousness and said that she was in today and that she was going to review and speak with my Vet as soon as she could.

A couple of hours later my Vet did call and I just got off the phone with him and the summary of what he said is this: Because of the BAT's coming back elevated it indicates that there is still inflammation due to either hepatitis or possibly a shunt. Because of her not having any symptoms, and her blood tests being as good as they are they gave me these options:

Exploratory surgery/Biopsy (If there is a shunt they would repair it and if not they would just get the biopsy)
*Dr Myers feels this is the best route to go because if there is a bleed they can control it and if there is a shunt then she would only end up with one surgery.
Laparoscopic biopsy
Ultrasound guided biopsy
OR
L/D Diet and Denemarin (sp?) and testing again in 6 weeks to see if her BAT's improve.

As of this moment my head is spinning and I need to talk to my hubby, I ordered the L/D and Denamarin because either way I think to start her on this diet would be best and then we will make our decision from there.

It just freaks me out to think of her under the knife because she is sooo little!
I think it would be different if she actually seemed sick or had any symptoms at all then I would not hesitate.
If we do anything at all I think we would do an ultrasound because I don't want to have her go through any type of surgery that may or may not be necessary.

[Ellie May]

You do have one other option. That would be a scintography. If they are worried about a shunt, because she is so young, it may be your best option. I'm sure they don't do it there though, so you may need to go somewhere else.

Has she been spayed? A lot of people elect to do a biopsy at the time of spay because they are in there anyway.

An ultrasound is fine, but if they don't see a shunt, that doesn't mean it's not there. Ultrasound guided biopsy gives very tiny samples and that isn't always adequate.

You could do the explore/biopsy and that sounds like an okay plan, but do you want this specialist fixing a shunt if it is present? How many shunt repairs have they done?

Just some things to consider.

If I had a young dog and the vets wanted to make sure a shunt wasn't present and they didn't feel an urgent need to look in there with ultrasound, then a scintography is what I would be doing. If you can afford to do an ultrasound and then do a scintography if nothing is seen, then that's great. JMO

But it really depends why the IMS wanted the biopsy. If they want to r/o hepatitis, then perhaps just letting somebody go in and look would be best. What does your regular vet think?

[107barney]

I think I'd start l/d and denamarin, but even if the #s improved on BATs, I would be going forward with additional diagnostics including the exploratory surgery.