Possible Shunt/Liver Disease

[aproctor]

1: You guys ROCK!! I applied for care credit and got approved right away...what a load off that is!!!

2: I contacted the vet again and got a referral for a good Internal Medicine Vet for the ultrasound and I am taking Lucy to BluePearl-Minnesota on Thursday at 1pm!!
I would go with the U of MN but it takes a long time to get in and it's a long process to get her in there so this was the better option.
I talked to two Vets here in Alex and they both said that Blue Pearl is a great place and I got the name of one of the Dr's there they both said is highly recommended!!

I am soo happy to get this going and I have all of you to THANK for that!!
You are right there is something not right and we need to get to the bottom of it or I will go crazy!

I am anxious and can't wait for Thursday now, I just hate stressing her out more by driving two hours to the specialist but it will be worth it in the long run!

I promise to keep you all informed!!

[107barney]

Honestly that place does not have bd. cert. internists except for one with bd. cert in oncology. There also is no bd. cert. radiologist listed.
The best bet for locating a shunt via ultrasound is by using bd. certfied specialists. IMO, there is no subsitute.

[ladyjane]

I totally agree with 107barney and would only go to a board certified specialist.

If you go to the website below, you can search for one. Look for SAIM in your state.



ACVIM

[aproctor]

Is there a reason that a vet that studied at the U of M wouldn't be able to do the same thing that they can do?

I will look to see if there is a Board Certified Specialist somewhere other than the U of M and see what I can find but I am not sure what I will do.

I thank you for the advice but I will figure it out from here and make the decision because to be honest I keep getting so much advice now that my head is spinning and I am getting a bit frustrated. I have a hard time believing that the 15 specialists in the state of MN are the only ones that can diagnose a shunt.
I will keep you all informed.

Thanks.

[ladyjane]

Simply trying to help since I have had many pups over the years who have needed specialists. Many!
Are they the only ones who can diagnose? No. Are they the best of the best? Yes.
And, if I am dealing with life threatening illness whether for myself or my pups, I want
the docs that have gone the extra mile in their specialty and who continue to educate
themselves. With a board certified vet I am assured of that.
Nothing is perfect...and you can find good and bad anywhere.
I just have certain standards that I require for myself and my pups as I said.
No one is trying to confuse you. Merely help.
Good luck with your decisions and to your Lucy. I hope that whoever you choose is
wonderful and you are happy with the outcome.
I will keep you all in my thoughts and prayers and not suggest anything else.

[107barney]

Originally Posted by aproctor

Is there a reason that a vet that studied at the U of M wouldn't be able to do the same thing that they can do?

I will look to see if there is a Board Certified Specialist somewhere other than the U of M and see what I can find but I am not sure what I will do.

I thank you for the advice but I will figure it out from here and make the decision because to be honest I keep getting so much advice now that my head is spinning and I am getting a bit frustrated. I have a hard time believing that the 15 specialists in the state of MN are the only ones that can diagnose a shunt.
I will keep you all informed.

Thanks.

No one is trying to make your head spin, we are telling you the gold standard. No one should be reading an ultrasound for a shunt who is not board certified in radiology and I think it is a waste of money to pay for imaging unless I'm getting the gold standard. We are just echoing what your first vet already told you -- go to the university and get the dog the right help. Good luck!

[aproctor]

I wasn't trying to be snippy and I do appreciate all of the advice given it is just frustrating because I was so excited about getting approved for carecredit and also getting her in to a specialist quickly and then I saw the posts and was like wow...I was on the phone all morning and now I have to start all over again.

I am sorry, just frustrated because my Lucy is sick and I do want her to get the best care I am just getting a little overwhelmed with all of this.

[ladyjane]

Originally Posted by aproctor

I wasn't trying to be snippy and I do appreciate all of the advice given it is just frustrating because I was so excited about getting approved for carecredit and also getting her in to a specialist quickly and then I saw the posts and was like wow...I was on the phone all morning and now I have to start all over again.

I am sorry, just frustrated because my Lucy is sick and I do want her to get the best care I am just getting a little overwhelmed with all of this.

Having a sick pup is overwhelming! The only reason we suggest things is because of our experiences....and reading about others.

If I can help someone avoid a pitfall, I try to do that.

Honestly, if she were mine, I would make the trip to Univ of MN. Your vet suggested it for a reason. Maybe you should call her and ask her where she would go if it were her pup. For something as serious as possible liver disease you want the best imo.

[aproctor]

Originally Posted by 107barney

No one is trying to make your head spin, we are telling you the gold standard. No one should be reading an ultrasound for a shunt who is not board certified in radiology and I think it is a waste of money to pay for imaging unless I'm getting the gold standard. We are just echoing what your first vet already told you -- go to the university and get the dog the right help. Good luck!

My Vet recommended the University because she herself went there. The Vet I am taking her to has also went to that same University which is a teaching hospital. I was excited to find someone who studied there.

If I take Lucy to the University I will have to wait a couple of weeks or so to get her in and I don't want to wait that long.

You have to understand...my nephew had open heart surgery by a highly recommended board certified heart surgeon and that surgery gave him a deadly infection that eventually killed him at the age of 17 so I don't put all of my eggs in the basket when it comes to Board Certified.

I will call my Vet tomorrow and ask her if the Vet at Blue Pearl (who she said was also a good place to go as well as the U of M) has experience in this specific issue and go from there.

Again I am sorry I snapped!

[ladyjane]

I am surprised that it would take a long time to get into Univ of MN. Is that the case if a vet is referring?
I know that most of the schools prioritize. Maybe they don't consider this a priority? I don't know...but I would certainly ask. It probably would be based upon the records that your vet sent to them.

[ladyjane]

There are always risks with ANY surgery whether it be on a person or animal and it can happen with any doctor or vet; BUT I still say, as Cathy did, that board certified is the way to go.
You are not planning surgery here. You want a definitive diagnosis and I would hate for you to end up in the same place as you are now and looking for yet another vet. I have seen that happen to many people.
But...as I said, you make your choice and hopefully it will lead you to a diagnosis for your precious Lucy. I agree that you should consult with your vet and go from there. My question to the vet would be: "who is the best and who would you take your pup to"? NOT ... tell me what I want to hear because I don't want to wait two weeks. We always want what we want and want it yesterday; but in a case like this, that is not always the wisest way to choose.

[Tae1107]

If you are looking for a shunt I would go to someone who specializes in (or at least has done it often) looking for shunt via doppler ultra-sound.... I had an ultra sound done on my Quinn when he was about 6 months old due to high post bile levels (60) no shunt was found.......so he was diagnosed as MVD and treated as such

Quinn is now almost 5 years old and just had surgery for Liver Shunt (as I mentioned earlier) the first person who did the ultra sound when he was a puppy missed the shunt....the second person found the shunten (it could have gotten bigger since he was a puppy...but it was missed)....luckliy when he crashed with severe symptoms I rushed him in and he was treated (as a liver dog) and reponded well...I was also lucky that they were able to do the surgery on him at his age...as often times the aorta is too damaged to now close the shunt safely off....

[aproctor]

Now I am really confused. I just called the U of M again to verify how long it would take to get in and this person said a few days but when I told her what we needed done and what for she went on to say that they "wouldn't do an abdominal ultrasound" for a shunt and that they would do either one of two procedures that I have never heard of and talked about surgery right away when we don't even know if she will need that. AND they are significantly more expensive too.

I think I need a drink! UGH...again my head is spinning!
I have a call into MY vet to ask her what that would all mean and to ask her if she would take her pet to Blue Pearl?! I am waiting for her to call me back either today or tomorrow.

[aproctor]

Originally Posted by Tae1107

If you are looking for a shunt I would go to someone who specializes in (or at least has done it often) looking for shunt via doppler ultra-sound.... I had an ultra sound done on my Quinn when he was about 6 months old due to high post bile levels (60) no shunt was found.......so he was diagnosed as MVD and treated as such

Quinn is now almost 5 years old and just had surgery for Liver Shunt (as I mentioned earlier) the first person who did the ultra sound when he was a puppy missed the shunt....the second person found the shunten (it could have gotten bigger since he was a puppy...but it was missed)....luckliy when he crashed with severe symptoms I rushed him in and he was treated (as a liver dog) and reponded well...I was also lucky that they were able to do the surgery on him at his age...as often times the aorta is too damaged to now close the shunt safely off....

I guess that is what they are looking for since her initial blood tests found her liver levels to be over 900 and her bile acids now are 103 fasting and 35.3 after food. I don't know???? My vet talked about PSS from the start of all this so that is what I assume they are looking for.
She also has a collapsed trachea so I am worried about what will happen if she does need surgery?!?!

[BabyGirl Rosie]

Originally Posted by aproctor

Now I am really confused. I just called the U of M again to verify how long it would take to get in and this person said a few days but when I told her what we needed done and what for she went on to say that they "wouldn't do an abdominal ultrasound" for a shunt and that they would do either one of two procedures that I have never heard of and talked about surgery right away when we don't even know if she will need that. AND they are significantly more expensive too.

I think I need a drink! UGH...again my head is spinning!
I have a call into MY vet to ask her what that would all mean and to ask her if she would take her pet to Blue Pearl?! I am waiting for her to call me back either today or tomorrow.

I am so sorry you are going through this. I know when your baby is sick it is so hard. Add trying to determine where to go and what to have done just adds to it. Hopefully your vet will guide you to what is best for you.

What two procedures are they suggesting? Maybe LJ will know about them.