Possible Shunt/Liver Disease

[aproctor]

Hi all!!

I just got off the phone with Dr Myers (IMS) and this is what she said: Because of Lucy's enzymes being so much better, because the BAT's are at the numbers they are, and because she has been Asymptomatic for this period of time she said it is more indicative of MVD vs. an actual PSS. Many of the PSS cases she has seen had BAT numbers that were much higher than Lucy's.

She does not think it was a toxin because if it was the BAT's would not have been as elevated as they were the first time.

The only reason she suggested the other procedures is if WE wanted to know for sure whether it is or is not MVD.
If it was confirmed MVD we would be treating her with the L/D and Denemarin.
So as we decided I think the best route at this point is to treat her as though it is MVD and if there is ANY sign of any little thing I will get her in right away but for now this seems like the best thing to do!
I asked her: Do you think one of these procedures is NEEDED at this time? She said: No it is not needed at this time, if you wanted to do one of them to verify that it is MVD then we could perform them but none of them are NEEDED.

I am also going in to speak with my regular Vet today because they have a can of L/D that I am going to pick up and I have ordered the dry L/D and the Denemarin. I don't know why Dr. Christensen (reg Vet) didn't make this more clear when I talked to him......He recommended the L/D and Denemarin but he just didn't explain why like Dr Myers did.

Dr Myers also said again that if this was her she would be doing the same thing that we are choosing to do because she sees no reason to do any invasive procedure on Lucy at this time. So with that I feel much better!

I wish this had been made more clear the first time around but I am very glad I called Dr Myers and talked to her so that I got a better picture of what is needed and what we should do.

I think part of the confusion was my fault because I didn't make it clear who suggested what...but I think I got it all clear now and I hope this helps!!

[AprilLove]

Originally Posted by aproctor

No offense but I think you all read what you wanted to read but skipped the part about what the IMS said:
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. *****When I said Dr Myers feels this is the best route - I meant between any of the PROCEDURES not the best route to take all together
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.

I am going to have a consult with my Vet today and then I am also going to ask to speak with Dr Myers myself later today after I talk to my Vet.

When I talked to him he didn't say "Dr Myers said you should do one of these procedures" he just told me what my options were just as they told me those options before and both times they said I can wait because of her specific case where the enzymes have gone down they don't think there is a rush to do any of the procedures.
Maybe I should have made that more clear when I wrote my first comment regarding this but I had just gotten off the phone with the Vet and was just trying to process the information again.

I also want to clear this up:
**When Lucy was first sick I went to the closest Emergency Vet I could find to help her which is the Vet that ended up doing the FIRST blood tests and BAT.
**Then I went to Blue Pearl to see Dr Myers who told me after examining her and doing a repeat blood test (NO BAT) which came out normal that if it was HER dog she would wait and repeat the tests in 4-6 weeks because she felt Lucy was in NO IMMEDIATE DANGER!
**During the waiting period I researched and found a different Vet that I was more comfortable with for Lucy because I felt the first place I went with her was not a good fit as I think they didn't deal with many small dogs. So, then I found my new Vet and after having a consultation with TWO Vets at the new clinic I felt much more comfortable with them and so I called BP and asked if it was a problem to have the BAT's repeated at the new Vets clinic and they said it was not a problem at all. So, I took Lucy there for the THIRD BT and SECOND BAT. The Vet also examined her and found her to be in very good shape - the physical exam came out perfect (and also when DR Myers saw her)!
**After getting the results my Vet called Dr Myers at BP and discussed it with her and that is now where we are at ABOVE........

I am not comparing my Lucy to anyone else and I want and will do what is best for her. The IMS has never to my knowledge said or recommended that I should do one of the procedures so I think that is where we all got a little confused.

I am 100% comfortable with my new Vet and 100% comfortable with Dr Myers at Blue Pearl (which is a hospital that has BC surgeons). I will continue to consult with them and do what they think is best for Lucy and I will update you on how she is doing.

Again, I thank ALL of you for your support and I appreciate all of the input that I have gotten.

Hi Ann,
Just checking in on Lucy and you! You are doing what a good furbaby mommy does and working with your vets to take care of Lucy. You are doing what you and they feel is best and you shouldn't feel the need to explain that to anyone here! No one here is closer to the situation than you and no one here is a DVM/ or is qualified to tell you what to do over the internet, only offer up advice or ideas/ experiences that you may or may not use, that is up to you and you only.
I hope Lucy continues to do well and her rechecks brings positive news! Huggles

[aproctor]

Thank you sooooo much!!
I do feel that Lucy is getting the best care possible and we will all continue to do what is best for her!!!

I am doing pretty well now that I have a more definitive answer from the Specialist....it is just hard because I wish she didn't have any of these issues but we will take care of her so she will be in good hands!!

Thanks again!!!

Originally Posted by AprilLove

Hi Ann,
Just checking in on Lucy and you! You are doing what a good furbaby mommy does and working with your vets to take care of Lucy. You are doing what you and they feel is best and you shouldn't feel the need to explain that to anyone here! No one here is closer to the situation than you and no one here is a DVM/ or is qualified to tell you what to do over the internet, only offer up advice or ideas/ experiences that you may or may not use, that is up to you and you only.
I hope Lucy continues to do well and her rechecks brings positive news! Huggles

[aproctor]

Originally Posted by ladyjane

You have already been advised by two vets that further testing should be done. Personally, I would be at a third vet...one that is board certified as I said. Then, I would be in a better place in terms of a decision. That's just me.

**NO vets have advised me to DO further testing they have only given the options if we want to further test~both times I spoke to the specialist she said that further testing is not needed at this time BUT if I want to have one of the procedures done then I can do that. If it is not necessary then why would I?

As to your question about whether I have ever seen a case like hers...... I am not a vet!! I cannot say I have seen it....or not. No one can do that online! No one here has seen your dog ... has the qualifications to diagnose or compare to other dogs. I have not advised you to do ANY testing...I have advised you to go to professionals with board certification. I don't go to my vet and tell them what tests and/or xrays to do. I might ask them if something is appropriate...but I seek out the best and trust them to explain why or why not to do them.

**You are not a vet but yet you are pushing me toward doing a procedure that neither my vet or the specialist told me is necessary! Why do you twist what I write and make it sound like I am not doing what my vet recommended?


I don't sit online and attempt to diagnose people's pups no more than I try to diagnose my own. I go to professionals for that. I pay a lot of money, yes, but that is in my mind the appropriate thing to do for a living being that is in my care. They did not choose to live with me...I chose them and I offer them the same treatment I would give to myself....and always provided for my son. I just don't try to diagnose...I am a retired RN and know a lot of medical stuff...but I still don't try to guess what my dogs have or other peoples' dogs either. It is simply stepping outside my boundaries. I seek out good vets and trust them with my pups.

**HERE WE GO AGAIN MAKING SOMEONE FEEL THAT THEY ARE NOT A GOOD PARENT!!!! I am doing what I feel is best for Lucy and if it were ME in this situation then I would do the same dang thing because I myself would not want an exploratory surgery if it was NOT NECESSARY!!!
I do not have a son or a daughter but I can assure you that I would also provide them with the BEST OF CARE if I did and I would do whatever needs to be done for them regardless of the cost!
I CHOSE LUCY AND I LOVE HER AND SHE MAY NOT HAVE CHOSEN ME BUT I CAN TELL YOU THAT SHE WOULD WANT NO OTHER PARENT BUT ME!!!!
I have sought out a good vet and a good specialist and I am working with THEM and I TRUST them!!!!!!!!!

I am happy with my decisions and I will continue to update those that are interested and that care about ME AND LUCY because I came here to seek out FRIENDS for support not to be judged!!!

[kjc]

Sorry I'm late in responding... I am so glad you are feeling better after talking to the specialist... it can be very confusing when things are not explained. I usually go into a state of shock after getting bad news and don't hear what the vet says the first time around, just get the meds and instructions and get home and try to sort it all out, Lol! Then I call the vet the next day and they explain it to me again!

[Patti]

I am glad you were able to get clarification from the vet and feel confident with everything. I know when I went through the process with Cali it was scary. I will keep positive thoughts that Lucy continues to stay asymptomatic.

[Ringo1]

Originally Posted by Patti

I am glad you were able to get clarification from the vet and feel confident with everything. I know when I went through the process with Cali it was scary. I will keep positive thoughts that Lucy continues to stay asymptomatic.

I'll send positive thoughts too!

Hopefully, the BATS will go down on the limited protein food.

My Lucy's BATS were low enough the 2nd time around that we are not severely restricting her protein.

[aproctor]

Originally Posted by kjc

Sorry I'm late in responding... I am so glad you are feeling better after talking to the specialist... it can be very confusing when things are not explained. I usually go into a state of shock after getting bad news and don't hear what the vet says the first time around, just get the meds and instructions and get home and try to sort it all out, Lol! Then I call the vet the next day and they explain it to me again!

Yes, I do feel better but I wish my vet would have told me what the specialist told me. He really didn't explain in much detail what Dr Myers suggested to do and that would have been helpful...not sure why he didn't!

[aproctor]

Originally Posted by Patti

I am glad you were able to get clarification from the vet and feel confident with everything. I know when I went through the process with Cali it was scary. I will keep positive thoughts that Lucy continues to stay asymptomatic.

Thank you so much!!! I hope so too!!!

[aproctor]

Originally Posted by Ringo1

I'll send positive thoughts too!

Hopefully, the BATS will go down on the limited protein food.

My Lucy's BATS were low enough the 2nd time around that we are not severely restricting her protein.

I hope so too!! Thank you for the positive thoughts...very much appreciated!!