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Old 12-12-2011, 03:58 AM   #1
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Default Liver shunt?!? What to do??

I first want to say thank you for taking a second to read this...dealing with something like this is so overwhelming and I feel like I am at the point of INFORMATION OVERLOAD.. which I guess is better then the "not knowing" stage...At this point I guess what I need is some direction on what the next right thing to do is....

I will give you guys the short version of what has brought us to this point and any help or feedback you have will be VERY APPRECIATED.....

I joined YT a few years ago when I/we got our first Yorkie,TYSON, and if it wasn't for all the great folks on here helping us thru the first year I'm not sure any of us would have made it thru our first year and I'm sure just like most Yorkie parents once you get your first Yorkie you just cant have one so Tyson got a sister. We got her from the same breeder ( I now use that word lightly since finding out she was running a puppy mill ) she is 4 years old today.MONDAY, 12-12, and we found out a few months ago after a lot of visits to the ER and many hundreds of dollars later that she has a liver shunt and I am at the crossroads of what to do, I know there is a lot of info on here and the PC about this but YT has ALWAYS been my go to on what to do with ANYTHING Yorkie and I need it now more then ever..I will write another post following this with some more detailed info on our how we came to find this out I guess the issue I'm struggling with now is Univ of Tenn vs. a general surgeon locally where we are in FL. Any info anybody can give or experience they have had with this would be great I have so many questions on how to make the best decision, on how to get us thru this anything will be appreciated, I will post a little more info on some other concerns I have with the tests that were done etc. THANKS SO MUCH for taking time to read this and any advice you can give me......

CHRISTINE
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Old 12-12-2011, 04:00 AM   #2
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I didn't want to write a short novel on the first thread because I really am wanting any feedback or direction on what to do with all this information overload regarding LIVER SHUNTS.....but I did want to give a short as possible time line in hopes that someone that reads this will know which direction I should go or give me ANY info on the services provided at UNIV of TENN....I have read what there is to read on the PC regarding what is offered there but I am looking for any personal experience info anyone would like to share....

First let me say I am a people nurse so I was able to keep up and understand some of what has gone on but learned early on my people nurse education didn't count for much in YORKIE WORLD....As I said in my previous post no matter how big or small my question/concerns are when it comes to my Yorkies its the information I receive in here that influences my decision on what to do so anything anyone gives me means more then I could ever explain..

MyLeigh's LIVER SHUNT Journey,

I guess I will start by saying MyLeigh is 4years old today, Monday, 12-12 and from what I have read and have been explained is somewhat more on the older side when it comes to discovering a Shunt....all of this started a little over 6 months ago or I guess I should say we noticed a few things were out of the norm a little over 6 months ago and of course they became noticeably worse at 2AM the early morning before her appt with her regular VET...Long story short she had the blood tinged urine, leaking of clear fluid leaving her and whatever she was laying on soaking wet,what looked like "sand" on her pee pee pad, urinating nothing but blood and without going into every nook and detail of every hour, day and minute of what brought us to the ER VET twice...We thought after the first trip and first round of antibiotics all was cleared for almost two months until it all came back worse. The second trip to the ER VET worried her and us enough to get MyLeigh into the Specialist ASAP since her X-RAYS showed us stuff was wrong but no idea what, so we went to the Specialist to get the Ultrasound done on her Kidneys and with all the overwhelming news we got about he Kidneys the VET said he was 99% sure he also saw a Shunt, he wanted to go ahead and do the surgery on her Kidneys..at that point he felt the R Kidney was so damaged from stones and it also had a large one trying to come down that it would most likely have to be removed and the L was on its way as it was filled with stones etc etc and while he was doing all this on her Kidneys he could do the Shunt surgery and also Spay her.....

Needless to say this was A LOT to take in all at once, not to mention putting my little girl thru all of that surgery all at once with obviously no guarantees, we didn't know if the stones were because of the Shunt.....at this point we thought we were just dealing with a Kidney issue, I cant explain the emotion, stress, feeling so helpless, etc....I was glad to find out why all the blood in the urine and finally something to give her for pain so we decided to think about this for a minute, let this infection clear up and go from there...We took her home and two days later I watched her strain twice to urinate while nothing came out as I told my boyfriend to call and tell the we were on my our way with her now to do this surgery I sat on the bed to put my shoes on and she stood in front of me,squatted to pee and I heard what sounded like a water balloon busting after being thrown from the roof, and I'm not sure if it was all the water/urine that caught my eye first or what looked like a rock, ( a ROCK, not a pebble ) A ROCK about the size of a dime and as thick as a pencil eraser....I could write an entire page on what that was like, what I felt and the amazement I was and still am in over what came out of this little girl.....We went back to Specialist the next day, he did a repeat U/S and he said her Kidneys were completely within normal limits she only had a small amount of sediment in her bladder and he would be sending the stone to the lab. The results came back on the stone as 100% ammonium urate related to liver dysfunction....I guess I'm glad..??!!..?? All of what I have just explained took place over about a 3-4 month span and the stone result is where we have left off and it has been a little over 3 month since we have done anything else. As of that last visit MyLeigh has done better then she ever has, after reading about Liver Shunts, the signs and syptoms etc I have to say MyLeigh never showed anything that would have alerted us earlier, I know being a nurse you dont have to have all of the signs and syptoms to qualify for a disease but I guess the only test she has not had is a Bile Acid test but the Vet said he saw it on the U/S and the stone confirmed it, the Bile Acid test would just be a tool to help us see the improvements pre and post surgery....The only other sign she does show that I have not mentioned yet is that her urine does have that amonia smell, sometimes more then others and since that last vet visit she has put on weight, become more playful and is really thriving I know what needs to be done and we actually just received some unexpected monies so as I've said I am really just looking for any info, help, suggestions, ANYTHING good, bad or indifferent......THANKS FOR YOUR TIME........

CHRISTINE
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Old 12-12-2011, 04:29 AM   #3
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I'm so sorry. I have no experience with liver shunt. If I were you, I would go to the place that I feel has the most expertise and experience. My guess is that it would be the Univerisity of TN....but hopefully someone with more knowledge can help advise you.

Either way, I just wanted to wish you the best...I'll say a prayer as well.
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Old 12-12-2011, 04:39 AM   #4
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BITSY,

Thank you so very much for your reply and well wishes...I continue to read and research any and everytime I am on the PC and from what I am reading now I guess another great source of info will be the YAHOO GROUP I have started to read about BUT at the end of the day the personal info and stoories I get from you guys is what I know and feel to be the BEST SOURCE of info FOR ME AND MY PUPS....Thanks again and ANY info ANYONE has the time to share is so appreaciated....
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Old 12-12-2011, 05:00 AM   #5
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I am so sorry, we will keep your family in our prayers. I hope someone with experience will be able to help you.
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Old 12-12-2011, 06:01 AM   #6
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I had a baby girl that had a liver shunt that was repaired by Dr Tobias at UT in 2008. There were many vets in the Houston area, including Gulf Coast Veterinary Specialists and Texas A&M University Veterinary School - which by the way, I think is fabulous - but when it came to liver shunt surgery, I wanted to go to the place that did the most. I took Lola and had the scintigraphy and surgery done at UT and have no regrets. It was absolutely the best thng I could ever have done for her. She is doing great today, and I know they do the surgery on older dogs, also. I loved UT, the people were wonderful and they were so very well equipped to handle any complication that might arise during and following this particular surgery. Good luck to you and your sweet baby!
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Old 12-12-2011, 06:12 AM   #7
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There is a doctor in florida who does liver shunt surgeries. Member LadyJane may know the name.
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Old 12-12-2011, 07:51 AM   #8
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The main thing right now is that your girl gets help. It has been a long time and with constant bladder and kidney issues she may be in quite a bit of pain. I'm sure there are plenty of qualified LS surgeons in FL (have you contacted U of FL?). If going somewhere locally is what you are able to do right now, then that is absolutely what you should do. If you only want the vet best LS surgeons touching her, then I would suggest going to UT, but not at the expense of putting this surgery off. They do this surgery all day. They also seem to have a lowered post op seizure rate than most or all other places (I'm thinking one of the other vet schools has even said if you want the best, go to UT). If this was my pup, I can tell you I'd go to UT. They tend to be cheaper than a lot of other places. So even with travel expenses, you are paying the same or a bit less. This may have changed recently though.

You don't need the bile acids test to diagnose a shunt if it has been seen on u/s. However, as the surgeon said, they will want pre and post surgery readings.

I hope your pup is on a special diet and supplements while awaiting her surgery...
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Old 12-12-2011, 08:48 AM   #9
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Originally Posted by Ellie May View Post
The main thing right now is that your girl gets help. It has been a long time and with constant bladder and kidney issues she may be in quite a bit of pain. I'm sure there are plenty of qualified LS surgeons in FL (have you contacted U of FL?). If going somewhere locally is what you are able to do right now, then that is absolutely what you should do. If you only want the vet best LS surgeons touching her, then I would suggest going to UT, but not at the expense of putting this surgery off. They do this surgery all day. They also seem to have a lowered post op seizure rate than most or all other places (I'm thinking one of the other vet schools has even said if you want the best, go to UT). If this was my pup, I can tell you I'd go to UT. They tend to be cheaper than a lot of other places. So even with travel expenses, you are paying the same or a bit less. This may have changed recently though.

You don't need the bile acids test to diagnose a shunt if it has been seen on u/s. However, as the surgeon said, they will want pre and post surgery readings.

I hope your pup is on a special diet and supplements while awaiting her surgery...
Ellie May is 100% correct. Thank goodness you have started down the road of getting your baby the help she needs. Imagine how sick she must feel with all that is going on in her precious little body....I'm glad she has you, now, ready to get her the help she so desperately needs!
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Old 12-12-2011, 09:09 AM   #10
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As some of you know I am just learning about the yorkshire terrier breed with your help. Can anyone tell me what is a liver shunt? I don't mean to sound dumb. Is there anyway to detect if a puppy has this? Is it inherited and will a breeder know? I have been hearing about this but I don't really understand what is a liver shunt and how this affects a puppy/dog.
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Old 12-12-2011, 09:20 AM   #11
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Originally Posted by tinalove View Post
As some of you know I am just learning about the yorkshire terrier breed with your help. Can anyone tell me what is a liver shunt? I don't mean to sound dumb. Is there anyway to detect if a puppy has this? Is it inherited and will a breeder know? I have been hearing about this but I don't really understand what is a liver shunt and how this affects a puppy/dog.
When a pup is digesting food, its byproducts (in the blood) normally go from the small intestinal to the liver via the portal vein. When this pathway is not fully functional, the blood misses the liver, is not detoxified, and this blood then goes into general circulation. The toxins from the food build up and cause neurological symptoms (hepatic encephalopathy). Some foods and drugs are worse than others.

Breeding lines should really be clear for at least ten generations. All breeding stock should have bile acids test to make sure their livers are functioning properly. However, even with every precaution taken, it can still happen, esp. in Yorkies.
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Old 12-12-2011, 09:37 AM   #12
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I am so sorry your baby is going through this. Hopeing and praying for the best for you and your little one.
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Old 12-12-2011, 09:44 AM   #13
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I just recently returned from UT. My 6 year, Gigi, had liver shunt surgery on December 1st and is now in recovery mode

The decision to go to UT was an easy one but like you there was SO much information out there concerning liver shunts from diagnosis, treatment, surgery, diet, medicines, and supplements, etc. I could go on and on.... With all of this information, I focused on confirming the liver shunt diagnosis and whether or not Gigi was a good candidate given her age (6 years). Most statistics available is heavily weighted and favorable to diagnosis and treatment within the first two years of a puppies life. Gigi was asymptomatic in her liver shunt symptoms (no HE, drowling, falling over etc) but she did have 2 UTIs within a 6 month period. There were bilirubin crystals in her urine and a slight ammonia smell to her urine. Her CBC bloodwork was within normal limits, as well as Protein C, but BAT were not (normal for pre and out of reference range for post 135). Her internist initially thought she had MVD but later diagnosed as a "possible" liver shunt via ultrasound.

I utilized a wide variety of resources to gather information (this website, Yahoo groups for liver shunt and MVD, and research on livers shunts in dogs) led me to UT. I wanted to give Gigi the best shot. UT has performed a gazillion surgeries with a high success rate. I even called UT and spoke to a resident prior to going to ask further questions. I felt she would be in the very best place to treat her should they encounter any complications. On the day of Gigi's surgery, they performed 5 liver liver shunt surgeries alone with varying degrees of difficulty. All pups made it through They have a phenomenal ICU!

For me, the benefits outweighed the risks of surgery to correct the liver shunt. Dr. Hodshon (the resident who performed the surgery) and Dr. Tobias were both very caring, supportive and understanding.

Please feel free to send me a PM should you want more specifics. Believe me, I can relate to what you are going through. Evaluate all of your information, weigh the pros and cons, and we'll be here to support you!

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Old 12-14-2011, 09:00 AM   #14
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Default Help need shunt not much money

Hello. I'M Catherine my yorkiE is Oliver ! Hes been in hospital for 3 days liver blood work came back very bad ! I know he'd in need a shunt I'm only 23 and at this time very broke I don't know what to do how to get help for this I'm in NEW YORK .. Can someone give Advice please ? Thank you ;(
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Old 12-14-2011, 01:27 PM   #15
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Quote:
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There is a doctor in florida who does liver shunt surgeries. Member LadyJane may know the name.
No, I do not know of a vet in FL that I would recommend for LS surgery.
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