Yorkie Chorkie with probable liver shunt
 

Toby is a 4 year old (11.5 lb) Chorkie who was until recently extremely healthy. He started chin rubbing, rear leg twitching, lip licking episodes and then would return to his normal happy self. We learned through bile acid blood work that he probably has a liver shunt. We are now managing this medically with lactulose, neomycin and low protein hepatic dry dog food. Has anyone had long term success with this illness by transitioning to a balanced, proven home made diet including the correct supplements?

I don't have any experience in this area but I wanted to bump your thread up for folks to see.

Praying for your little one.

Hi and welcome to YT. So sorry to hear about your baby's diagnosis. I know that I have read threads about people managing LS with diet and medications. If you use the search function on the upper bar and seach liver shunt you will find threads where members have discussed their Yorkies issues and how they manged their diet and care.
Sending prayers and best wishes to you and Toby.

I am no expert in this but I don't believe the odds are really good treating a liver shunt that way. The best odds I believe are with surgery.
I saw one person do it and the dog ended up with multiple shunts and other medical issues. Very sad.
I am sure others will contribute to this thread with their personal experiences.

Hi and Welcome to YT!

What type of food and water bowls does he eat and drink from?

Sorry... I have to go soon... the symptoms your describe sound like a plastics toxicity (starts with chin rubbing) from a sensitivity to chemicals that leech out into the food and water from plastic food bowls. If these are liver toxic, it can give high liver enzyme bloodwork results, and will also give high Bile Acids results. A positive BAT does not always mean the dog has a Liver Shunt.

If you can post his bloodwork and BAT results it would be helpful.

To answer your question... there would be no difference whether you use a formulated manufactured diet or homecook... but if homecooking... I would get an approved diet from a nutritionist.

Thanks
 

This reply is for kjc....thanks funny you should say that cause our dog did eat out of plastic bowls but we have since given him stainless steel bowls. Do you know where I can find any more info about plastics toxisity?

http://www.squidoo.com/safe-healthy-dog-bowls

and this is concerning people, but if it isn't safe for me, it's not safe for my dogs...

Step 5: Be Wise With Plastics | The 5 Easy Steps | Healthy Child Healthy World

Also with any kind of liver problem, I'd get him on Denamarin... found at the vet's or online... it's a nutroceutical.... liver protectant plus.

I obviously misread this ... so your pup is not definitively diagnosed with a shunt. Isn't the vet recommending other tests? I would definitely want a diagnosis rather than simply guessing the treatment for the unknown condition. Perhaps an internal med specialist might be good to see.

The symptoms you describe here are also that of a Chiari malformation & could also explain why the liver enzymes are off.

Wow thanks! Very good to know!

I am very new to this site? Can anyone tell me how to answer someone right within their message and not at the bottom of the page?

Just click the "quote" button at the bottom (underneath) of their message. :)

Ok got it! Thanks so much!

Thank you, you are correct and that will be the next step if we can not get him stabilized medically first. His blood work came back perfect but his bile acid readings were 60s (fasting) and 170s (2 hours post feeding). This we believe is causing the mini seizures. We have several vet telephone consults that suggest medical stabilizing first then a gradual transition to a home made low protein diet with all the appropriate supplements including hepato support (contains milk thistle), livaplex, multi vitamins/blus green algae. Apparently many dogs with LS adapt to a low protein diet and live long and normal lives. We consider invasive surgery the very last option. Some say diet alone can repair, mediate and mend the liver. Time will tell! Thanks so much!

If I were you, I would do a LOT of reading. There are websites that tout these cures, but I am not a fan. I don't believe that a liver shunt will repair itself with the things you have mentioned. I suppose it is possible, but the odds would not be in her favor. I personally saw an online person do that for a couple of years and the dog ended up to be a case that was not operable because of the delay. Very sad when things like that happen.

I am not one to diagnose NOR suggest any diets and/or treatments for people's dogs online. I can only suggest that they consult with the best and that would be boarded internists.

Best wishes to you and your pup. :)

My Tink's BAT was over 300 but she never had seizures from it. The Bile Acids Test tests the ability of the liver to function. Normally a BAT over 100 is indicative of a shunt, but with the other bloodwork being within normal limits, I have doubts that this is a shunt. Be careful with things like vitamins, vaccines, and some drugs, as they are processed by the liver, and will not work as expected in a dog with a liver problem (you may end up giving the liver more work to do instead of lightening the load).

I would request further testing, and have the dog seen by a neurologist. Actually, a vet school would be the best place to go, as they have all the Vets in different speciaties there onsite. I really feel you need more info and a firmer diagnosis concerning these symptoms, before assuming this is a liver shunt and how to manage it.

Dogs with LS also most often have recurring Urinary Tract infections and crystals in their urine, and many older (over 2 years) dogs can have kidney stones. This can be life threatening and needs to be ruled out before any long term decisions are made.

Lactulose is great, but after long term use (2 years here) it can cause abdominal pain and bloating, which makes the dog stop eating.

My Tink's LS was unoperable, the vet specialist tried but when he got in there he found multiple shunting, no large shunt (a large shunt was seen on doppler Ultrsound), and a problem with her gall bladder (which caused the multiple shunting). Kidney stones were seen on the U/S too, but the vet specialist said her kidneys are fine.

Milk thistle and liver supplements are good, but they only help with the part of the liver that is still functioning. It has no effect on a liver shunt, or on liver cells that have already been destroyed.

This link will take you to the world's leading Liver Shunt Specialists:

Portosystemic Shunts FAQ

Thank you very much! I agree that these dietary cures seem a little too good to be true? We are now planning further evaluation at a veterinary college after we get him stabilized. He also has classic symptoms of MVD too so who knows what he has for sure. Only the experts can tell.

Thank you so much! This was one of the first sites I looked at and have read almost everything available. We have decided to get him to a veterinary college for further testing after he is stabilized. He seems to be responding well to his medication so hopefully we can get him in soon. He does have urinary crystals so we are keeping that monitored also. Hopefully the experts can positively diagnose him. All the best to you and yours!

That's great that you are going to a vet school! Good luck and please let us know how things go!!

Thank you very much! We are learning daily! He has stabilized completely on his new diet, Lactulose and Neomycin and has spent a few very happy days for the first time in months. We are still considering different diets and are leaning toward a complete and balanced home made low protein diet (possibly one of Hilary Watson's). We are hopeful to get him in in the near future for ultra sound but in the mean time our goal is to transition to better food and remove the antibiotics. The seizures have completely stopped now which gives us time to concentrate on moving forward with diet changes and future treatments. One day at a time.....thank god we have a fantastic vet! All the best!

Sending prayers and best wishes for your Yorkie. I know how difficult it is to see them sick, but never give up. I do not know much about this condition, but I know that Yorkie Chorkie will be fine.

Thank you so much! I really hope that you are right! All the best to you and yours!

Update
 

Toby has finally stabilized for the most part on his new diet (RCH/veg) and meds (Lactulose, Neomycin, Hepato support, Probiotics). Our latest discovery may have been there all along because his mouth/muzzle area has been very sensitive for months? He has pink puffy areas around his whiskers and when he scratches his muzzle he yelps at times? We are working with the vet to determine if this is a separate allergy or a spinoff of the liver shunt/MVD? He is now taking a weak antihistamine for a week to see if it helps. Meanwhile we are in the process of booking an ultrasound to determine the type and extent of the shunt. One day at a time! Thanks all!:

The mild antihistamine stopped all chop licking, chin rubbing, pinky cheeks/lips and we now have a completely transformed, playful, normal acting dog...amazing! After trying to determine what could cause an allergic reaction we finally found one common thread in all his previous diets....chicken fat? Has anyone heard of a dog being allergic to chicken fat? They say it has no protein and protein is required to trigger an allergy but we have read that if a dog is allergic to chicken protein then you need to remove the fat also? Does anyone know about this?

Also do not store any of his food in any type of plastic containers... glad he's doing better.

Glad to hear that the seizures have stopped. I was headed down a similar path with my Cruz a couple months ago. Last July, he had his first seizure,then another in October. His bile acids after both seizures were not extremely high but still above the normal (1st Test were pre-3.5 & post-29.8. The results after the 2nd Test were pre-28.2 & post-58.6). This is when we were referred to a specialist where we had an ultrasound done. The ultrasound did not show any visible shunting outside the liver so they suspected Cruz had MVD.We started him on Hills prescription L/D and eliminated all treats. He has not has a seizure since! After 2 months of being on the diet completely we retested his bile acids and his numbers went down to pre-1.9 & post-45.4.

I hope the diet continues to work for Toby! One thing the specialist told us to keep in mind was that MVD can only be truly diagnosed by a liver biopsy and there is no surgery to fix MVD only diet & meds. I also read some things about a Protein C test that can be done to rule out PSS.

This forum was SO helpful when I need information. Just like others have suggested search MVD or PSS. Some members who have been through this with their little ones were so nice to share their stories with me. It was the only thing that gave me peace of mind! Best of luck to you & Toby!

Glad to hear Toby is doing better sending prayers that the ultrasound goes well.

Checking in on Toby. Hope things are going well...