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Old 02-04-2013, 06:30 PM   #1
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Default Liver shunt surgery for a Yorkie?

Hey guys! I just joined this site. I've been reading posts on here about yorkies ever since I got my Louie. I recently posted a question on Yahoo Answers, but figured yorkietalk would be a much better choice.

My Yorkie, Louie, was diagnosed with liver failure back in May (ate something poisonous). Since then, we have been treating him for a "bad liver" by feeding him The Hill's Diet K/d, giving him lactulose, and clavamox.

He recently was slowly switched to Royal Canin and taken off of his clavamox. He did extremely well without the clavamox, but most likely got a GI tract infection from the Royal Canin.

Because he didn't do so well with the new food, and because of his elevated bile acids (the post-results were over 300 in October), an internal medicine veterinarian has diagnosed Louie with a liver shunt. I understand that shunts are very common in Yorkies, but he's been doing completely fine with the medicine and low protein diet.

My question is, should we consider the shunt surgery? What about treating him medically? I know he wouldn't live as long, but there's a slight change he might not make it through/after the surgery. Past experience would be quite helpful.

Note- we are planning on making an appointment with a surgeon within the next couple of months to talk about things.

Also, he just turned one yesterday! I was so excited we made it through the year. It was a rough one, but the whole process has brought me closer to him, and I couldn't be more blessed to have him in my life.
He's extremely playful and barks at the sight of his leash. He loves going "bye bye," and my mom is his favorite person. Ever.
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Old 02-05-2013, 05:07 AM   #2
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First, WELCOME to YT !!!

I know you'll get some great advice regarding the options with liver shunt. I haven't had to personally deal w/ LS, so I'll leave the good advice to those who have experience. There are so many people here who have gone thru what you're going thru, and their yorkies are doing just awesome!

Would love to see some piccies of your kiddo sometime, I bet he's a doll. Tell him Happy Belated Birthday!
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Old 02-05-2013, 07:55 AM   #3
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I haven't had experience with liver shunt but I know that there are varying levels of severity. Some shunts are more complicated than others. I am sure the specialist that you are going to see will give you some good advise. There are several tests they can do to determine how severe you little guy's case is. If there is anything they can to to improve you guy's quality of life I would certainly encourage you to do it.

I'm sure others with experience will answer you soon. Please let us know how your visit goes.
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Old 02-05-2013, 08:20 AM   #4
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Hi and Welcome to YT!

I would also get him on Denamarin asap. Very good for the liver. More tests are needed to truly determine if he has a shunt. Here's some great info:

Portosystemic Shunts FAQ
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Old 02-05-2013, 09:53 AM   #5
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Welcome to YT! God willing, if I ever had cause to think one of my babies had a liver shunt of any kind, I would do whatever was necessary to get that dog to University of Tenn. to Dr.Karen Tobias. She has been doing research and surgery in this area for years and as far as I am concerned, she is the benchmark for liver shunt surgery. Those people are wonderful up there and you can even call and someone on her staff will talk with, and answer questions and give you some kind of guidance...I am sure there are vets that have trained with her and can do the procedure...they can probably give you references in your area or at least closer to you if you are not able to make the trip to UT. You can google Dr.Tobias and learn about her and her program, and go from there! Her success rate is second to none.....Good luck and keep us posted!
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Old 02-05-2013, 10:55 AM   #6
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Thanks for all of the replies! We live in Florida, so Tennessee is sort of out of the question. We are having to save (like we have been) for the surgery. I'm pretty sure we're going to choose the surgery over medically treating him. My number one desire is to have him as long as I possibly can, so the surgery is a big consideration.

Kjc: I'll ask my local vet about Denamarin. I'm also wondering if I should put him on milk thistle since I've heard it does wonders for the liver.

I'm hoping our next visit will be better. I was thinking that, since he did go through liver failure, maybe it's just liver disease? I have no idea.

Again, thank you!
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Old 02-05-2013, 11:01 AM   #7
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God bless your lil one and happy 1st birthday.

I hope all turns out great!
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Old 02-05-2013, 12:00 PM   #8
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I believe liver shunt is actually a deformed liver. It can have different levels of deformity. I'm pretty sure they have to do an ultra sound to find out how bad it is. It is something he was born with if it is liver shunt.
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Old 02-05-2013, 12:14 PM   #9
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Quote:
Originally Posted by MyLittleLooster View Post
Thanks for all of the replies! We live in Florida, so Tennessee is sort of out of the question. We are having to save (like we have been) for the surgery. I'm pretty sure we're going to choose the surgery over medically treating him. My number one desire is to have him as long as I possibly can, so the surgery is a big consideration.

Kjc: I'll ask my local vet about Denamarin. I'm also wondering if I should put him on milk thistle since I've heard it does wonders for the liver.

I'm hoping our next visit will be better. I was thinking that, since he did go through liver failure, maybe it's just liver disease? I have no idea.

Again, thank you!
First welcome to YT. Yahoo groups does have a liver shunt support group.

If your dog has an "extrahepatic" shunt, as opposed to Microvascular Dysplasia or MVD, many of the first kinds of shunts can be operated on successfully, baring complications from other system disease(s).

I am not sure if you had done all the diagnostic testing to confidently confirm a diagnosis of Liver Shunt. Scintography is usually recommended.

Dr Karen Tobias herself or her office can recommend the top knotch hospital in FLA for this procedure, and will consult with your general vet or even that Internal Medicine Specialist

What I can say is that I probably live a 10 - 12 hr drive from that University and I would go there myself for this kind of operation. In fact a person I know that lives near to me, just last year did the very same thing! All in, including hotel room stays(6 nights), she made most of her own meals, gas, pre surgery testing the cost was about $2500. The scintography and various pre lim blood work was done here in Toronto, the rest in the USA.

Note the six nights - worked out 2 overnights on the road, 2 nights in hospital, one day hanging around "just in case" ... she is a very conservative woman and wanted if anything untoward happens after hospital discharge she could hurry back, and she was so anxious to get home she did the 12 hour drive in one day

Just my own thoughts having "liver failure" in the past as a puppy, have you asked the question how much or if any liver damage is apparent with the liver?

There are a multitude of different threads in Sick and Emergency and sometimes Yorkie Health and Diet on LS. You can do a search for LS and believe me many will pop up.

The very best to you and your boy
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Old 02-05-2013, 02:13 PM   #10
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marlenemaria: Thank you! He's been doing so much better since we've put him back on his K/d; I just wish he were this happy on his birthday

gemy: I'm praying that is it an extra-hepatic shunt and that surgery is successful. I would hate to choose surgery and then something go horribly wrong.

I'm extremely protective over Louie; therefore, I would have stayed probably 4 or 5 nights AFTER the surgery just to be safe. Louie doesn't really like car rides, so driving home right after (even if it is two days after) surgery wouldn't be an option.

It's really up to my parents on where the surgery is done. Here in Jacksonville, we have Affiliated Veterinarian Specialists, which is where Lou went when his liver failed. Doctor Carlos Aragon is who Dr. Tashach (internal medicine specialist) recommended for us, but I most definitely will look into Dr. Tobais' recommendation.

I've looked over his chemistry test results a few times. His protein was 1.9 December 31, and on January 29 it was 2.2 (said it could have been a misreading, but I don't believe it). His ALT in Dec. was 59; Jan it was 38. So, from what I see, he's still IMPROVING. To me, his ALT wouldn't just "elevate." He has to be getting better some way or anything. Also, with the test results in January, we were feeding him that little bit of Royal Canin and he was off of his Clavamox. The only thing that was actually wrong was the bloody diarrhea, but Yorkies have sensitive digestive systems.

I am just so lost at what we should do. I know surgery is the best option, but we'd have to save, causing the surgery to be a little late.
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Old 02-06-2013, 06:47 AM   #11
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Hi again - I'm going to move your thread to the Sick section so that your thread doesn't fade away and so that it gets the support you need. Keep us posted .
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Old 02-06-2013, 07:43 AM   #12
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Hi again - I'm going to move your thread to the Sick section so that your thread doesn't fade away and so that it gets the support you need. Keep us posted .
Thank you, Wylie's Mom!
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Old 02-06-2013, 03:53 PM   #13
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It has been a very long time since I have been on here.

We just found out our Nakisha has Proto Liver Shunt. So heart breaking, I am sorry what you are going though but I know how you fill. She is on the meds that some one told you about, and the L/H diet. Some days are good but most are not. Plus her blood sugar keeps dropping, So honey in water plus has to have sugar water 3 times a day.
There are days where she can't even go up and down the steps or get on or off the couch. She looks so sad. The treats are the hardest thing. Good Luck with your little one
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Old 02-06-2013, 04:22 PM   #14
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It has been a very long time since I have been on here.

We just found out our Nakisha has Proto Liver Shunt. So heart breaking, I am sorry what you are going though but I know how you fill. She is on the meds that some one told you about, and the L/H diet. Some days are good but most are not. Plus her blood sugar keeps dropping, So honey in water plus has to have sugar water 3 times a day.
There are days where she can't even go up and down the steps or get on or off the couch. She looks so sad. The treats are the hardest thing. Good Luck with your little one
I'm so sorry to hear that Nakisha has a liver shunt! Do you know yet if it's extrahepatic or intrahepatic? Have you considered the surgery? How old is she?

I haven't considered the L/H diet, since Louie has been doing fine on K/d. I have noticed, though, that he has been barking a lot more than usual. He barks at my mom the whole time she's walking him outside, and he barely lets us put his leash on his harness anymore. He has to sleep with his harness on! He's really out of control.

I'm sorry that Nakisha isn't as active as she used to be. I definitely know it's extremely heart breaking to see your baby girl just laying around. I also know how devastating it is to feel helpless in the whole situation :c I hated it when Louie was having diarrhea and couldn't walk up the steps to get inside.
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Old 02-06-2013, 09:03 PM   #15
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She has the Extrahepatic. From what the test have showen so far. Nakisha will be 4 yrs in April. A year ago she was sick and while in the vet and staying there a couple of days we thought it was just something else. Back then I had tried and tried to get a hold of my breeder and ask her ? for my vet and she would not return calls or emails. And then she got worse just within the last month or so. And we ran test and redid them and redid the to make sure they all came back the same . And than that is what we found out was the Porto Shunt and it is Extrahepatic. So we are going to 1st try the diet and meds.. Some days are good but never the same. She just isn't herself. lays around and is always spaced out alot, Just so sad.. But thank you for your reply. I just hope we are doing the right thing.
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