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04-12-2013, 02:02 PM | #1 |
Yorkie Yakker Join Date: Jan 2013 Location: Canada
Posts: 29
| Toby Update: High Bile Acids - No Shunt Hello all! Its been a while since we posted about Toby. We are on our way back (30 hours drive total) from the Western College of Vet Medicine in Saskatoon, Saskatchewan, Canada. Toby (4 year old Chorkie) was diagnosed with a probable liver shunt back in January 2013 due to high BATs (pre 63/post 174) and exhibiting HE like seizure symptoms. Medical liver shunt management and diet changes did not seems to relieve his symptoms to a manageable level. After 3 days of extensive testing (urinalysis, chem panel - standard SA, pre and post ammonia tolerance test, abdomen ultra sound, MRI, CS spinal tap and spinal fluid analysis) Toby's liver tested normal in both size and function and no liver shunt was found or suspected. We could not grasp why his bile acids were so high yet no liver shunt and liver enzymes/liver size/liver function perfect? Apparently there are several reasons for elevated bile acids and one is that some dogs gall bladders will excrete excessive amounts of bile before the food reaches that area of the intestine. They found they could induce his HE symptoms by pressing on his jawline. A dental X-ray showed no dental problems according to the dental specialist. The case was now turned over to the neurological team. An MRI showed the brain was clear of leisons so a spinal tap revealed excess fluid on the spine. The fluid was tested for spinal disease (which is fatal) and cleared of that. The excess fluid was caused by some unknown earlier trauma and was the cause of all neurological HE like symptoms. Toby has been HE free for 3 days now on his new meds of Prednisone and Gabapentin. It is hoped this treatment can be removed after the spinal fluid dissipates but time will tell! And that is the story of the liver shunt doc that wasn't! Folks on this site always say to go to a vet med school for testing and they are absolutely correct! Never have we experienced that quality of care and professionalism! Kudos WCVM! |
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04-12-2013, 02:15 PM | #2 |
I♥PeekTinkySaph&Finny Donating Member Join Date: May 2009 Location: Baltimore, Maryland
Posts: 18,866
| Wow! Glad you got some answers. I'm surprised the vets didn't put him on Omeprazole, it slows the production of spinal fluid in dogs. I'll assume they think the pred will reduce the swelling enough to be curative. Are you supposed to get his BAT redone in a few months?
__________________ Kat Chloe Lizzy PeekABooTinkerbell SapphireInfinity |
04-12-2013, 02:26 PM | #3 |
Donating YT 30K Club Member | I am glad no shunt was found. Hopefully he will do well on the medicines.
__________________ Cali Pixie Roxie : RIP Nikki; RIP Maya;RIP my sweet Dixie girl 1/17/08 http://callipuppyscastle.bravehost.com/index.html |
04-12-2013, 03:33 PM | #4 |
Resident Yorkie Nut Donating YT 20K Club Member Join Date: Sep 2006 Location: Texas
Posts: 27,451
| Good for you! Going to a specialist or vet school for these very sick pups is essential imho in arriving at a diagnosis and treatment. I am particularly impressed with that trip you took!!! I travel 45 minutes each way to the specialist and 2.5 hours each way to the vet school and think that is long. You are GOOD! I am glad you went and have shared this with all of us. Hope that Toby improves. Did they consider MVD?
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04-12-2013, 04:09 PM | #5 |
Princess Sophie's Choice Donating Member Join Date: Jan 2013 Location: Clinton, IL, DeWitt County
Posts: 2,758
| Been wondering where you were. Glad to hear there's no shunt! That's a big deal from what I've read from others posts. Hope the future is much brighter now.
__________________ Diane owned and loved by Hansel and Princess Sophie |
04-12-2013, 04:16 PM | #6 |
Donating YT 500 Club Member Join Date: Apr 2011 Location: montana
Posts: 2,945
| glad that there isn't any liver shunt// hope the meds help |
04-12-2013, 04:22 PM | #7 |
and Shelby's too Donating Member Join Date: Aug 2012 Location: Millbrook, AL
Posts: 7,842
| Sounds like they took very good care of Toby and gave him a full work up. Great news
__________________ Terri, proud mom to Mandie & Shelby-Dale |
04-12-2013, 04:38 PM | #8 |
Yorkie Yakker Join Date: Jan 2013 Location: Canada
Posts: 29
| That is exactly what they were thinking and they did mention they could introduce a medication that would minimize the formation of spinal fluid. They started with low doses of pred to see what happens. We are keeping strict notes on his progress. They want a report in two weeks and will move forward from there. |
04-12-2013, 04:47 PM | #9 | |
Yorkie Yakker Join Date: Jan 2013 Location: Canada
Posts: 29
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04-12-2013, 04:51 PM | #10 | |
Resident Yorkie Nut Donating YT 20K Club Member Join Date: Sep 2006 Location: Texas
Posts: 27,451
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04-13-2013, 06:14 AM | #11 |
Donating YT 3000 Club Member | Glad to hear that you found out some answers. That is a long drive but I see it was worth it
__________________ Teri . . . Galen Jameson Frazier Seraphina Luna Rosencrantz, Saber Tooth Tiger, Pussy Willow Pandora Guildenstern |
04-13-2013, 09:41 AM | #12 |
Donating YT 500 Club Member Join Date: Feb 2011 Location: With CharlieBrown of course!
Posts: 1,403
| that is quite an adventure I am so glad that you finally got answers, now Toby can move on to recovering.
__________________ Mom to Bug and Charlie-R.I.P my sweet Charlie 2021 |
04-13-2013, 05:28 PM | #13 |
T. Bumpkins & Co. Donating YT Member Join Date: Dec 2008 Location: New England
Posts: 9,816
| I'm so glad you've gotten some information! I also want to say that I'm totally impressed that you traveled over 30 hours to help your dog! Some people won't travel even two or three hours for a specialist. The world needs more people like you. You have a very lucky dog!
__________________ Washable Doggie Pee Pads (Save 10% Enter YTSAVE10 at checkout) Cathy, Teddy, Winston and Baby Clyde...RIP angels Barney and Daisy |
04-14-2013, 04:00 AM | #14 | |
Yorkie Yakker Join Date: Jan 2013 Location: Canada
Posts: 29
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