Liver Shunt?

[jerseymo7]

So my poor Brody was admitted to the hospital last night. I came home from lunch yesterday to find him in his crate (where he is every day when I leave for work) with yucky poop and even some blood smeared all over his blankey. He NEVER goes in his crate. The blood was from a scrape on the top of his nose. I freaked. I called my vet and luckily I was able to bring him right in. Mind you, we were just at the vet the night before for a pre-neuter evaluation and while I was there, I had mentioned to my vet that Brody had some diarrhea issues all day Sunday but he seemed back to normal that next day. (I fed him plain rice and veggies Sunday night so Monday his stools were back to solid. He told me to just watch him and if it happened again, to bring him in). So now here we are Tuesday, I rush him to the vet after finding him like this, the vet began performing some vision tests that Brody apparently wasn't responding to so the vet became concerned there was issues with his sight (mind you, Brody is only 7months old) and thought he could have possibly had a seizure. I was directed to take him right to the hospital, which I did. I was a nervous wreck. The doctor there performed similar vision tests and Brody seemed to be responding fine and the optometrist confirmed his vision was fine. Relief there. However, now in trying to figure out what caused this episode, they advised I should have some blood work done so we can try and rule out any other options such as low blood sugar. So we do the blood work, all levels come back normal. The doctor now thinks all of Brody's symptoms point to a possible liver shunt, which I'm told is very common in small dogs, especially yorkies and they are supposedly born with it. The only way to know if he does have this shunt is to do another blood test but requires fasting. So they recommended I leave him overnight to be monitored, then take the blood and feed him afterwards. This was all last night. I just heard from the hospital this morning and Brody is doing fine, but definitely nervous as he didn't eat (which I had expected) and his stools are still loose which concerns me. They said they are giving him an antidiarrheal/anti inflammatory to help with his stools and will supposedly help with his liver if he does indeed have this shunt.

Has anyone ever had this happen to their puppy??? Part of me is thinking he got into something and it just hasn't passed through or digested properly and he likely couldn't hold it until I came home for lunch (which I do every day, same time) and let it out and possibly tried to rub his nose on the crate to get out and hit a rough edge which could have scraped his nose?? I'm wracking my brains as to what could have happened. I didn't see it, so I'm not sure it was a seizure, but its possible. He has acted fine in between everything else. Playing, eating, drinking and going outside to potty. If anyone has some insight, it would be greatly appreciated. Can't wait to bring my baby home today, I have been lost without him for 24 hours!

[yorkietalkjilly]

A lot of dogs with liver shunt or MVD will rub their faces and heads a great deal - almost obsessively so your little one probably rubbed it raw or cut his face somehow while rubbing it. I'll explain it badly but here's what I understand about the condition: The liver isn't correctly cleaning the blood and the toxins from proteins go directly to the brain(rather than into the liver for proper cleaning/disposal) after eating and cause many odd/bad symptoms, including the head rubbing, lethargy, loss of appetite, nausea, vomiting, even diarrhea. Once the dog has fasted and the toxins are out of the system, the dog feels better, eats normally and is playful again but shortly the toxins are working on him again and all the symptoms start over.

My Tibbe always had normal liver tests on his routine blood work but because he was symptomatic, has been tested for MVD with a fasting Bile Acids test, which were high after eating, then a nuclear scintigraphy followed by an abdominal sonogram, and the two radiologists which did his tests and read them and examined him said he likely has Microvascular Dysplasia which often gives many of the same symptoms as liver shunt and is treated conservatively with special diet changes and sometimes medications. Tibbe has done pretty well and had but a few bad bouts of nausea/lethargy/itching since he was begun on his hepatic diet last summer. He's most a feisty toot once again and doing well. I hope your little one doesn't have a shunt that needs surgery but if so, it almost always to correct their symptoms, I understand.

Here's some information I was given when Tibbe was initially having his symptoms:

Portosystemic Shunts FAQ

[Wylie's Mom]

Bumping for you and moving to the Sick forum.

[Elliott]

My little man Elliott is also MVD just found out in the summer. He is on medication and symptoms were mostly neuro. He is on Hills KD but seems to still be doing a lot of face rubbing and very low energy. He is 5. What diet do you have your little one on?

[jerseymo7]

He is on the Hills ID diet for now. I need to discuss further diet options with my bet today. I just got his rest results back last night and the bile acid levels were indeed elevated higher then the normal range so there's reason to think he has a shunt. But I'm going to explore the diet and medication options first as surgery is very scary and serious especially at such a young age. My breeder was dead set against it and highly recommended I try the diet ASAP.

[yorkietalkjilly]

Originally Posted by jerseymo7

He is on the Hills ID diet for now. I need to discuss further diet options with my bet today. I just got his rest results back last night and the bile acid levels were indeed elevated higher then the normal range so there's reason to think he has a shunt. But I'm going to explore the diet and medication options first as surgery is very scary and serious especially at such a young age. My breeder was dead set against it and highly recommended I try the diet ASAP.

They thought Tibbe might have liver shunt when his bile acids were high too but he didn't! I would go ahead and find out if he has a shunt by having the scinitigraphy done but he could very well just have MVD and not need any surgery. Tibbe does very well most of the time on his Hill's I/D GI and Hill's I/D Hepatic - half and half which I prepare different ways for him. I make his treats out of that same food also and he works hard to get his treats! He never get a bite of anything else. He has had a bad episode of nausea from time to time with occasionally spitting up bile(the last time was in the fall) but I gave him his Cerenia(for N&V) and he sleeps and would wake up hungry in 8 - 10 hours and was back to normal. Thankfully, he hasn't had any symptoms for about two months now!