Possible Liver Shunt - YorkieTalk.com Forums

sophiesmominva · 08-25-2014, 07:09 AM

Took my 6 month old baby to get spayed and her liver enzymes were elevated so they also did a Bile Acid test which came back 'off the charts'. I have an appointment for ultrasound for her tomorrow. Currently she is experiencing a little vomiting and diarrhea but this is only recent. So worried about her and came to Yorkie Talk for much needed support. Thank you.

MauiGirl · 08-25-2014, 08:47 AM

Hi, Welcome to Yorkie Talk. I am sorry that your lil girl is having a problem, and hope that things turn out ok for her. Many members on Yorkie Talk have been in the same situation, and we are all here to support you.

In fact, my Tiki was also suspected of having LS when she was 7 months old, following pre-spay blood work. I know how terrifying that is, and how frustrating it is to go through the various tests. First of all I want to say that although it is scary, it is not a death sentence. If there is a shunt it likely can be repaired, and there is a possibility that it is not a shunt, but something else, like other toxicity, or MVD (microvascular displasia) also known by a new name I can't recall.

My Tiki turned out to have MVD, which is managed medically by diet, and I'm happy to say she is doing just great at 6 years old.

Here is a link to a brochure full of great info about liver diseases which is so common in Yorkies. It is a good overview of liver disease and treatments, and is written by Dr. Tobias, of Univ. of Tennessee, who is the top Doc in dealing with liver disorders.

http://www.vet.utk.edu/clinical/sacs...NAL-201304.pdf

I'm praying all will be well for your little one. Keep us posted on her status, and do come here whenever you need a hug. Many of us have gone through this, and we truly understand how stressful it is.

sophiesmominva · 08-25-2014, 01:58 PM

Thank you so much! Her liver enzymes were only slightly elevated (except for the ALT which was 3 x) and her cholesterol was low -- regular vet said it was all indicative of a shunt and recommended bile acid test which was done same day and results after eating were in the 300's (vet said he had only seen a handful of results that high in his career which of course further alarmed me).

She is 6 months old and now that I think of it, the signs were there but I didn't think anything of it. About a month ago, she started eating less and sleeping more. Also a little vomit and/or diarrhea here and there but nothing persistent. Also, some scratching going on but again I didn't think anything of it because it is summer and she likes to play in the grass.

So, given that her post meal bile acid test was over 300; you would 'think' that she would show more signs of distress but she doesn't.

So fingers crossed tomorrow .... just hoping whatever ails her is treatable and/or fixable. Prepared to do what it takes (like most people, cannot afford surgery but will have to sell items to pay for it) as she is such a sweet girl and deserves to live a long, pampered life.

Will post tomorrow after I get the results.

Lolasmom1211 · 08-25-2014, 02:00 PM

I'm so sorry it has taken me all day to reply to your message...it's been one of those days! My little girl was also diagnosed with a liver shunt when I took her in to be spayed. We did the BAT and her numbers also were really high - pre 43 / post 237! I felt like someone had kicked me in the gut when my vet called to tell me! That was in February 2009. Lola only weighed 3.5 lbs. She had never been really sick, other than the first weekend I had brought her home and they told me she had been hypoglycemic. She did have a poor appetite and her coat was not full - but no seizures or any other neurological symptoms. I had her shunt "repaired" (ameroid ring) 3/6/09, and she was also diagnosed with MVD. Lola just turned 6, she is hardly ever sick - maybe an ear infection once or twice a year and is doing great! The surgery saved her life and you would never know she had anything wrong. Liver shunt is scary when you read about it, but it is treatable with surgery, diet and medications. Tons of people of YorkieTalk have been through what you are going through...ask lots of questions if you have them and make sure you are comfortable and happy with your vet. I would suggest a specialist when you have the surgery done...prayers coming your way from Texas!

GracieJane · 08-25-2014, 02:23 PM

After elevated enzymes when her luxating patellas were fixed in July, the surgeon told me to have Gracie (now 11 months) retested in a few weeks. Those numbers were still high last week, so we did bile acids and they were no better. She is having ultrasound on Friday. I am glad to see encouraging responses to your questions because I have been quite anxious about her. Let's hope they both do well!
Gracie is pretty much asymptomatic, so I hope we are catching this early and she will not have lasting damage. The comment about the coat was interesting--hers is thin and wavy-totally unlike her parents, so maybe that will improve with treatment. A long as she is healthy, though, I will just keep it cut short and cute.
Please keep us updated, and if you want to talk to someone local, please PM me and we can trade notes about what is going on.
If you need a surgeon, we were very pleased with the one who fixed Gracie's patellas, and the specialty center was fabulous.

sophiesmominva · 08-25-2014, 02:36 PM

Thank you for your replies! Both those who have gone through this and of course those who are going through this right now. You have no idea how much I appreciate the support.

ladyjane · 08-25-2014, 03:06 PM

My adult pup, Teddy Bear, had surgery for liver shunt last February and he is doing fine now.

I see you have been given some good information already. Hope all goes well tomorrow...will keep your pup in my thoughts and prayers. Please keep us posted.

Welcome to YT!

Also, good luck to Gracie....does she have a thread about her testing?

GracieJane · 08-25-2014, 05:55 PM

I had added an update to an earlier post when we last week, but it has disappeared under all of the newer stuff. I will start a thread when we get ultrasound results.

Here is hoping for both little sweeties!

sophiesmominva · 08-26-2014, 12:36 PM

Took Sophie to get an ultrasound but after talking with Dr. they recommended not to do one and do surgery instead for a couple of reasons. 1) ultrasound may or may not show a shunt -- only 75% of time and 2) they would need a liver biopsy anyway. So, I saved some money there that I can apply toward the surgery.

Dr. said pretty sure it is a shunt or multiple shunts or of course liver disease. But I felt that she was betting on a shunt.

Put her on lactulose, Hills low protein Rx food and an anti-seizure medicine. She has not had seizures but she said dogs who have surgery, sometimes have seizures post-op and want to prevent that so Sophie will take that medicine for one week prior to surgery.

I asked about Sophie's very high BAT results 300 + and she said that is not indicative of the severity of her disease which made me feel good.

Getting Rx filled tonight but immediately purchased the low protein food and gave her (just hoping she does not react to it). Originally Dr. was not going to change her diet right before surgery but later changed her mind -- perhaps because surgery would not be for 2 weeks or so. I have a surgery consult next Tuesday and we go from there.

sophiesmominva · 08-26-2014, 12:38 PM

Also said she was 'thin' for a puppy

and they tried to take a urine sample but her bladder was empty. Sent me home with a cup which I will try to do and take it right up to my normal vet.

Nalah143 · 08-26-2014, 02:19 PM

Hi there. I know exactly what you're going through as my beloved Nalah was diagnosed with liver shunt (PSS) about 4 years ago. She was having seizures followed by partial blindness, which really scared us. After the blood work was completed, we finally opted for the portal scintigraphy exam to confirm her diagnosis. I was a wreck when I found out... At the time, I was a college student and unable to afford the surgery. I suggest surgery if your baby is a good candidate. We medically managed Nalah's condition daily with Lactulose, Sam-E, Hills L/D food and a STRICT diet. She did great with treatment! You would have never known she was sick for the last 4 years of her life.

Just want to let you know we are here for you. You are not alone. You and your baby can get through this.

God bless.

Lolasmom1211 · 08-26-2014, 06:23 PM

Quote:

Originally Posted by sophiesmominva

Took Sophie to get an ultrasound but after talking with Dr. they recommended not to do one and do surgery instead for a couple of reasons. 1) ultrasound may or may not show a shunt -- only 75% of time and 2) they would need a liver biopsy anyway. So, I saved some money there that I can apply toward the surgery.

Dr. said pretty sure it is a shunt or multiple shunts or of course liver disease. But I felt that she was betting on a shunt.

Put her on lactulose, Hills low protein Rx food and an anti-seizure medicine. She has not had seizures but she said dogs who have surgery, sometimes have seizures post-op and want to prevent that so Sophie will take that medicine for one week prior to surgery.

I asked about Sophie's very high BAT results 300 + and she said that is not indicative of the severity of her disease which made me feel good.

Getting Rx filled tonight but immediately purchased the low protein food and gave her (just hoping she does not react to it). Originally Dr. was not going to change her diet right before surgery but later changed her mind -- perhaps because surgery would not be for 2 weeks or so. I have a surgery consult next Tuesday and we go from there.

I also had the scintigraphy done rather than an ultrasound. I was told that the scintigraphy was much more accurate in positively identifying a shunt. Did the surgeon advise putting your baby on anti-seizure meds? Just curious because mine was never put on any. I'm so glad you are having the consult next week - what a lucky baby that you are taking care of this so quickly. You'll be happy you did! Please keep us posted - good luck!

sophiesmominva · 08-27-2014, 04:04 AM

Quote:

Originally Posted by Lolasmom1211

I also had the scintigraphy done rather than an ultrasound. I was told that the scintigraphy was much more accurate in positively identifying a shunt. Did the surgeon advise putting your baby on anti-seizure meds? Just curious because mine was never put on any. I'm so glad you are having the consult next week - what a lucky baby that you are taking care of this so quickly. You'll be happy you did! Please keep us posted - good luck!

Lolasmom: Hmmm...I was never offered a scintigraphy but vet made it very clear that with or w/o an ultrasound, she would still need a biopsy, hence the suggestion to skip ultrasound and go right to surgery. I have not met with surgeon yet but it was the internal medicine vet who recommended the anti-seizure medicine to be taken at least one week prior to surgery. At the vet hospital, they have different specialties under one roof but each specialty is a different practice/company. She did speak to the surgeon when I was there waiting about Sophie so perhaps that is what the surgeon told her. Since I do not have the surgery scheduled, have not started her on the anti-seizure meds.

sophiesmominva · 08-27-2014, 04:16 AM

Quote:

Originally Posted by Nalah143

Hi there. I know exactly what you're going through as my beloved Nalah was diagnosed with liver shunt (PSS) about 4 years ago. She was having seizures followed by partial blindness, which really scared us. After the blood work was completed, we finally opted for the portal scintigraphy exam to confirm her diagnosis. I was a wreck when I found out... At the time, I was a college student and unable to afford the surgery. I suggest surgery if your baby is a good candidate. We medically managed Nalah's condition daily with Lactulose, Sam-E, Hills L/D food and a STRICT diet. She did great with treatment! You would have never known she was sick for the last 4 years of her life.

Just want to let you know we are here for you. You are not alone. You and your baby can get through this.

God bless.

Thank you for sharing your experience. So, did your baby have or not have the surgery? I have heard of dogs being medically managed without surgery and of course if there are multiple shunts presents (which I pray not), that would be the course of action. Personally, I would like to hold off on surgery for a month or two and get her acid levels down and weight up, etc. Would also give me a little time to come up with the money. I am a single woman who just paid for my daughter's wedding in St. John, USVI ! But I do have a responsibility to my dog and will make it work financially regardless. Worse case scenario for her is that it is not a single shunt and instead multiple shunts or something else that cannot be corrected.

I started Sophie on the L/D food (canned) last night and she also had some this morning. She was barking at me when I was fixing it (mixed some with her old food) this morning because she wanted it so bad. She inhaled it when I gave it to her and could have eaten more but of course I don't want to overfeed her belly then she will throw up for sure. Weird thing is that she has not had a BM for past 2 meals of canned food and you would think this stuff would make her go poo due to it being wet food and an alteration in diet. I'm watching her outside to see if she goes and of course looking in my house for areas she might sneak to, to go poo as she is not house broken yet -- which is another issue but the least of my concerns right now.

sophiesmominva · 08-27-2014, 05:17 AM

I know this sounds odd and probably a coincidence, but since starting Sophie on her new low protein diet at 8pm last night along with the lactulose, I see an increase in appetite along with energy level. This morning after she ate, she ran around and played when before she would eat and go right back to sleep.Two hours after her morning meal, I had to give her another small serving of food and when she saw me prepare it, she started doing her tricks I have taught her without me asking -- so cute.

08-25-2014, 07:09 AM	#1
sophiesmominva Yorkie Yakker Join Date: Aug 2014 Location: Richmond, VA Posts: 59	Possible Liver Shunt Took my 6 month old baby to get spayed and her liver enzymes were elevated so they also did a Bile Acid test which came back 'off the charts'. I have an appointment for ultrasound for her tomorrow. Currently she is experiencing a little vomiting and diarrhea but this is only recent. So worried about her and came to Yorkie Talk for much needed support. Thank you.

08-25-2014, 08:47 AM	#2
MauiGirl Donating YT 1000 Club Member Join Date: May 2008 Location: Maui, Hawaii Posts: 7,740	Hi, Welcome to Yorkie Talk. I am sorry that your lil girl is having a problem, and hope that things turn out ok for her. Many members on Yorkie Talk have been in the same situation, and we are all here to support you. In fact, my Tiki was also suspected of having LS when she was 7 months old, following pre-spay blood work. I know how terrifying that is, and how frustrating it is to go through the various tests. First of all I want to say that although it is scary, it is not a death sentence. If there is a shunt it likely can be repaired, and there is a possibility that it is not a shunt, but something else, like other toxicity, or MVD (microvascular displasia) also known by a new name I can't recall. My Tiki turned out to have MVD, which is managed medically by diet, and I'm happy to say she is doing just great at 6 years old. Here is a link to a brochure full of great info about liver diseases which is so common in Yorkies. It is a good overview of liver disease and treatments, and is written by Dr. Tobias, of Univ. of Tennessee, who is the top Doc in dealing with liver disorders. http://www.vet.utk.edu/clinical/sacs...NAL-201304.pdf I'm praying all will be well for your little one. Keep us posted on her status, and do come here whenever you need a hug. Many of us have gone through this, and we truly understand how stressful it is. __________________ SANDY, MOM TO TIKI , KAYLA , KARLEE , R.I.P. MEIKA

08-25-2014, 02:23 PM	#5
GracieJane Senior Yorkie Talker Join Date: Dec 2013 Location: Richmond VA Posts: 176	Close by, in your shoes After elevated enzymes when her luxating patellas were fixed in July, the surgeon told me to have Gracie (now 11 months) retested in a few weeks. Those numbers were still high last week, so we did bile acids and they were no better. She is having ultrasound on Friday. I am glad to see encouraging responses to your questions because I have been quite anxious about her. Let's hope they both do well! Gracie is pretty much asymptomatic, so I hope we are catching this early and she will not have lasting damage. The comment about the coat was interesting--hers is thin and wavy-totally unlike her parents, so maybe that will improve with treatment. A long as she is healthy, though, I will just keep it cut short and cute. Please keep us updated, and if you want to talk to someone local, please PM me and we can trade notes about what is going on. If you need a surgeon, we were very pleased with the one who fixed Gracie's patellas, and the specialty center was fabulous.

08-25-2014, 03:06 PM	#7
ladyjane Resident Yorkie Nut Donating YT 20K Club Member Join Date: Sep 2006 Location: Texas Posts: 27,451	My adult pup, Teddy Bear, had surgery for liver shunt last February and he is doing fine now. I see you have been given some good information already. Hope all goes well tomorrow...will keep your pup in my thoughts and prayers. Please keep us posted. Welcome to YT! Also, good luck to Gracie....does she have a thread about her testing? __________________ CLOUD NINE BEDS--YORKIE HAVEN RESCUE MY ETSY SHOP

08-25-2014, 05:55 PM	#8
GracieJane Senior Yorkie Talker Join Date: Dec 2013 Location: Richmond VA Posts: 176	I guess I should start one! I had added an update to an earlier post when we last week, but it has disappeared under all of the newer stuff. I will start a thread when we get ultrasound results. Here is hoping for both little sweeties!

08-25-2014, 01:58 PM	#3
sophiesmominva Yorkie Yakker Join Date: Aug 2014 Location: Richmond, VA Posts: 59	Thank you so much! Her liver enzymes were only slightly elevated (except for the ALT which was 3 x) and her cholesterol was low -- regular vet said it was all indicative of a shunt and recommended bile acid test which was done same day and results after eating were in the 300's (vet said he had only seen a handful of results that high in his career which of course further alarmed me). She is 6 months old and now that I think of it, the signs were there but I didn't think anything of it. About a month ago, she started eating less and sleeping more. Also a little vomit and/or diarrhea here and there but nothing persistent. Also, some scratching going on but again I didn't think anything of it because it is summer and she likes to play in the grass. So, given that her post meal bile acid test was over 300; you would 'think' that she would show more signs of distress but she doesn't. So fingers crossed tomorrow .... just hoping whatever ails her is treatable and/or fixable. Prepared to do what it takes (like most people, cannot afford surgery but will have to sell items to pay for it) as she is such a sweet girl and deserves to live a long, pampered life. Will post tomorrow after I get the results.

08-25-2014, 02:00 PM	#4
Lolasmom1211 Donating YT 500 Club Member Join Date: Apr 2008 Location: Texas Posts: 664	I'm so sorry it has taken me all day to reply to your message...it's been one of those days! My little girl was also diagnosed with a liver shunt when I took her in to be spayed. We did the BAT and her numbers also were really high - pre 43 / post 237! I felt like someone had kicked me in the gut when my vet called to tell me! That was in February 2009. Lola only weighed 3.5 lbs. She had never been really sick, other than the first weekend I had brought her home and they told me she had been hypoglycemic. She did have a poor appetite and her coat was not full - but no seizures or any other neurological symptoms. I had her shunt "repaired" (ameroid ring) 3/6/09, and she was also diagnosed with MVD. Lola just turned 6, she is hardly ever sick - maybe an ear infection once or twice a year and is doing great! The surgery saved her life and you would never know she had anything wrong. Liver shunt is scary when you read about it, but it is treatable with surgery, diet and medications. Tons of people of YorkieTalk have been through what you are going through...ask lots of questions if you have them and make sure you are comfortable and happy with your vet. I would suggest a specialist when you have the surgery done...prayers coming your way from Texas!

08-25-2014, 02:36 PM	#6
sophiesmominva Yorkie Yakker Join Date: Aug 2014 Location: Richmond, VA Posts: 59	Thank you for your replies! Both those who have gone through this and of course those who are going through this right now. You have no idea how much I appreciate the support.

08-26-2014, 12:36 PM	#9
sophiesmominva Yorkie Yakker Join Date: Aug 2014 Location: Richmond, VA Posts: 59	Update on Appointment with Internal Medicine Took Sophie to get an ultrasound but after talking with Dr. they recommended not to do one and do surgery instead for a couple of reasons. 1) ultrasound may or may not show a shunt -- only 75% of time and 2) they would need a liver biopsy anyway. So, I saved some money there that I can apply toward the surgery. Dr. said pretty sure it is a shunt or multiple shunts or of course liver disease. But I felt that she was betting on a shunt. Put her on lactulose, Hills low protein Rx food and an anti-seizure medicine. She has not had seizures but she said dogs who have surgery, sometimes have seizures post-op and want to prevent that so Sophie will take that medicine for one week prior to surgery. I asked about Sophie's very high BAT results 300 + and she said that is not indicative of the severity of her disease which made me feel good. Getting Rx filled tonight but immediately purchased the low protein food and gave her (just hoping she does not react to it). Originally Dr. was not going to change her diet right before surgery but later changed her mind -- perhaps because surgery would not be for 2 weeks or so. I have a surgery consult next Tuesday and we go from there.

08-26-2014, 12:38 PM	#10
sophiesmominva Yorkie Yakker Join Date: Aug 2014 Location: Richmond, VA Posts: 59	Also said she was 'thin' for a puppy and they tried to take a urine sample but her bladder was empty. Sent me home with a cup which I will try to do and take it right up to my normal vet.

08-26-2014, 02:19 PM	#11
Nalah143 Yorkie Yakker Join Date: Aug 2014 Location: CA Posts: 29	Hi there. I know exactly what you're going through as my beloved Nalah was diagnosed with liver shunt (PSS) about 4 years ago. She was having seizures followed by partial blindness, which really scared us. After the blood work was completed, we finally opted for the portal scintigraphy exam to confirm her diagnosis. I was a wreck when I found out... At the time, I was a college student and unable to afford the surgery. I suggest surgery if your baby is a good candidate. We medically managed Nalah's condition daily with Lactulose, Sam-E, Hills L/D food and a STRICT diet. She did great with treatment! You would have never known she was sick for the last 4 years of her life. Just want to let you know we are here for you. You are not alone. You and your baby can get through this. God bless.

08-27-2014, 05:17 AM	#15
sophiesmominva Yorkie Yakker Join Date: Aug 2014 Location: Richmond, VA Posts: 59	I know this sounds odd and probably a coincidence, but since starting Sophie on her new low protein diet at 8pm last night along with the lactulose, I see an increase in appetite along with energy level. This morning after she ate, she ran around and played when before she would eat and go right back to sleep.Two hours after her morning meal, I had to give her another small serving of food and when she saw me prepare it, she started doing her tricks I have taught her without me asking -- so cute.