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looking for info on liver shunt I was just wondering if there was anyone on here who has a baby who has had to have surgery for a liver shunt? I have read all the info but would like to hear from someone who has experienced it first hand. My eleven week old brucey had several seizure's sunday morning. I took him to the emergency hospital and they checked him for hypoglycemia. They also talked about liver shunts. He seems to be doing better now, he's still a little lethargic. He hasn't had anymore seizures, he had three that I know of. Anyway, after all this rambling I was just wanting to hear from someone who has gone through this first hand. Thanks! |
I am just bumping this up for you, I do know of a member that when through it this summer. I am sorry to hear this, but please let us know what they find out. We will keep you in our prayers. |
My Indiana has had surgery 2 times, both to fix an extrahepatic liver shunt. He was first diagnosed last year when he was 6months old. He didn't have seizures, but he did have squinty eyes, almost like he was asleep on his feet. The surgeon called it pre-seizure activity. He was always a laid back puppy, played hard and slept really sound. He didn't fit the typical liver shunt puppy in that liver shunt puppies tend to be small and don't grow and thrive. Indy weighed 10lbs when he was diagnosd. We had the shunt fixed, and all went really well. By six months his bile acids were pretty much normal, his fasting was still a couple points high, but the eating one was completely normal. He gained 2lbs with in 3 weeks after the surgery and continued to grow and gain weight. At about a year (in July) I had another bile acid done and it came back high. We put him back on the Hills L/D prescription diet and tested again in 6 weeks, they had almost doubled. We went back to the surgeon and had another ultrasound and they found a second shunt. Odd thing was his liver had almost doubled in size and the veins going into it were big and healthy. They said he had the liver of a normal dog. So, he had a second surgery in Sept and at this point doing well. He goes in for his first post op bile test next week so hopefully they will have come down. I am told that a second shunt in a dog with a liver of normal size is rare, 1 in 200 dogs get a second shunt. My luck!! If you have any questions, please IM me. I would be glad to relate any of my experiences with liver shunts! Good luck! Kim |
He has not had the bile acid tests done yet, my local vet thought that was jumping the gun a little bit. I think that I will insist he have them when he goes back later this week. He isn't acting sick anymore with no more seizures but I'm still worried. He is twelve weeks this friday and he still only weighs 1.6 lbs. He always seems to busy to eat! I literally have to pick him up and hand feed him to eat to get him started! My vet seems to think that the seizures may have been caused by a head injury because he still has a open fontanel. I guess I'm just still worried because after I took him to the emergency hospital sunday they had me convinced he had a shunt, I cried all day! Thanks so much for the info, I'm so glad I ran across this board! |
Was his blood sugar in normal range when they checked it? Lacy had many seizures as a result of hypoglycemia (confirmed by blood test). She did finally outgrow it and was healthy. Why the rush to judgment for liver shunt? Did something show up in the blood test results? |
his blood sugar was 151. I guess because of the seizures they wanted to rule it out. But to do this they wanted me to put him in the hospital on a dextrose drip to do the fasting test. The estimated cost was $500 -$600. I was shocked because on Saturday he was his normal happy self. I signed him out AMA and called my regular vet( I have recently moved). He told me to give him half a pet enema and a anti-inflamatory. He automatically had results from the enema and after the anit-inflamatory he was his old self again, just a little tired. I guess after reading up on shunts I got scared because he is not growing well and had the seizures. |
It sounds like hes having seizures from the toxin build up in his body if the enema has helped him so much, but this is a guess Im not a vet. Here is a group I belong to that is very helpful with livershunt info. http://pets.groups.yahoo.com/group/L...d_MVD_Support/ I would join and chat with others who experience the same thing. This baby needs to have a bile acid test done ASAP Your vet should be able to do it and its not a real pricey test. |
I'm going to see about getting them done this week. Will he need to stay at the vet for the fasting test? I don't want him to become hypoglycemic. Thanks so much for all the help! |
At 151, definitely not hypoglycemia, normal is 68 to 125, Lacy was like 30 if I'm remembering correctly (and this was after being given Nutrical)! Seizures can be a symptom of many things. I wouldn't panic yet. Does he still have an open fontanel (soft spot on top of head that hasn't closed yet)? I would have a complete blood panel done. They may have already done this and you just need to request the results, but it is possible to only test for blood glucose. If the ALT, Bilirubin, or BUN (blood urea nitrogen levels) are out of the normal range, then I would request a bile acid test pre (fasting 12 hours) and post feeding (wait two hours retest after giving high protein canned food). If all is normal, probably not liver related. ALT 15 - 84 U/L ALT 10 - 80 U/L TOTAL BILIRUBIN 0.0 - 0.4 mg/dL TOTAL BILIRUBIN 0.0 - 0.2 mg/dL UREA NITROGEN 9 - 27 mg/dL UREA NITROGEN 20 - 30 mg/dL |
If the blood panel shows a reason to do further testing on the liver - There is a new bile acid test done on the urine which requires no fasting and only one test. Here's a link to read about it, your vet may or may not be familiar with the test. http://www.canine-epilepsy-guardian-...id_testing.htm I was looking at the above normal values in blood tests - the first is for dogs, the second set is for cats. |
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Yes my Gucci had liver shunt, she had extrahepatic portal shunt and had the ameroid constrictor put on. Gucci too had several incidents of hypoglycemia. When we rushed her to vet hospital she had reading of 50 which is very low. They diagnosed her with liver shunt and she had the surgery this past August. Gucci is doing great she is able to go back on regular dog food and I have to retest her bile acids in 6 mts. Her last reading was good but I believe her pre was still a littler high but not as high as pre surgery. The surgeon said it takes sometimes a year to come down.... If you have any questions please pm me and I will answer your concerns... Good luck! Gina |
My yorkie also has a liver shunt, but unfortunately his is intrahepatic and it cannot be repaired, so it is managed through diet and medications. He is doing very well now, and you would never even know he has it. He is so sweet and very spoiled!! IMO having a bile acid test done is important for yorkies as so many are diagnosed with liver shunts. It is a fairly inexpensive test that runs between $50-$100 depending on where you live, but it is well worth every penny for that peace of mind. I will pray for your little guy, and if you have any questions, please feel free to ask. |
I think that I will go ahead and have a complete blood panel done, then if anything is out of whack I will get the bile acids test. He has not had any problems since sunday. You would not know he was ever sick, he's back to bossing my husband's boxer around! |
Urine Bile Acid Test A urine bile acid test is not accurate nor is the IDEXX SNAP Bile Acid Test. The only accurate test is a pre and post prandial Bile Acid Test. This should be the first test done and if it proves positive then an Ultrasound, Portogram or Scintigraphy should be done to determine where the shunt is and how severe it is. The technician that performs an Ultrasound should be well versed in reading the results as some inexperienced technicians are not competent enough to see the shunt, especially if it's hidden behind other soft tissue. There are links on my web site http://yorkies.com for information on Liver Shunt. You can also join a Yahoo group that I help moderate that deals with Liver Shunt & MVD. To join send a blank email to: Liver_Shunt_And_MVD_Support-subscribe@yahoogroups.com Or go to: http://groups.yahoo.com/group/Liver_...d_MVD_Support/ |
I wish the best for your baby and hope he stays well.:aimeeyork I'm going to have to disagree that the UBAT is not accurate. Studies have shown it to be very accurate. I hate to see someone not use a test that is so easy to do, and has advantages over SBAT in some cases. Key is timing to getting the urine sample. 4-8 hours after eating is optimal, so no fasting is wanted. Dr. Jean Dodds reads these tests if they are sent through to Hemopet. It costs about 45-50 dollars and they fax the report to your vet. Here is the link to the article with the findings. http://www.dvmnews.com/dvm/article/a....jsp?id=134764 |
UBAT vs Serum Bile Acid Test The Urine Bile Acid Test does give an indication that an abnormality can exist in the liver however like the IDEXX SNAP test it only show an elevated Bile Acids and doesn't give a number that's indicative of a Liver Shunt as compared to MVD/HMD (Microvascular Dysplasia / Hepatic Microvascular Dysplasia). Generally a Serum Bile Acid level in the range between 30 to 80 is more indicative of MVD/HMD and is treated with a proper low protein diet along with Lactalose and possibly Milk Thistle whereas a Post Prandial number above 100 is more indicative of a Liver Shunt and requires corrective surgery. The Urine Bile Acid test and IDEXX SNAP Bile Acid Test does not quantify those numbers to as accurate a degree as the Serum Bile Acid Test. The Urine Bile Acid Test also doesn't show reversed Bile Acid numbers that can happen from a dream/nightmare where the dog is excited and that excitement results in increased Gastric activity and elevated Bile Acid numbers. Dr. Karen Tobias of the University of Tennessee in Knoxville, a foremost authority on liver disease in dogs and specifically Yorkshire Terriers, does not recommend the UBAT or the IDEXX SNAP Bile Acid Test because their results are not definitive. Since the cost of a Serum Bile Acid Test is about the same as either of the other tests mentioned and is considered the standard protocol for diagnosis of Liver disease, I can not see any reason to use a test that requires further testing to know what's going on. Ultimately it's up to the dog's owner and that of their vet as to what test should be done. Advise given here is only to meant to provide information that can aid in acting as an advocate for your Yorkie and should not be taken as definitive. |
In 2001 a study was done showing that less than 2% of Yorkies were diagnosed with a liver shunt. Of course, 2% is too high, but we have to remember that leaves 98% unaffected. There is NO test that is 100% reliable in showing a liver shunt, except: Liver Imaging Radiography - Invasive - A dye is injected into the spleen and the dye is tracked through Radiograph through the blood vessels. A blood vessel bypassing the liver can easily be seen on the image. This is the only universally accepted method of confirming a shunt, short of major surgery, it however is extremely invasive. Tests, blood or urine, only indicate how the liver is functioning at best. Other Liver Dysfunctions that could mimic Liver Shunt: Acute Hepatic Failure - Rapid loss of liver function due to death of liver cells caused by drugs, toxins, infectious diseases and lack of oxygen. Mimics Liver Shunt signs and symptoms. Hepatic Lipidosis - The accumulation of fatty tissue within the liver caused by appetite loss which promotes the accumulation of lipid in the liver. Mimics Liver Shunt signs and symptoms. Hepatitis Chronic Active - Inflammation of the liver causing the accumulation of inflammatory cells and scarring. Mimics Liver Shunt signs and symptoms. Copper Storage Disease - Genetic disease caused by excessive accumulation of copper in the liver. Mimics Liver Shunt signs and symptoms. Infectious Hepatitis: Viral disease that targets the liver, kidneys, eyes and blood stream. Mimics Liver Shunt signs and symptoms. Benign Tumors: Abnormal cell accumulation that affects the livers ability to filter and process properly. Mimics Liver Shunt signs and symptoms. Cancer: Abnormal cell accumulation that affects the livers ability to filter and process properly. Mimics Liver Shunt signs and symptoms. Toxins: Excessive overload of impurities in the blood stream that overloads the livers ability to filter and process properly due to illness or disease. Mimics Liver Shunt signs and symptoms. Parasites: Such as liver flukes or HEARTWORMS which invade the liver causing the livers inability to filter and process properly. Mimics Liver Shunt signs and symptoms. Liver Abscess: Lesions that cause the livers inability to filter and process properly. Mimics Liver Shunt signs and symptoms. Cirrhosis - One form of the end stage of liver disease causing the liver to be unable to filter and process properly. Mimics Liver Shunt signs and symptoms. Trauma - Severe or blunt blow to the liver region causing contusions. Mimics Liver Shunt signs and symptoms. Pancreatitis - A severe inflammatory process that occurs with digestive enzymes that can spill over into the liver and cause severe disease. Mimics Liver Shunt signs and symptoms. ADVENOVIRUS - Viral disease of canines. Mimics Liver Shunt signs and symptoms. POISONS: Toxic substances ingested by mouth or absorbed through the skin into the blood stream that can have deadly consequences to your animal such as Oleander, Azalea, Rhododendrons, Poinsettias and Japanese yews to name a few. Causes liver malfunction and can mimic Liver Shunt signs and symptoms. MEDICINES: There are several chemicals that could be toxic to the liver including medicine given daily to many animals such as Rimadyl (arthritis treatment), Thiacetarsamide (heartworm treatment), Ketaconazole (fungal treatment), Tylenol (acetaminophen), Glucocorticoids (cortisone), Anthelmintics (wormer), Parasiticides, Phenobarbital (epilepsy meds). |
2% Liver Shunt is Inaccurate The 2% Liver Shunt victims you quoted were statistics compiled in 2001 but were accumulated in the five previous years and they didn't take in account the dogs with MVD/HMD. This percentage has increased drastically in the last several years as the popularity of the Yorkie increased and climbed to the #3 AKC registered dog. Yorkies have a 36% greater instance of Liver Shunt than all other breeds combined. While you quote all other maladies that could be connected with Liver Disease you seem to set aside the importance and incidence of Liver Shunt in this breed. I don't have a Liver Shunt dog nor have I ever had one because the breeders I got my Yorkies from make every effort to make sure they don't breed carriers that would produce Liver compromised dogs. They don't allow a puppy to leave their kennel until it's at lease 16 weeks old and they also Bile Acid test each of the puppies before they leave for their forever homes. I help moderate a Yahoo group that deals with Liver Shunt and MVD/HMD and I've done this for over 10 years. I was also on the board of a group that funded Liver Shunt surgery for those that didn't have the funds to do it themselves. Until you've walked in their shoes you'll never know the grief and heartache they experience. I've sat in the vets office with some of them, having made the trip to U/T myself, and watched them cry their eyes out when they had one of the 5% that don't make it after the surgery. After seeing that I'm not so quick to dismiss the cavalier attitude that most of the disreputable breeders have towards Liver Shunt and related diseases. I receive hundreds of emails a year from people with Liver Shunt and MVD/HMD dogs. They are looking for answers on how to care for their dogs and ways to fund the necessary surgery if that's required. It's sad, oh so very sad, when they have to put the dog to sleep because the breeder won't assist in the financial burden that's brought to bear on the dog's owner and they can't afford to pay for the surgery themselves. They didn't bargain for a very sick dog when they spend their hard earned money for what was represented to them as a healthy dog. Most breeders just bury their heads in the sand and say it's not their responsibility. Over the years I've sent over 150 Yorkies to U/T for Liver Shunt surgery since that facility will perform the test and surgery for less than half the cost of other well known veterinary teaching facilities or private veterinary practices. All the other liver maladies you quoted are but a small percentage of liver disease and don't come anywhere near the incidence of Liver Shunt or MVD/HMD. To give the impression they they account for more than they do is a disservice to the readers of this forum. To argue back and forth is pointless and doesn't help those that are looking for answers so I'll refrain from continuing this thread. Anyone that wants to contact me for more information can do so privately by emailing me at: satman@inbox.com |
I really appreciate everyone's help. Brucey is running around like nothing ever happened. He does still have a open fontanel so I'm starting to think the seizures came from a head injury like the vet suggested as one possibility. He is still going to get some blood work done the next time he is at the vet so I will keep everyone posted! Again thanks to everyone! Cindy |
Quote from satman: you seem to set aside the importance and incidence of Liver Shunt in this breed. I don't know how saying the the only definitive test for liver shunt is a radiography dye test is negating the importance of liver shunts. I simply disagreed with your findings that there was a blood test that could do this. I have never purchased, sold, or bred a victim of liver shunt and hope I can continue to claim that in the future. I just don't see any reason to yell FIRE!!!!!! until you at least see smoke! |
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Yes, I have experienced a dog with Liver Shunt, and when I had her surgery done, there were others at the Purdue University having the same surgery. Now that is just from a small area of my state, so what would it be nation wide. If breeders had been open before instead of covering it up, there would not be so many today. Also, many dogs have died because the problem goes undetected, because vets and people did not know to check for this. People are being educated now becaue of all the lists that talk about it. |
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But in yorkies you need you yell FIRE and hope its not the real thing! Livershunt is so common in yorkies |
Here is the website of Dr. Kaen Tobais, the leading livershunt research veternarian. When I had a question about one of my kids, I sent her an email and she responded within 24 hours. http://www.yorkielane.com/LiverShunt/ Liver shunt can be very difficult to diagnose -- many different illnesses share the same type symptoms. A full fasting blood profile will give your vet a starting point to decide on what other tests might be necessary. |
I forgot to say that I am sending get well hugs :ghugs: and sending prayers that you do not have a LS problem. |
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First I am glad to see the baby is somewhat better. If he has an open font you'll want to keep a good eye on him. A few of my thoughts on LS testing and then I will leave it alone. Since this really doesn't help the OP who is worried about her baby. We all hope everything works out the best for him. As far as the livershunt info. I have supported Terri and the group as best I could since its inception. Its a good cause and has helped many Yorkies to live who otherwise may have had no hope. My point was that both SBAT and UBAT are only screening tools and not diagnostic tools, further testing would be required if either were abnormal. SBAT can be elevated by other things such as lipemia and hemolysis. UBAT are not effected by these. It is sensitive to the liver function itself. It's supposed to have 100% sensitivity. I hope this could possibly help in reducing unnecessary invasive tests that could be done in false positives from the SBAT. While I respect Dr. Tobias, I asked her opinion prior to my using the UBAT she told me she could not comment on it due to not having used it. I also respect Dr. Dodds who is a leader in the field of Vet. medicine as well. I think more people would screen their dogs if it was an easier procedure than fasting and drawing blood twice from a squirming pup. I think this type of screening is key to slowing down the instances of Yorkies bred and born with liver shunt/mvd. I know vets who won't do the SBAT on an asymptomatic pup but have no problem with the UBAT. This I would think is the goal. Get as many dogs screened as possible. It is up to each person and their Vet to make the choice, which is why I didn't think UBAT should be discarded so easily. I am not concerned with the cost. I would pay a higher price for the UBAT because the stress on the pup is my first concern. I believe all options available to us should be able to be considered. A dog with symptoms needs all the care we can give no matter what the tests involve. This is JMO (I am not a Vet) and we all do what we think is best for our dogs. |
Just wanted to update everyone. Brucey is doing great! He has not had a seizure in a week and a half. He has shown no signs of a livershunt or no gastrointestinal problems at all! He was very tired for 3 days or so after the seizures but I expect that to be normal in dogs, as it is in people. My vet thinks that it is a waste of time and money to do the tests at this point. He did advise me to let him know if any of the symptoms return. It was a very scary week. My heart goes out to anyone who has a livershunt baby! I just knew(or so I thought!) that he had a liver shunt. I was trying to decide what I was going to do. I would do everything in my power to save him but my checkbook does not have endless funds(as I am sure many others don't as well). I was thinking well I could try to control it by diet( if that's would have even been an option). But that would probably mean cutting his life short or him living a sickly life. The other option I thought of was giving him up to a rescue organization. That way they could get him the surgery he needed and then adopt him out to a new family. Of course that to me seems to only be punishing the original owner. It's not like you choose for your puppy to have such a serious health problem. I think there should be more programs( or a program) to help people get their dogs the help they need and let the dog stay with its owner. Of course I may be speaking of something I don't know anything about. With rescuses maybe the person adopting the dog takes on the vet bills. Thanks to everyone for all the responses and helpful information. I will continue to keep you posted! p.s. Sorry for the rambling! |
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