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-   -   possible liver shunt (https://www.yorkietalk.com/forums/sick-injured-emergencies-talk/84576-possible-liver-shunt.html)

kodibear 06-27-2007 02:46 PM

possible liver shunt
 
Cody went into the vet today because he just hasn't picked up after his vaccines last week. She ran some blood tests on him and his liver levels were high. She didn't do a bile acid test or anything so she couldn't say for sure that he had a shunt, but is a very real possibility right now. He took a bad fall two days before the vaccines, so she said the trauma may have caused his levels to be higher so she sent us home with lactulose because he's been getting wobbly and disoriented, an antibiotic just to rule out infection, an anti-vomiting medication, and i/d canned food. We're also supposed to keep up on the nutrical (we thought he was hypoglycemic) On Friday she wants to do another blood test and a bile acid test to see if it is a shunt.

So, I have some questions- If it is a shunt, what then? Is it something that he will need medication for the rest of his life? Can it be managed with a special diet? (he won't touch the food the vet gave us) Do yorkies usually need surgery for a portosystemic shunt?

My parents are talking about putting him back up for rescue if it turns out to be a shunt- more so because if he's going to be high maintenance and sickly they're not ready to deal with that emotionally... We all felt sick when the vet was explaining all the medications and restrictions she was sending us home with and with talk of hospitalizing him for an IV and observation and possibly having to go in all day when he goes for his next vaccinations so they can give him a steroid first and then observe him for a reaction and hearing hims scream in the other room as they were injecting who knows what into him after drawing his blood...

We just can't bear to see him this way :( We're shoving medications down his throat, he doesn't want to be by us, he's just sleeping and won't touch his food...:cry:

Any info you can give me on the liver shunt and its management would be very helpful to me right now. We have to be ready to make the decision about keeping him by Friday when we see if he's doing better or not...

CO_yorkie_momma 06-27-2007 02:58 PM

You can do a search on here for liver shunt. I know there are alot of threads here with very good information. I hope it is just the flu or something and not a shunt. Good luck.

kodibear 06-27-2007 03:32 PM

I hope so too, but the enzyme level was almost twice the normal:confused: She did say that it can be the combination of all the stress he had last week though... I hope...

paulapoo 06-27-2007 03:41 PM

I'm so sorry he's sick. I hope it's just the vaccines that elevated his bile acid levels. Please do extensive research and educate your parents because liver shunt and MVD babies can live normal lives be it through surgery or diet and lactulose with supplements. I hope you don't give up on him. My boy is on lactulose and special food and is doing fine. He's NORMAL. The knowledge that I gained from this site and the Yahoo group for liver shunt/MVD was incredibly helpful, and it made me realize that I could handle whatever there was to come. Giving him medicine twice a day and spending a little more on his food is nothing compared to the love and enjoyment he brings to my life. I'll be praying for Cody, and that your family is lead to make the right decision. I beg you to be educated, informed, and know what your dealing with before you send him back to a rescue

Yorkieluv 06-27-2007 03:46 PM

I'm so sorry to hear this...When my yorkie had his vaccines as a pup, he had a very hard time after them...At the time, we did not know about his liver problems...But we did later find out that he has liver shunt/mvd
An extrahepatic portosystemic shunt does require surgery in order for your pup to live a good normal life...If he recovers 100% without aquired shunting and he doesn't have secondary MVD, then he will be able to stop special diet and medications within a few months after surgery...
I'm confused as to why your dog was sent i/d if your vet suspects liver problems. Usually, they send you home with l/d which is specifically for the liver. Read the ingredients of the i/d and make sure it doesn't contain any meat products like chicken or pork or organ meats like liver...Those are high in protein and he should be on low non-animal protein right now until they figure all this out.
The lactulose is super important. Do not miss a dose of that, and it's best to give it directly after meals. His stool needs to be soft, not firm...
I know it seems overwhelming right now, but let's see what the results of the bile acid test are...Take it one step at a time...If it turns out that your baby has a portosystemic shunt, then surgery needs to be done. If it turns out that your baby has microvascular dysplasia (HMD/MVD), then he can live a normal life with his special diet, lactulose, and supplements like milk thistle and denosyl (sam-e).
Usually liver compromised dogs like Royal Canin Hepatic LS 14 much better than Hill's products like the i/d, k/d, l/d, etc. It seems to be more palatable. If your vet doesn't carry it, you can always get a prescription for it from your regular vet and get it at another vet's office or at Banfield....
How old is your little Cody??

kodibear 06-27-2007 04:10 PM

Quote:

Originally Posted by Yorkieluv (Post 1199351)
I'm so sorry to hear this...When my yorkie had his vaccines as a pup, he had a very hard time after them...At the time, we did not know about his liver problems...But we did later find out that he has liver shunt/mvd
An extrahepatic portosystemic shunt does require surgery in order for your pup to live a good normal life...If he recovers 100% without aquired shunting and he doesn't have secondary MVD, then he will be able to stop special diet and medications within a few months after surgery...
I'm confused as to why your dog was sent i/d if your vet suspects liver problems. Usually, they send you home with l/d which is specifically for the liver. Read the ingredients of the i/d and make sure it doesn't contain any meat products like chicken or pork or organ meats like liver...Those are high in protein and he should be on low non-animal protein right now until they figure all this out.
The lactulose is super important. Do not miss a dose of that, and it's best to give it directly after meals. His stool needs to be soft, not firm...
I know it seems overwhelming right now, but let's see what the results of the bile acid test are...Take it one step at a time...If it turns out that your baby has a portosystemic shunt, then surgery needs to be done. If it turns out that your baby has microvascular dysplasia (HMD/MVD), then he can live a normal life with his special diet, lactulose, and supplements like milk thistle and denosyl (sam-e).
Usually liver compromised dogs like Royal Canin Hepatic LS 14 much better than Hill's products like the i/d, k/d, l/d, etc. It seems to be more palatable. If your vet doesn't carry it, you can always get a prescription for it from your regular vet and get it at another vet's office or at Banfield....
How old is your little Cody??

:2omg: i/d contains turkey and pork liver... I think she gave it to us because she was thinking it would be a good bland food since he's been throwing up. We'll call tomorrow and see if she can switch him to a food that doesn't have meat protein in it if she's so worried about his liver enzymes. He's ignoring it anyway... says we're shoving too many things down his throat when he just wants to sleep.

as for how old he is, we really don't know. The animal hospital where we got him from says 2 months, the one where he got his shots at last week says 3 months, and the vet we saw today (we weren't impressed last week) says 4 months and that we can consider neutering anytime (and we thought we had a baby!) and that the blood work he got done today would be enough for that.

I'll try to explain all of this to my parents but my guess is that if he needs surgery then we won't be keeping him. They wanted to look into options so that the decision would be made before we were in the vets office finding out that he needs surgery (we already let the vet know that there would be a decision to be made and she gave us some suggestions on rescue networks)

Yorkieluv 06-27-2007 06:33 PM

I just sent you a pm.

drawlins27 06-27-2007 07:37 PM

I really hate to say this, but if your parents don't want a high maintainance dog, then a Yorkie was not the best choice. Even when healthy, a Yorkie is high maintainance.

If you do decide to put him up for rescue, then I suggest you try here first. There are a lot of people on here who are knowledgable about liver shunt and would love to take him. And you would know that he was going to a great home.

I hope that everything works out for you.

drawlins27 06-27-2007 07:58 PM

Wanted to add that you should give yourself more time to make your decision. The bile acid results will likely not even be in by Friday. I know how attached you are already and you seem like you are giving him a really good home. It would be such a shame for him to uprooted again when the two of you have already bonded.

And the others are right, if its MVD only, then no surgery is required. Just a few medications and a change in diet is all that should be needed. My Lily has MVD and its not difficult to manage it. A few extra minutes of my time every day is certainly worth all the love I get from her in return.

lisatodd 06-28-2007 03:51 AM

that is awful. i am so very sorry. i hope all turns out well

kodibear 06-28-2007 05:28 AM

Quote:

Originally Posted by drawlins27 (Post 1199751)
I really hate to say this, but if your parents don't want a high maintainance dog, then a Yorkie was not the best choice. Even when healthy, a Yorkie is high maintainance.

If you do decide to put him up for rescue, then I suggest you try here first. There are a lot of people on here who are knowledgable about liver shunt and would love to take him. And you would know that he was going to a great home.

I hope that everything works out for you.

My parents didn't go out looking for a yorkie, let alone, a dog. We've had dogs all our lives, but 1.5 years ago, our lab of 13 years was put to sleep. It was then that my parents said NO MORE DOGS! However, for some reason they were led to follow up on a rescue situation when they were on vacation and heard that there was a litter of puppies up for rescue. They immediately fell in love with Cody and despite the fact that they adopted him from a hospital, they never told my parents about the possibility of liver shunts or any of the other problems that Yorkies can have. (why wasn't he tested before he was adopted out BY A VET?!)

We are not ready to go through the testing, my parents were both raised with the understanding that if a dog is suffering, then you don't put it through all kinds of medical procedures that it doesn't even understand- you put them out of their misery. Now, they have no intentions of putting Cody to sleep- he's too young for that:( and they know that if it is a liver shunt and it's operable then he can live a normal life... but they don't want to be the ones to put him through all the medical stuff.

My mom is on the phone right now with the animal hospital where we got him... I'll keep you guys updated:(

kodibear 06-28-2007 06:35 AM

we're trying the medication for a couple days- if he keeps getting worse, then we're taking him back- it sounds as though they have experience with liver shunts and they suspect it's a single large vessel based on how bad he's getting in such a short period of time. He's awake and alert right now, but earlier he couldn't even stand up to relieve himself because he kept falling over every time he tried to squat...

we just need some time to process this... if they're right about what it is, then he's going to need surgery

In the meantime, we're calling our vet to see about getting him on l/d instead of i/d

Yorkieluv 06-28-2007 07:12 AM

i/d is going to make him worse...Insist that they give you l/d

diggy4 06-28-2007 07:21 AM

What state are you in? If you are anywhere near Michigan....I would consider taking him....I dont know how rescues work and if this has to go thru the rescue or whatever. Lets start with first things first...Let me know if your still considering giving him up.

kodibear 06-28-2007 07:22 AM

we called about getting l/d but they told us his vet isn't in for another hour. He's been chowing down the i/d since he got up and had a burst of energy- attacked his stuffed duck with a ferocity that we haven't seen in a week but is still wobbly. We tried giving him rice instead of the i/d but he won't eat it (so we mixed it in with the i/d so that he was getting more rice than dog food) the i/d is still a lot lower protein than his puppy food but hopefully we'll have him on l/d by the end of the day so he's not getting the turkey and pork liver that's in the i/d

his belly is getting really swollen- is this going to have to be drained or does it go away as he gets better?


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