cost of liver shunt surgery
 

A friend's 6 month old Yorkie has been diagnosed with liver shunt and cost estimate for surgery in $4000-$5000. This included spaying, but not the diagnostics leading up to this point. Does anyone have recent experience with this who can say whether this estimate is reasonable? I've tried phoning veterinary hospitals in the area and they're very secretive with this information. Thanks very much.

The cost probably depends on the area of the country you're in. I personally haven't had that expense, but have read others who paid about $4,000.

I'd venture to say the vet's offices aren't being so much secretive...as they hesitate to quote a price on an animal they haven't examined and unknown variables.

Has your friend contacted her breeder?

Good luck to her...I know she must be worried sick.

If there is any way your friend can go to University of Tennessee, that is the best. LS surgery with spay should be less than $2000 depending on what has to be done. They should give you an estimate over the phone.

$5000 and even $4000 is probably way too much.

I've known several people who have traveled to the University of Tennessee from all over the country that have paid between $1600-$1800 including spay/neuter, diagnostic tests, pre-op care, post-op care, etc.
If traveling is not a possibility, has your friend checked vet schools in her area?

The puppy does have a health guarantee that breeder said he'd honor--refund my friend's money, but that's still going to leave a huge vet bill and she's very upset. I do think they're secretive--a couple so far have been forthcoming with info, albeit qualified because they haven't seen the puppy, but willing to give a range the average case would fall into. So far I've come up with two, one a major university veterinary hospital and another a small, local surgical practice. They came in close to each other in the $2000-3000 range. This is for a Northeast US region.

I live in Alabama, and the cost to have this done at Auburn University, including the ultrasound, is $2,000.

We are possibly facing the same thing. Logan will be retested June 4rd. I went to the breeder today, who is a vet, and gave him a copy of the blood work and bile acid test results. He seemed irritated that so many vets are worrying people about liver shunts and doubts Logan has one. He said he wouldn't pay for the surgery but would "replace" Logan with another puppy. I don't want another puppy. I want a healthy Logan.

I can tell you from experience my yorkie had Liver shunt surgery it will be two years next Sept. If you go back and read my posts you can follow her history. Yes I paid over $4,000 just for the liver shunt surgery and she had the Ameroid constrictor placed. I have an excellent vet hospital nearby and two surgeons who do this operation. So I didn't have to travel to Tenn. Is it worth it .. Yes I spent a lot of money but she is doing well. Thank God :)


My advice to you is to to tell your friend not wait to long to have it done. You will not get anyone to give you estimates over the phone. So find a vet that your friend feels comfortable with who does this surgery. My suggestion is to call and ask if they deal with liver shunt disease, and yes Tenn. is a number one place to go if there is no one closer to do this surgery..

Good luck!

That would make me angry....and I think he needs to be told...it isn't other vets worrying people....it's Logan's test results.

Personally if I were you...I would schedule Logan for a protein C test. This will determine whether it's a liver shunt or MVD.

[QUOTE=puppy_Love08;1944268]We are possibly facing the same thing. Logan will be retested June 4rd. I went to the breeder today, who is a vet, and gave him a copy of the blood work and bile acid test results. He seemed irritated that so many vets are worrying people about liver shunts and doubts Logan has one. He said he wouldn't pay for the surgery but would "replace" Logan with another puppy. I don't want another puppy. I want a healthy Logan.[/QUOTE

I must admit I also have wondered if some vets are needlessly worrying people and rushing prematurely into surgery---I've read too many accounts of false positive tests followed by more inconclusive or marginal tests followed ultimately by surgery, at great risk to the dog and strain to the owner's finances. And, are they going to come back after surgery and say "oops, it wasn't liver shunt after all?"The vets seem to be making out real well with it though. Also, why are they not quoting prices over the phone? They should know if the "average" price is around $3000 or closer to $5000, you know, a ballpark figure.

[quote=belindaY;1944671]
That is exactly why Dr. Center recommends all Yorkie puppies have a bile acids test before going to their new home. This is from page 22 of the handout from her seminars:


2: The best approach to avoid "over diagnosis" is to test bile acids in young dogs of highly affected breeds (at 4 mths of age) while they are clinically healthy and before they are adopted into pet homes. Highly affected breeds include: Yorkshire Terrier, Cairn Terrier, Maltese, Tibetan Spaniels as well as many other "terrier" type breeds (Miniature Schnauzer, Lhasa Apso, Shih Tzu, Dachshund, Bichon Frise, Pekingese, Toy and Miniature Poodles, and Havanese and others). Proactive assessment of serum bile acids will limit the awkward circumstance imposed when an MVD dog, with minor health issues, is suddenly recognized to have abnormal bile acids by a pet owner's veterinarian. This circumstance can lead to unnecessary diagnostic confusion and unwarranted invasive tests such as liver biopsy and portovenography.

Surgery should be the last step, after a bile acids test, then a Protein C test, and finally scintigraphy. (Don't waste your money on ultrasounds as they are at best only 80% accurate according the the U of Tennessee, as low as 60% according to Dr. Center.)

This is also from Dr. Center and explains the various tests:

Hepatic Vascular Disorders - WSAVA 2006 Congress

I've actually found that most regular vets are not that knowledgable about liver shunt and don't even know that it could be a real possibility.
When my yorkie was a pup, he had all the signs pointing to liver shunt and we took him to the emergency vet and told her our concerns because he was doing so terribly. She literally told us that it was "not possible because he's too young"...Can you believe that?!? They're born with it...
Anyway, it's better to be safe than sorry when it comes to liver shunt. The earlier you catch it, the better off the dog will be. If it takes a long time to diagnose, the liver gets damaged with each and every day that goes by that it's not receiving liver support.
Also, keep in mind that although a dog may not have an extrahepatic liver shunt, many dogs with elevated bile acids do have MVD...

belindaY are you in Redmond Oregon? If so NW vet specialists has awesome surgeons that do the shunt surgeries. Ive got 2 babies that are going in May 6th for the surgery and I was quoted $3000-$3900 per dog. I can let you know what I think once its over if that will help further.

Teddi had her surgery at University of Tennessee and it was $1,245 in December 2007. It was going to be between $4,000 and $5,000 here in California.

I'm in Washington but the sick puppy is on the east coast. It's good to know about NW in case I need them. How did you end up with 2 sick babies?

To Ladymom, Thanks for your input and links. I know some people strongly advocate bile acid testing, but I'm unclear as to just how helpful that is. It's my understanding that it COULD point to a problem in a very young puppy but is still inconclusive. Can it be used to rule out shunt in a 16 week old, so that 2 months later when a vet says "he has a big liver shunt" we can figure the vet is lying or made a mistake?

Duh I dont know why I thought a Redmond was in Oregon....lol

I am just the chosen lucky one to have 2 sick babies. They are litter mates too. I just pray that the surgery goes well and works! Its so hard to watch them so sick and tired all the time.

scintography test liver shunt
 

Hello to everyone!

My Yorkie had another blood test done ( before and after eating) which was sent to the IDEXX lab, the results were again high. 35o before eating and 250 after eating. This problem has been ongoing since around the holidays when she was put on metronidazole. My yorkie girl has had an ultrasound done at Tufts and they also tested her blood before and after eating. Everything was negative! However, she did in up with an eye ulcer which took nearly a month to clear on a strict regiment of eye antibiotics.

She continued on the medication and had the above mentioned blood work was done this week. Please note, other than the vomiting of bile and diareah she experienced in December, she has been completely without symtoms! She eats well and plays and has had no problems.

Tufts university has been notified and now step 2 is to have a scintogography test done with the dye injection. She will need to be in the hospital for 3 days. I am concerned because she is under 6 lbs. and this is an invasive procedure. The doctor/case manager has been notified about the eye ulcer which supposedly is a rare event. Hmm.

Also, does anyone have an approximate cost? I will phone Tufts on Monday and they will certainly have a definite answer. I am just wondering about different experiences people may have had.

My husband would like to bring her back to Tufts for another blood test before and after eating just to confirm IDEXX's results before putting our baby through the scintigraphy. After all, the blood work tests they did there after the ultrasound were, again, negative. After all, they are a top rated hospital and they have all the state of the art equipment. If everything is done on site, hopefully, all is done correctly. Has anyone out there been to Tufts for liver shunt problems?

Thoughts? All input is appreciated. My yorkie, Emma, will be 2 years old in March.

Thanks again. This is a wonderful forum.
DAB

I'm sorry it came back abnormal again. :(

Since she did have the vomiting and diarrhea, it may be best to proceed. I thought scintography was about $600 but it varies. From my understanding, anesthesia is usually used but it isn't extremely invasive. I have also never heard of having to stay for three day. They are usually kept til the dye is eliminated which takes about a day.

What are the chances of going to Cornell instead? They are very familiar with liver issues there.

My Yorkie had a liver shunt surgery on February 3, 2009. It cost us $2,750.00. She just needed to stay overnight. The next day she was discharged. They spayed her, did a liver biopsy, and drew blood. The surgeon gave us a very detailed list of everything.

Good luck to you. What state are you in?

My Little boy blue
 

I am hopeful for you!

liver shunt
 

My 2 year Yorkie was just diagnosed with bladder stones and liver shunt. I am horrified as he came from an excellent breeder with NO history of any of this. I've started my own search for "the best" surgeon for precious Micah. Any hints for me. Wish I had answers for you. :(

liver shunt
 

My Emma Angel was diagnosed with a liver shunt when she was about 2 years old. The surgery was done at Tuffs University, Foster Hospital for Small Animals in North Grafton, MA. Dr. John Berg operated on her and repaired the stint. Her diagnosis was failure to thrive....but now she eats well and is healthy!! She turned 5 years old in March. My husband and I were very pleased with her care....all staff members were very kind and understanding.

Prior to surgery her BAT numbers were very high. She saw Dr. Michael Stone, an internist, and had 2 ultrasounds which were negative but finally, after a scinctigrafy (spelling?), it was determined that she had an external liver shunt which could be repaired....internal ones can not be repaired...however, most small dogs have the repairable shunts. I would say to save money and time, have the scinctigraphy first.....the ultrasounds are not reliable no matter what the doctors say. As soon as emma had the dye injected in her and the procedure done, the doctors saw the shunt right away.

I hope this helps you......we were pleased with Tuffs but maybe another university hospital closer to you can help. Dr. Tobias (very famous for her work on liver shunts) is in Tennesee but we were not able to get our Emma there. Please note that Emma takes metronidozole daily with her breakfast and probally will continue that for life. She eats very high quality dog food..... the protein count should not be too high. also, emma needs a good fiber count in the food.

Good luck. Please keep me posted. My prayers are with your littl one. :aimeeyork

Suspicion of a liver shunt
 

I took my dog, Cooper, to the vet because I suspected he had a urinary tract infection. The dr. told me that they were going to do a quick scan ultrasound to see what was going on. They found a bladder stone so they ran bloodwork. The bloodwork is pointing toward liver dysfunction and the urinalysis says the stone is struvite. Now they want to do an abdominal ultrasound which will cost $300 and that may not be conclusive. In which case they would do another series of blood tests and some kind of a scan with contrast. All I know is this is getting very expensive very fast but I love my dog. I am wondering if any facility in TX will do these procedures less expensively and if he needs liver shunt surgery who in TX might do it for a more reasonable price. Cooper and I are in San Antonio. Please help!

Robyn
(Cooper's mommy)

Liver shunt - Cooper
 

Hello! My Emma - now age 8 - had surgery to repair a liver shunt when she was 2 yrs old. Surgical repair was done by Dr. John Berg at tufts University at the Foster Hospital for Small Animals. We had repeated blood work done at my vet's office and then x-rays, ultrasounds, and finally the scintigraphy (sp?) done to finally determine that she actually had a shunt. Here is my advice: skip the ultrasound and go right for the more expensive scintigraphy. Why? We had 2 ultra sounds and they kept saying no shunt. But Emma got sicker and sicker - failure to thrive. It seems that with an ultrasound the dog is not really put under anesthesia - so if said dog does not stay perfectly still - the shunt won't show. We had their "expert" do the ultrasound. :( Anyway, had we just went ahead and insisted on the scintigraphy ( that is the procedure where the dye is injected before the film is taken), we would have found it right away! That would have saved us the cost $$ of the 2 ultrasounds - money we could have used toward the scintigraphy. It took people on this wonderful forum to explain this all to me. The scintigraphy at the time was about $300. the ultrasounds were about $150 each. The shunt was found and it was then surgically repaired. Not cheap though. But it saved my Emma's life and she is thriving just fine now. Thanks to St. Francis and the wonderful staff and vets at Tufts, especially Dr. Berg. I am from Massachusetts and do not know about texas. Please join Crazy Yorky Ladies on Facebook as well as other yorky sites there; You may be able to find someone in Texas who has had this done and perhaps either on this site or there some funding help. Not sure.