Is liver shunt always hereditary? - Page 3 - YorkieTalk.com Forums

belindaY · 08-13-2008, 04:28 PM

Liver shunt surgery is a huge money maker for some veterinarians, so be careful about who you're dealing with. Many vets will be thrilled to charge you a small fortune for surgery, then come back and say "oops, it's MVD, not shunt, and surgery was a failure except we got a really good biopsy. That will be $4000 please." What too few people are talking about is that mildly elevated bile acids are normal for many Yorkies, mild MVD and small shunt not a big deal and most respond extremely well with medical management--low protein diet, lactulose, phonebarb for those having some seizure activity. READ, SEARCH, READ. These operations are dangerous and often useless.

AmyChristine · 08-13-2008, 04:40 PM

Thankyou everyone who has been so supportive through all of this, and who has provided me with information and links to information. I just got off of the phone with the vet she is sure from the results of the bile acid that Copper has liver shunt. I am kind of in shock, but it also feels like I knew already. We have come up with a "plan of action" she has a few patients that she is treating right now with LS, one of them is not a case where it is opperable and she has lived many years beyond the orriginal expectancy, and still thriving. My vet also feels that the elvated BUN was due to the LS. Thank you again for all the support. oh for those of you that are currious about numbers; before the feeding he was at 8 and after he was at 125 I beilieve that levels after feeding should be between 0-20.

bchgirl · 08-13-2008, 04:50 PM

The bile acid results can't determine if it's liver shunt. That test merely determines the function of his liver. Further testing would determine shunt. Like a protein C test. From his results it doesn't sound like LS...those figures are usually higher than 100. He may have mvd though and that is controlled by diet and supplements.

Good luck...

Ellie May · 08-13-2008, 05:00 PM

Bile acid tests alone can't diagnose liver shunt. While if the post is over 100, it is often LS, it could still be something like MVD. Ellie's most recent post was 106 and we don't know what it is but ultrasound, although often inconclusive, shows no shunt... Biopsy showed no MVD but only one sample was taken... So bile acid test results can't be the only test used for this.

Ladymom · 08-13-2008, 05:11 PM

I agree. Although the numbers suggest a shunt, they are still low enough that MVD is possible. The next step would be a protein C test.

If you vet suggests an ultrasound, tell her "no". Depending on the skill of the technician, they can only be 60% accurate according to Dr. Center. Scintigraphy is the correct test to do.

Most local vets just aren't knowledgable enough about liver disease. It's always best to go to a vet school if possible.

AmyChristine · 08-13-2008, 06:08 PM

Quote:

Originally Posted by Ladymom

I agree. Although the numbers suggest a shunt, they are still low enough that MVD is possible. The next step would be a protein C test.

If you vet suggests an ultrasound, tell her "no". Depending on the skill of the technician, they can only be 60% accurate according to Dr. Center. Scintigraphy is the correct test to do.

Most local vets just aren't knowledgable enough about liver disease. It's always best to go to a vet school if possible.

I will consider the vet school

We are doing some more testing just in case. I also talked to his breeders they said that they had a litter with LS years ago, she thought that they had gotten it under controll by no longer breeding those dogs. Copper's mother is related to the one of those dogs

Would MVD cause him to rub his head after eating? or siezures? I will make sure that a protein C test is being done, thank you. I am trying to read and take in as much info as possible it just takes me a while sometimes to file everything in my head.

AmyChristine · 08-13-2008, 06:18 PM

There is a really good vet school in WA but it is in Pullman which is in the opposite corner of the state from me, I will contact them and go from there.

TLC · 08-13-2008, 06:42 PM

Prayers are coming your way. LS and MVD are not a death sentence, he can live a normal happy life, it's good to get to the bottom of this though, so you know what path to go on.

I agree with everyone, 125 may or may not be LS - Please don't waste your money on an ultrasound, as others have stated it's not 100% accurate, and then you will be forced to spend more money on other tests (which you could have skipped to in the first place).

Roxy's first BAT was 43 (pre) and 100.9 (post) - we did a full CBC, urinalysis, coagulation and a U/S - everything came back normal. Roxy doesn't have any of the more obvious symptoms, but she does have something wrong with her liver. I have opted to maintain her with diet and supplements (for now, as the next step would be a biopsy, and I don't want to put her through that). Both my general Vet and her Internal Medicine Specialist feel (based on what we have done so far) that she has MVD

AmyChristine · 08-13-2008, 07:00 PM

Quote:

Originally Posted by TLC

Prayers are coming your way. LS and MVD are not a death sentence, he can live a normal happy life, it's good to get to the bottom of this though, so you know what path to go on.

I agree with everyone, 125 may or may not be LS - Please don't waste your money on an ultrasound, as others have stated it's not 100% accurate, and then you will be forced to spend more money on other tests (which you could have skipped to in the first place).

Roxy's first BAT was 43 (pre) and 100.9 (post) - we did a full CBC, urinalysis, coagulation and a U/S - everything came back normal. Roxy doesn't have any of the more obvious symptoms, but she does have something wrong with her liver. I have opted to maintain her with diet and supplements (for now, as the next step would be a biopsy, and I don't want to put her through that). Both my general Vet and her Internal Medicine Specialist feel (based on what we have done so far) that she has MVD

Thankyou, I will deffinately opt for the other tests first. We are planning on a long healthy life together. Does Roxy seem to do well on the diet and supplements? This is what my vet wants to use for now or at least untill we have finished all the testing. She also said that she can use fluids to detox and that has helped others in the past. I have learned so many things this week that I never though I would need to know before. I cannot thank everyone enough for being supportive. He is so important to me.

cvasquez · 08-13-2008, 08:30 PM

I agree with others when stating bile acid results do not diagnosis a liver shunt. After I got Paisley's bile acid results we did a scintigraphy. And that was the test that diagnosed her liver shunt. I had no other tests done on her. From there we went to the University of Tennessee and they were satisfied with the tests she had and took her into surgery.

I would urge you to do your research and do the tests that you feel are necessary.

08-13-2008, 04:28 PM	#31
belindaY Senior Yorkie Talker Join Date: Apr 2008 Location: redmond Posts: 132	study up and be informed Liver shunt surgery is a huge money maker for some veterinarians, so be careful about who you're dealing with. Many vets will be thrilled to charge you a small fortune for surgery, then come back and say "oops, it's MVD, not shunt, and surgery was a failure except we got a really good biopsy. That will be $4000 please." What too few people are talking about is that mildly elevated bile acids are normal for many Yorkies, mild MVD and small shunt not a big deal and most respond extremely well with medical management--low protein diet, lactulose, phonebarb for those having some seizure activity. READ, SEARCH, READ. These operations are dangerous and often useless.

08-13-2008, 04:40 PM	#32
AmyChristine YT 1000 Club Member Join Date: Jul 2007 Location: Washington Posts: 1,184	Thankyou everyone who has been so supportive through all of this, and who has provided me with information and links to information. I just got off of the phone with the vet she is sure from the results of the bile acid that Copper has liver shunt. I am kind of in shock, but it also feels like I knew already. We have come up with a "plan of action" she has a few patients that she is treating right now with LS, one of them is not a case where it is opperable and she has lived many years beyond the orriginal expectancy, and still thriving. My vet also feels that the elvated BUN was due to the LS. Thank you again for all the support. oh for those of you that are currious about numbers; before the feeding he was at 8 and after he was at 125 I beilieve that levels after feeding should be between 0-20. __________________ My belongs to Copper and Maddie Mae RIP Sweet Rocky Mommy misses you

08-13-2008, 04:50 PM	#33
bchgirl Donating YT 10K Club Member Join Date: Apr 2005 Location: at da beach Posts: 15,444 Blog Entries: 2	The bile acid results can't determine if it's liver shunt. That test merely determines the function of his liver. Further testing would determine shunt. Like a protein C test. From his results it doesn't sound like LS...those figures are usually higher than 100. He may have mvd though and that is controlled by diet and supplements. Good luck... __________________ Deb, Reese, Reggie, Frazier, Libby, Sidney, & Bodie Trace & Ramsey who watch over us www.biewersbythebay.com Last edited by bchgirl; 08-13-2008 at 04:51 PM.

08-13-2008, 05:00 PM	#34
Ellie May And Rylee Finnegan Donating Member Join Date: Apr 2007 Location: Metro Detroit, MI Posts: 17,928	Bile acid tests alone can't diagnose liver shunt. While if the post is over 100, it is often LS, it could still be something like MVD. Ellie's most recent post was 106 and we don't know what it is but ultrasound, although often inconclusive, shows no shunt... Biopsy showed no MVD but only one sample was taken... So bile acid test results can't be the only test used for this. __________________ Crystal, Ellie May (RIP), Rylee Finnegan, and Gracie Boo🐶

08-13-2008, 05:11 PM	#35
Ladymom Donating YT 2000 Club Member Join Date: Sep 2007 Location: North Carolina Posts: 8,317	I agree. Although the numbers suggest a shunt, they are still low enough that MVD is possible. The next step would be a protein C test. If you vet suggests an ultrasound, tell her "no". Depending on the skill of the technician, they can only be 60% accurate according to Dr. Center. Scintigraphy is the correct test to do. Most local vets just aren't knowledgable enough about liver disease. It's always best to go to a vet school if possible. __________________ http://www.myladysdogbows.com/ http://www.facebook.com/home.php?ref...6213341?ref=nf

08-13-2008, 06:18 PM	#37
AmyChristine YT 1000 Club Member Join Date: Jul 2007 Location: Washington Posts: 1,184	There is a really good vet school in WA but it is in Pullman which is in the opposite corner of the state from me, I will contact them and go from there. __________________ My belongs to Copper and Maddie Mae RIP Sweet Rocky Mommy misses you

08-13-2008, 06:42 PM	#38
TLC Slave to My Rug-Rats Donating Member Join Date: Jun 2005 Location: Long Island Posts: 7,247	Prayers are coming your way. LS and MVD are not a death sentence, he can live a normal happy life, it's good to get to the bottom of this though, so you know what path to go on. I agree with everyone, 125 may or may not be LS - Please don't waste your money on an ultrasound, as others have stated it's not 100% accurate, and then you will be forced to spend more money on other tests (which you could have skipped to in the first place). Roxy's first BAT was 43 (pre) and 100.9 (post) - we did a full CBC, urinalysis, coagulation and a U/S - everything came back normal. Roxy doesn't have any of the more obvious symptoms, but she does have something wrong with her liver. I have opted to maintain her with diet and supplements (for now, as the next step would be a biopsy, and I don't want to put her through that). Both my general Vet and her Internal Medicine Specialist feel (based on what we have done so far) that she has MVD __________________ Adopt Donate Foster www.yorkie911rescue.com

08-13-2008, 08:30 PM	#40
cvasquez Senior Yorkie Talker Join Date: Mar 2008 Location: justin tx Posts: 130	I agree with others when stating bile acid results do not diagnosis a liver shunt. After I got Paisley's bile acid results we did a scintigraphy. And that was the test that diagnosed her liver shunt. I had no other tests done on her. From there we went to the University of Tennessee and they were satisfied with the tests she had and took her into surgery. I would urge you to do your research and do the tests that you feel are necessary. __________________ Christina