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-   -   portosystemic shunt (https://www.yorkietalk.com/forums/yorkie-health-diet/147699-portosystemic-shunt.html)

Ladymom 11-30-2008 07:49 AM
Quote:
Originally Posted by JaLaYorkieGirl (Post 2264563)
I am so sorry you are going through all of this.

I would recheck BA's in 4-6 week and then if they are still elevated I would recommend having a Protein C test done next. Your vet will have to collect the sample and send it to Cornell University but it is the least invasive way to determine if elevated BA's are from MVD or from a livers shunt.

Normal Protein C Activity and elevated BA's = MVD
Abnormal Protein C Acvtivity and elevated BA's = Most likely a shunt

IF you get an abnormal protein C then you can proceed with a scintograhy

I agree 100%. Here is the information about the Protein C test and where to send it. Most vets see so little liver disease they are not familiar with the current protocol.

Comparative Coagulation -- NYS Animal Health Diagnostic Center

LillyBug 11-30-2008 07:57 AM
Abnormal Bile Acid Panel
 
Hi all, I also just joined the forum. My 7 month old yorkie was found to have high liver levels pre labs for her spay. We just underwent the Bile acid panel and were informed- abnormal. Pre level was 33.7, post meal was 68.4. My vet is either recommending 1) medical mgment only and diet which can eventually catch up with her or 2) a referral to other hospital for extensive testing. He suggests this is a shunt. Any feedback or information? I am just lost, my little Lilly is my cuddlebug.

dwerten 11-30-2008 08:10 AM
Quote:
Originally Posted by LillyBug (Post 2354371)
Hi all, I also just joined the forum. My 7 month old yorkie was found to have high liver levels pre labs for her spay. We just underwent the Bile acid panel and were informed- abnormal. Pre level was 33.7, post meal was 68.4. My vet is either recommending 1) medical mgment only and diet which can eventually catch up with her or 2) a referral to other hospital for extensive testing. He suggests this is a shunt. Any feedback or information? I am just lost, my little Lilly is my cuddlebug.
no i do not necessarily think that is a shunt with those numbers and the post number is below 100 - is your baby having seizures, head pressing, picky eater? if not then most likely mvd and just get her on a low protein diet - my dd had post of 76, 53 and now 26 on low protein diet and she has no symptoms so 22% protein is safe for no symptoms if dog has symptoms 18% protein or less - if symptoms then i would supplement and do further testing but for now her gall bladder could have contracted when test was done which happens and numbers can be higher -- did vet biopsy liver while doing spay to test for mvd as that would have been the best thing as your dog probably has mvd with those numbers

dwerten 11-30-2008 08:15 AM
Quote:
Originally Posted by Ladymom (Post 2354357)
I agree 100%. Here is the information about the Protein C test and where to send it. Most vets see so little liver disease they are not familiar with the current protocol.

Comparative Coagulation -- NYS Animal Health Diagnostic Center
100% agree my new vet tests all yorkies and maltese for liver shunt up front and dd was 3 before they ever questioned it and i had been to a few vets so he knew a little but not enough as he wanted me to have dd do scinitography with no symptoms and bats below 100 so i told him no after joining this group and learning more about it as i do not believe in doing unnecessary testing and i believe you treat the dog not always the blood work Liver_Shunt_And_MVD_Support@yahoogroups.com

Yorkieluv 11-30-2008 12:25 PM
Quote:
Originally Posted by LillyBug (Post 2354371)
Hi all, I also just joined the forum. My 7 month old yorkie was found to have high liver levels pre labs for her spay. We just underwent the Bile acid panel and were informed- abnormal. Pre level was 33.7, post meal was 68.4. My vet is either recommending 1) medical mgment only and diet which can eventually catch up with her or 2) a referral to other hospital for extensive testing. He suggests this is a shunt. Any feedback or information? I am just lost, my little Lilly is my cuddlebug.
What kinds of symptoms is your baby exhibiting? Is she a picky eater? does she vomit? any UTIs? dark urine? smelly urine? occassional lethargy? head bobbing? etc?

Typically numbers that are above normal but under 100 are more indicative of MVD (microscopic shunting throughout the liver) and numbers above 100 are more indicative of liver shunt. This is ONLY a *guideline* though...There are dogs that have had numbers under 100 with a liver shunt and dogs with numbers above 100 with MVD.

The main thing right now if your baby has any symptoms at all is to get her on the right *type* of protein which should be vegetarian/dairy because these types are less encephalogenic.
Canned L/D or dry Royal Canin Hepatic LS 14 are recommended if symptomatic. If not, Natural Balance Vegetarian.
Also, it's important to avoid single large meals. Make sure she's eating at least 4 small meals per day to help lighten the load on the liver.

LillyBug 11-30-2008 01:55 PM
Quote:
Originally Posted by dwerten (Post 2354387)
no i do not necessarily think that is a shunt with those numbers and the post number is below 100 - is your baby having seizures, head pressing, picky eater? if not then most likely mvd and just get her on a low protein diet - my dd had post of 76, 53 and now 26 on low protein diet and she has no symptoms so 22% protein is safe for no symptoms if dog has symptoms 18% protein or less - if symptoms then i would supplement and do further testing but for now her gall bladder could have contracted when test was done which happens and numbers can be higher -- did vet biopsy liver while doing spay to test for mvd as that would have been the best thing as your dog probably has mvd with those numbers
I do not notice any symptoms like you mentioned. I did buy natural balance with fresh chicken and switched her off Iams toy breed to this on Friday. This has 23% crude protein, wonder if this is low enough? Since changing her food I did notice that her bowel movements seem to be easier for her, prior she passed very hard stools and was difficult. The vet did not do a biopsy while doing her spay, initially he thought her high liver levels could have been something she had gotten into that did not agree with her ex. toxic.

LillyBug 11-30-2008 02:02 PM
Quote:
Originally Posted by Yorkieluv (Post 2354711)
What kinds of symptoms is your baby exhibiting? Is she a picky eater? does she vomit? any UTIs? dark urine? smelly urine? occassional lethargy? head bobbing? etc?

Typically numbers that are above normal but under 100 are more indicative of MVD (microscopic shunting throughout the liver) and numbers above 100 are more indicative of liver shunt. This is ONLY a *guideline* though...There are dogs that have had numbers under 100 with a liver shunt and dogs with numbers above 100 with MVD.

The main thing right now if your baby has any symptoms at all is to get her on the right *type* of protein which should be vegetarian/dairy because these types are less encephalogenic.
Canned L/D or dry Royal Canin Hepatic LS 14 are recommended if symptomatic. If not, Natural Balance Vegetarian.
Also, it's important to avoid single large meals. Make sure she's eating at least 4 small meals per day to help lighten the load on the liver.
I haven't researched much on MVD. Is this managed with diet and medications with no surgery? Is life expectancy shortened? I just switched her from Iams Toy breed to Natural Balance with chicken which has 23% crude protein. I do not notice any symptoms like you mentioned. She does seem tired at times however this is after playing with my golden. Definately will start 4 smaller meals, makes sense!

Jwoge02 11-30-2008 04:24 PM
All I have done so far is changed him to canned LD food because it has lower protein than dry. I plan to take him back to get another bile acids test since he has been on it now for awhile just to see if it has gone down at all. You can do ultrasounds and things like that but it is going to cost quite a bit of money. Good luck with everything.

TLC 11-30-2008 07:33 PM
Quote:
Originally Posted by LillyBug (Post 2354371)
Hi all, I also just joined the forum. My 7 month old yorkie was found to have high liver levels pre labs for her spay. We just underwent the Bile acid panel and were informed- abnormal. Pre level was 33.7, post meal was 68.4. My vet is either recommending 1) medical mgment only and diet which can eventually catch up with her or 2) a referral to other hospital for extensive testing. He suggests this is a shunt. Any feedback or information? I am just lost, my little Lilly is my cuddlebug.
I would get the Vegetarian Natural Balance and retest BAT in a few weeks, along with a complete blood panel and urinanalysis. The post is sorta high, but I would not think it was a shunt, especially if there aren't really any major symptoms. It is most like MVD which is managed with diet and supplements, and YES they can live a long healthy life. Try not to panic.....

Roxy's first BAT was 100.9 and with diet change and supplements, she has come down to the 60 to 85 range. She is doing well ;)

LillyBug 12-02-2008 05:15 PM
I have an appointment with the vet tomorrow to discuss options. I will certainly request a repeat of BAT. The vet originally put Lilly on Adenosyl when her first liver enzyme came back high. Funny thing is when I took her in for the BAT he said her liver enzymes had come down to normal? I have continued her on the Adenosyl as he never said to stop it. Any suggestions for low protein treats? She is always chewing on my golden's bones, I assume I should keep these away from her?:confused:

TLC 12-02-2008 07:36 PM
Quote:
Originally Posted by LillyBug (Post 2358217)
I have an appointment with the vet tomorrow to discuss options. I will certainly request a repeat of BAT. The vet originally put Lilly on Adenosyl when her first liver enzyme came back high. Funny thing is when I took her in for the BAT he said her liver enzymes had come down to normal? I have continued her on the Adenosyl as he never said to stop it. Any suggestions for low protein treats? She is always chewing on my golden's bones, I assume I should keep these away from her?:confused:
Dried Sweet Potato ;)

bellasmomok 12-02-2008 08:05 PM
Quote:
Originally Posted by LillyBug (Post 2354885)
I do not notice any symptoms like you mentioned. I did buy natural balance with fresh chicken and switched her off Iams toy breed to this on Friday. This has 23% crude protein, wonder if this is low enough?
Quote:
Originally Posted by TLC (Post 2355441)
I would get the Vegetarian Natural Balance ...
:thumbup: Good start switching to a better quality food....unfortunately, not only does the amount of protein matter, but the TYPE of protein matters. The NB Vegetarian doesn't contain animal proteins (e.g. beef, lamb, chicken, etc...)--all it's protein comes from potato protein I think. Animal protein breaks down into ammonia, and if blood is bypassing the liver, then ammonia will build up in her system eventually because she isn't able to get rid of it. So good sources of protein would include vegetable sources and dairy sources (and egg whites are ok too), but not animal meat. I didn't see anyone mention this, so I thought I'd better....I've been learning a LOT lately since my baby has a high ALT and high pre and post bile acids. :( Seems like there are a lot of us out there lately.....

bellasmomok 12-02-2008 08:08 PM
I should have said, those are good protein sources...to start with! Several members who have liver compromised dogs manage their disease just fine using chicken and fish in their diet, but you should probably start out a little more strict until you know for sure what you're dealing with. At least, that's what I've heard and what I'm doing. Then, you could add chicken or fish (no red meats though!) back in depending on her symptoms and diagnosis.

MauiGirl 12-02-2008 08:09 PM
Quote:
Originally Posted by TLC (Post 2358426)
Dried Sweet Potato ;)
Do you make your own Dried Sweet Potato, or is it available is stores? Sounds like just what I need for my Liver Challenged/ not yet diagnosed, Tiki.

Ladymom 12-02-2008 09:32 PM
Quote:
Originally Posted by MauiGirl (Post 2358463)
Do you make your own Dried Sweet Potato, or is it available is stores? Sounds like just what I need for my Liver Challenged/ not yet diagnosed, Tiki.
Cloud Star makes dehydrated sweet potato chips:

http://www.cloudstar.com/8B85D0640D2...E42118096B204A

I love Cloud Star's Itty Bitty Buddy Biscuit Sweet Potato Madness.

Just make sure you are giving Tiki enough protein. Unlike dogs with kidney disease, low protein diets are not appropriate for liver compromised dogs. They can actually damage the liver further and/or prevent it from repairing itself. The key is to feed high quality protein from dairy or chicken and fish. Protein should be about 20% of their diet.


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