liver shunt vs. hypoglecemia - YorkieTalk.com Forums

Austin's Mama · 03-04-2005, 09:29 AM

I have a question regarding my 7 month old Austin. We got him when he was about 10 weeks old and a couple of weeks later he had an "episode". He got dizzy, shakey, and acted drunk. Well it scared me to death! He had symptoms of hypoglecemia and the vet confirmed it. We gave him some honey and that was that. I didn't notice any more "episodes" until about 2 months ago. He did the same thing-especially shake. The vet mentioned that it could be liver shunt instead of hypoglecemia because he should not have these types of episodes considering how healthy he is and that they don't happen after any strenuous activity or anything. They just happen whenever and wiothout warning. I still give him honey but am beginning to think it doesn't help. I know what liver shunt is, but how can I tell what the difference is? The symptoms of both hypoglecemia and liver shunt seem to be similiar. Also, is it developed due to heredity?

Yorkease · 03-04-2005, 12:21 PM

Try this website and see if it clarifies what you need to know. i know you are scared to death for your baby.

www.yorkies.org/dogs/health.html

If that doesn't help let me know. I'll help you any way I can.

orinskye · 03-04-2005, 04:25 PM

i know a bile acid test will tell you for sure

Austin's Mama · 03-04-2005, 07:28 PM

The link didn't help, it went someplace strange. Thank you for trying though!

Yorkease · 03-06-2005, 09:42 AM

THIS CAME FROM ANOTHER SITE:

Hypoglycemia is defined as a blood glucose or blood sugar concentration of less than 70 milligrams per deciliter(mg/dl) of blood. Symptoms depend on how quickly the blood glucose concentration decreases but rarely occur until it falls below 50 mg/dl.

Symptoms reflect the rate of decrease of the blood glucose concentration, the underlying cause of hypoglycemia, and the chronicity of the problem. One common form of hypoglycemia is called juvenile hypoglycemia because it occurs in puppies less than three months of age. Juvenile hypoglycemia is common in puppies because they have not fully developed the ability to regulate their blood glucose concentration and have a high requirement for glucose. Stress, cold, malnutrition, and intestinal parasites are problems that may precipitate a bout of juvenile hypoglycemia. Toy breed dogs less than three months of age are most commonly affected.

Other causes of hypoglycemia include fasting before vigorous exercise, which may be a factor in the syndrome called “hunting dog hypoglycemia”; Addison’s disease, an endocrine problem caused by a lack of hormone production by the adrenal glands which can cause weakness, vomiting, diarrhea, and collapse; excessive insulin administration, as may occur in pets with diabetes mellitus; insulin-producing tumors of the pancreas, called “insulinomas” or “beta cell tumors”; severe liver disease; some other tumors that produce insulin-like factors; dogs with portosystemic shunts, which are congenital blood vessel abnormalities the cause blood from the intestines to by-pass the liver; hereditary diseases arising from abnormal storage of glucose as starch in the liver, or glycogen storage disease; and serious systemic bacterial infection, or sepsis.

What to Watch For

Loss of appetite

Extreme lethargy

Incoordination

Trembling

Muscular twitching

Weakness

Seizures

Unusual behavior

Dilated pupils

Apparent blindness

Stupor or coma

Diagnosis

Diagnostic tests are needed to identify hypoglycemia and determine its cause. Tests may include:

A complete medical history and physical examination

Measurement of blood glucose concentration

Other diagnostic blood tests such as complete blood count (also called hemogram or CBC), routine serum biochemistry tests, urinalysis, and serum insulin concentration to try and establish the underlying cause of hypoglycemia.

Ultrasound examination of the abdomen to try and identify a pancreatic or other tumor that could be causing hypoglycemia.

Treatment

Treatments for hypoglycemia may include the following:

Administration of glucose orally or by intravenous injection to increase blood glucose concentration.

Treatment for the underlying cause of hypoglycemia

Home Care and Prevention

Administer as directed any medications prescribed by your veterinarian. Observe your dog’s general activity level, appetite and attitude.

If you have reason to suspect hypoglycemia, you should rub Karo® syrup on your dog’s gums and call your veterinarian immediately. Schedule an appointment with your veterinarian to identify, treat, and monitor the underlying cause of hypoglycemia.

See your veterinarian for regular check-ups as directly.

Provide a warm environment, frequent feedings, routine vaccinations and de-worming procedures for puppies as recommended by your veterinarian. Provide frequent, regular feedings. Young puppies should be fed at least 3 to 4 times a day.

Feed a high quality dog food and provide extra feedings or snacks to working dogs.

I Will post the liver shunts in a minute. Hopefully.

Portosystemic Shunt (Hepatic Shunt)
by: Dr. Erika De Papp

Next Page (Information In-depth)

Section: Overview

A portosystemic shunt is an abnormal communication between blood vessels, which causes blood to bypass the liver. The portal vein is a major vessel in the body which enters the liver and allows toxic components of the blood to be detoxified by the liver. When a shunt is present, the portal vein, or one of its related veins, is inappropriately connected to another vein which creates blood flow around the liver.

The most common type of shunt is a single congenital shunt. This means that the animal is born with the problem. Acquired shunts may occur secondary to liver disease.

Congenital shunts occur in both dogs and cats. Most animals start showing signs by six months of age. However, shunts have been diagnosed in adults as old as 10 years.

Shunts are more common in purebred dogs than mixed breeds. The breeds predisposed to congenital shunts include: miniature schnauzer, Yorkshire terrier, Irish wolfhound, cairn terrier, Maltese, Australian cattle dog, golden retriever, Labrador retriever, and Old English sheepdog.

It occurs more often in female dogs, and of the affected males, there is also an increased incidence of cryptorchidism, in which one or both testicles remain undescended.

The impact of a portosystemic shunt on your pet can present itself in a variety of ways. The most common clinical signs are a result of elevated toxin levels in the blood secondary to failure of removal by the liver. One of the important toxins is ammonia, which causes abnormalities of the central nervous system.

What to Watch For

Lack of appetite

Lethargy

Weakness

Disorientation

Stumbling

Circling or pacing

Apparent staring into the corner

Pressing of the head against objects

Seizures

Blindness

Behavioral changes

Excess salivation (more common in cats)

Vomiting

Diarrhea

Increased thirst and frequent urination (more likely in dogs)

Straining to urinate

Blood in the urine

Failure to grow and thrive

Weight loss

Diagnosis

History and physical exam

Complete blood count (CBC)

Biochemical profile

Urinalysis

Bile acids

Blood ammonia level

Clotting tests

Abdominal radiographs (x-rays)

Abdominal ultrasound

Portography (special dye study)

Transcolonic scintigraphy to monitor the pattern of blood flow

Abdominal exploratory surgery

Treatment

Surgical ligation (closure) of the shunt is the treatment of choice. However, animals must be medically stabilized prior to surgery.

IV fluid therapy restores hydration deficits and corrects electrolyte imbalances.

Lactulose decreases absorption of intestinal toxins such as ammonia by altering intestinal pH.

Antibiotics alter intestinal bacteria such that ammonia production is decreased.

Feeding a protein restricted diet since protein in the diet can precipitate neurologic abnormalities.

In animals with vomiting and diarrhea, gastric protectants help reduce acidity of the gastrointestinal tract and may alleviate some of the symptoms.

Anti-convulsant drugs may be necessary in animals with seizures that are not responsive to the aforementioned medical treatments.

Home Care and Prevention

Give all medications as prescribed by your veterinarian. Feed only the prescribed diet. Monitor your pet for recurrence or worsening of the original clinical signs that alerted you to a problem.

As this is a congenital disorder, there are no known preventative measures for your individual pet. However, any cat or dog with a shunt should never be used for breeding purposes.

I got this information from Petplace.com it looks like they have a whole medical library.

Yorkease · 03-06-2005, 09:49 AM

I am SO SO SORRY for such a very long post. I just felt it was important to get as much of the info I could for you. Maybe you can print it out and read through it better that way. Again, I AM SO SORRY!

Austin's Mama · 03-06-2005, 10:25 AM

Please dont apologize! The information was so helpful, THANK YOU! We have an appointment with the vet on the 14th for a complete blood testing, etc. Thank you again for being so helpful. It scary to think what these lil guys can go through, but thank God for technology! I know most of it can be cured or treated.

fasteddie · 03-06-2005, 12:11 PM

Yorkease: Don't worry about long posts, yours was full of great info! I'm sure the servers can handle it!

Bella · 03-06-2005, 12:50 PM

to be sure, get a bile acid assay test. i experienced the exact episode as u when my 2 yr old bella was only about 3 months old. they checked her for hypo and said that was not it. they said her blood sugar was fine. not sure if i believed them since i was almost sure it was hypo. that day bella ate next to nothing. just wanted to rest. she was only 1.75lbs so i thought if she just ate a few pellets throughout day she would be ok. since that day she has been fine although when i did get her bile acid assay test, it came back poiting toward a poosible shunt or liver disease. i immediately put her on a high carb, low protein diet, LD is the name of the food. besides that, i cut out all treats. every morning and night she gets steamed brown rice mixed w/ sweet potatoes and green beans w/ alittle corn oil. throughout day she picks on dry food. i was supposed to get her checked again since she's been on this diet for about 1 year. she acts fine, looks fine, eats good, weighs 5lbs. i think i'll get a bile acid test again but not sure what to do if it comes back the same or worse. if she does have a shunt and i want to get her operated on, i have to accept the risk of a small dog w/ a shunt possibly not waking up from anesthesia. i was told that it's possible for a dog w/ a shunt to not wake up...
don't know what to do. 1 lesson i learned is that if i ever buy another dog, especially a yorkie, i will get him/her checked while there is still a health gaurantee and before i get attatched. even so, i was attatched to this dog immediately. my wife wanted to give the dog back when this episode happened and i said no way. we both love the dog as if it was a child and don't know what to do. i'm sure u are in same situation as me.

schatzie · 03-06-2005, 12:58 PM

Yorkease - thank you so much for sending all this info. I have pasted/copied and placed it in my health file for future reference.

littlelizzy · 03-06-2005, 08:07 PM

I was in the process of posting a new thread to ask what a liver shunt was, but decided to do a "search" first, glad I did. Thank you so much for taking the time to post such great info. For the first time I think I finally understand the difference in the two conditions.
Thanks again,

Austin's Mama · 03-07-2005, 09:37 AM

I don't know if I am in denial or what, but after reading all that great info on shunts, I do not think Austin has it or not! He shivers and cries at night about 2-3 times a week, but other than that he doesn't have any other symptoms. He eats great, is EXTREMELY playful (except during "episodes"), and weighs just over 5 pounds (He eats regularly). I guess I am just gonna have to be patient and wait until next week for the tests!

Yorkease · 03-07-2005, 10:02 AM

I glad you found the info helpful. I pray everything turns out Ok for your little baby. I too am the cautious person who has little patience when it comes to wanting to know something like this (I hit the internet and research AFTER CALLING MY VET). My husband & I are probably my vet's worst nightmare because we always call him for the least little things. He met us at his office one Sunday morning when one of my yorkies had a strong episode with Hypoglycemia, she's fine now. We set up one night and set the alarm clock for every two hours to give her Nutri-Cal or just keep an eye on her because at night was when she seemed to get worse so we kept a very close eye on her that night.
I am also happy that everyone didn't mind such a long post. I am hoping everything turns out fine.

Please keep us posted.

03-04-2005, 09:29 AM	#1
Austin's Mama Yorkie Yakker Join Date: Dec 2004 Location: Crosby, Texas Posts: 26	liver shunt vs. hypoglecemia I have a question regarding my 7 month old Austin. We got him when he was about 10 weeks old and a couple of weeks later he had an "episode". He got dizzy, shakey, and acted drunk. Well it scared me to death! He had symptoms of hypoglecemia and the vet confirmed it. We gave him some honey and that was that. I didn't notice any more "episodes" until about 2 months ago. He did the same thing-especially shake. The vet mentioned that it could be liver shunt instead of hypoglecemia because he should not have these types of episodes considering how healthy he is and that they don't happen after any strenuous activity or anything. They just happen whenever and wiothout warning. I still give him honey but am beginning to think it doesn't help. I know what liver shunt is, but how can I tell what the difference is? The symptoms of both hypoglecemia and liver shunt seem to be similiar. Also, is it developed due to heredity? __________________ Tara and Austin Tacious

03-04-2005, 12:21 PM	#2
Yorkease YT Addict Join Date: Mar 2005 Location: Sardis TN Posts: 358	Try this website and see if it clarifies what you need to know. i know you are scared to death for your baby. www.yorkies.org/dogs/health.html If that doesn't help let me know. I'll help you any way I can. __________________ Yorkease

03-04-2005, 07:28 PM	#4
Austin's Mama Yorkie Yakker Join Date: Dec 2004 Location: Crosby, Texas Posts: 26	The link didn't help, it went someplace strange. Thank you for trying though! __________________ Tara and Austin Tacious

03-06-2005, 09:42 AM	#5
Yorkease YT Addict Join Date: Mar 2005 Location: Sardis TN Posts: 358	THIS CAME FROM ANOTHER SITE: Hypoglycemia is defined as a blood glucose or blood sugar concentration of less than 70 milligrams per deciliter(mg/dl) of blood. Symptoms depend on how quickly the blood glucose concentration decreases but rarely occur until it falls below 50 mg/dl. Symptoms reflect the rate of decrease of the blood glucose concentration, the underlying cause of hypoglycemia, and the chronicity of the problem. One common form of hypoglycemia is called juvenile hypoglycemia because it occurs in puppies less than three months of age. Juvenile hypoglycemia is common in puppies because they have not fully developed the ability to regulate their blood glucose concentration and have a high requirement for glucose. Stress, cold, malnutrition, and intestinal parasites are problems that may precipitate a bout of juvenile hypoglycemia. Toy breed dogs less than three months of age are most commonly affected. Other causes of hypoglycemia include fasting before vigorous exercise, which may be a factor in the syndrome called “hunting dog hypoglycemia”; Addison’s disease, an endocrine problem caused by a lack of hormone production by the adrenal glands which can cause weakness, vomiting, diarrhea, and collapse; excessive insulin administration, as may occur in pets with diabetes mellitus; insulin-producing tumors of the pancreas, called “insulinomas” or “beta cell tumors”; severe liver disease; some other tumors that produce insulin-like factors; dogs with portosystemic shunts, which are congenital blood vessel abnormalities the cause blood from the intestines to by-pass the liver; hereditary diseases arising from abnormal storage of glucose as starch in the liver, or glycogen storage disease; and serious systemic bacterial infection, or sepsis. What to Watch For Loss of appetite Extreme lethargy Incoordination Trembling Muscular twitching Weakness Seizures Unusual behavior Dilated pupils Apparent blindness Stupor or coma Diagnosis Diagnostic tests are needed to identify hypoglycemia and determine its cause. Tests may include: A complete medical history and physical examination Measurement of blood glucose concentration Other diagnostic blood tests such as complete blood count (also called hemogram or CBC), routine serum biochemistry tests, urinalysis, and serum insulin concentration to try and establish the underlying cause of hypoglycemia. Ultrasound examination of the abdomen to try and identify a pancreatic or other tumor that could be causing hypoglycemia. Treatment Treatments for hypoglycemia may include the following: Administration of glucose orally or by intravenous injection to increase blood glucose concentration. Treatment for the underlying cause of hypoglycemia Home Care and Prevention Administer as directed any medications prescribed by your veterinarian. Observe your dog’s general activity level, appetite and attitude. If you have reason to suspect hypoglycemia, you should rub Karo® syrup on your dog’s gums and call your veterinarian immediately. Schedule an appointment with your veterinarian to identify, treat, and monitor the underlying cause of hypoglycemia. See your veterinarian for regular check-ups as directly. Provide a warm environment, frequent feedings, routine vaccinations and de-worming procedures for puppies as recommended by your veterinarian. Provide frequent, regular feedings. Young puppies should be fed at least 3 to 4 times a day. Feed a high quality dog food and provide extra feedings or snacks to working dogs. I Will post the liver shunts in a minute. Hopefully. Portosystemic Shunt (Hepatic Shunt) by: Dr. Erika De Papp Next Page (Information In-depth) Section: Overview A portosystemic shunt is an abnormal communication between blood vessels, which causes blood to bypass the liver. The portal vein is a major vessel in the body which enters the liver and allows toxic components of the blood to be detoxified by the liver. When a shunt is present, the portal vein, or one of its related veins, is inappropriately connected to another vein which creates blood flow around the liver. The most common type of shunt is a single congenital shunt. This means that the animal is born with the problem. Acquired shunts may occur secondary to liver disease. Congenital shunts occur in both dogs and cats. Most animals start showing signs by six months of age. However, shunts have been diagnosed in adults as old as 10 years. Shunts are more common in purebred dogs than mixed breeds. The breeds predisposed to congenital shunts include: miniature schnauzer, Yorkshire terrier, Irish wolfhound, cairn terrier, Maltese, Australian cattle dog, golden retriever, Labrador retriever, and Old English sheepdog. It occurs more often in female dogs, and of the affected males, there is also an increased incidence of cryptorchidism, in which one or both testicles remain undescended. The impact of a portosystemic shunt on your pet can present itself in a variety of ways. The most common clinical signs are a result of elevated toxin levels in the blood secondary to failure of removal by the liver. One of the important toxins is ammonia, which causes abnormalities of the central nervous system. What to Watch For Lack of appetite Lethargy Weakness Disorientation Stumbling Circling or pacing Apparent staring into the corner Pressing of the head against objects Seizures Blindness Behavioral changes Excess salivation (more common in cats) Vomiting Diarrhea Increased thirst and frequent urination (more likely in dogs) Straining to urinate Blood in the urine Failure to grow and thrive Weight loss Diagnosis History and physical exam Complete blood count (CBC) Biochemical profile Urinalysis Bile acids Blood ammonia level Clotting tests Abdominal radiographs (x-rays) Abdominal ultrasound Portography (special dye study) Transcolonic scintigraphy to monitor the pattern of blood flow Abdominal exploratory surgery Treatment Surgical ligation (closure) of the shunt is the treatment of choice. However, animals must be medically stabilized prior to surgery. IV fluid therapy restores hydration deficits and corrects electrolyte imbalances. Lactulose decreases absorption of intestinal toxins such as ammonia by altering intestinal pH. Antibiotics alter intestinal bacteria such that ammonia production is decreased. Feeding a protein restricted diet since protein in the diet can precipitate neurologic abnormalities. In animals with vomiting and diarrhea, gastric protectants help reduce acidity of the gastrointestinal tract and may alleviate some of the symptoms. Anti-convulsant drugs may be necessary in animals with seizures that are not responsive to the aforementioned medical treatments. Home Care and Prevention Give all medications as prescribed by your veterinarian. Feed only the prescribed diet. Monitor your pet for recurrence or worsening of the original clinical signs that alerted you to a problem. As this is a congenital disorder, there are no known preventative measures for your individual pet. However, any cat or dog with a shunt should never be used for breeding purposes. I got this information from Petplace.com it looks like they have a whole medical library. __________________ Yorkease

03-06-2005, 09:49 AM	#6
Yorkease YT Addict Join Date: Mar 2005 Location: Sardis TN Posts: 358	I am SO SO SORRY for such a very long post. I just felt it was important to get as much of the info I could for you. Maybe you can print it out and read through it better that way. Again, I AM SO SORRY! __________________ Yorkease

03-04-2005, 04:25 PM	#3
orinskye YT 2000 Club Member Join Date: Nov 2004 Location: California Posts: 2,990	i know a bile acid test will tell you for sure

03-06-2005, 10:25 AM	#7
Austin's Mama Yorkie Yakker Join Date: Dec 2004 Location: Crosby, Texas Posts: 26	Thank You! Thank You! Please dont apologize! The information was so helpful, THANK YOU! We have an appointment with the vet on the 14th for a complete blood testing, etc. Thank you again for being so helpful. It scary to think what these lil guys can go through, but thank God for technology! I know most of it can be cured or treated. __________________ Tara and Austin Tacious

03-06-2005, 12:11 PM	#8
fasteddie *YT 6000 Club Member* Join Date: Nov 2003 Location: Seattle, WA Posts: 6,238	Yorkease: Don't worry about long posts, yours was full of great info! I'm sure the servers can handle it!

03-06-2005, 12:50 PM	#9
Bella YorkieTalk Newbie! Join Date: May 2004 Posts: 4	to be sure, get a bile acid assay test. i experienced the exact episode as u when my 2 yr old bella was only about 3 months old. they checked her for hypo and said that was not it. they said her blood sugar was fine. not sure if i believed them since i was almost sure it was hypo. that day bella ate next to nothing. just wanted to rest. she was only 1.75lbs so i thought if she just ate a few pellets throughout day she would be ok. since that day she has been fine although when i did get her bile acid assay test, it came back poiting toward a poosible shunt or liver disease. i immediately put her on a high carb, low protein diet, LD is the name of the food. besides that, i cut out all treats. every morning and night she gets steamed brown rice mixed w/ sweet potatoes and green beans w/ alittle corn oil. throughout day she picks on dry food. i was supposed to get her checked again since she's been on this diet for about 1 year. she acts fine, looks fine, eats good, weighs 5lbs. i think i'll get a bile acid test again but not sure what to do if it comes back the same or worse. if she does have a shunt and i want to get her operated on, i have to accept the risk of a small dog w/ a shunt possibly not waking up from anesthesia. i was told that it's possible for a dog w/ a shunt to not wake up... don't know what to do. 1 lesson i learned is that if i ever buy another dog, especially a yorkie, i will get him/her checked while there is still a health gaurantee and before i get attatched. even so, i was attatched to this dog immediately. my wife wanted to give the dog back when this episode happened and i said no way. we both love the dog as if it was a child and don't know what to do. i'm sure u are in same situation as me.

03-06-2005, 12:58 PM	#10
schatzie *Moderator Emeritus* Join Date: Sep 2004 Location: Tontitown Arkansas Posts: 4,909	Yorkease - thank you so much for sending all this info. I have pasted/copied and placed it in my health file for future reference. __________________ ~~~~ Schatzie and Ransom ~~~~

03-06-2005, 08:07 PM	#11
littlelizzy Senior Yorkie Talker Join Date: Feb 2005 Location: Warren Texas Posts: 139	I was in the process of posting a new thread to ask what a liver shunt was, but decided to do a "search" first, glad I did. Thank you so much for taking the time to post such great info. For the first time I think I finally understand the difference in the two conditions. Thanks again, __________________ Kim and Mia http://dogster.com/?359747

03-07-2005, 09:37 AM	#12
Austin's Mama Yorkie Yakker Join Date: Dec 2004 Location: Crosby, Texas Posts: 26	I don't know if I am in denial or what, but after reading all that great info on shunts, I do not think Austin has it or not! He shivers and cries at night about 2-3 times a week, but other than that he doesn't have any other symptoms. He eats great, is EXTREMELY playful (except during "episodes"), and weighs just over 5 pounds (He eats regularly). I guess I am just gonna have to be patient and wait until next week for the tests! __________________ Tara and Austin Tacious

03-07-2005, 10:02 AM	#13
Yorkease YT Addict Join Date: Mar 2005 Location: Sardis TN Posts: 358	Austin's Mama I glad you found the info helpful. I pray everything turns out Ok for your little baby. I too am the cautious person who has little patience when it comes to wanting to know something like this (I hit the internet and research AFTER CALLING MY VET). My husband & I are probably my vet's worst nightmare because we always call him for the least little things. He met us at his office one Sunday morning when one of my yorkies had a strong episode with Hypoglycemia, she's fine now. We set up one night and set the alarm clock for every two hours to give her Nutri-Cal or just keep an eye on her because at night was when she seemed to get worse so we kept a very close eye on her that night. I am also happy that everyone didn't mind such a long post. I am hoping everything turns out fine. Please keep us posted. __________________ Yorkease