Liver Shunt Advice Please - LONG (Sorry!!)
 

This is long. Sorry!

One of my babies has been having a strange concoction of symptoms: vomiting every 3-4 days, frequent urination, excessive thirst, crystals in his bladder. So far he's shown no neuro symptoms. He's ~2 1/2 yo. and we've always had trouble keeping his weight up. He eats nearly the same amount as our 15 lb yorkie who we have to carefully monitor his weight.

6 mo ago after a particularly bad bladder infection our vet raised the possibility of a liver shunt. He's been doing fairly well since then so we did not pursue further diagnostics at the time. However, about a month ago he started vomiting every 3-4 days, and I decided to take him to the vet to see what was going on. His liver enzymes came back elevated, but not excessively so. The vet hoped we were just dealing with some hepatitis and possibly a systemic infection which was stressing his liver. We did 2 weeks of anti-biotics and began daily Denamarin. He has shown some signs of improvement since then - the vomiting is less frequent and his personality has perked up some.

This week he has been waking us up to go out at least 4-5 times a night. I'm 6 mo pregnant and he's up more than me! So, I took him in this morning to check for a bladder infection and repeat his liver panel. They found crystals in his urine and a tiny bit of blood and his liver enzyme levels are significantly elevated - more so than a month ago. Today he was way off the charts. So obviously we still have a larger problem at work here and the vet is more convinced we are likely looking at a shunt than she was before. He is not presenting in the traditional clinical sense, but we're starting to amass unexplained symptoms that can be tied to a shunt.

We are now on another 2 week round of anti-biotics to clear out whatever infection might be going on in the bladder. We are continuing the Denamarin daily and adding Lactolase 2x/day. Additionally, we're now beginning to transition him to a low protein diet (Purina NF).

We will retest his liver enzymes in 2-3 weeks and discuss how to proceed based on the results.

I'm just wondering what others experience with this condition has been. What diagnostics/treatment did you pursue? How did your pet respond? If you did surgery how has your pet fared since then? What questions should I be asking? I'm feeling a little overwhelmed so any advice you have would be wonderful!

We live in N. AL so both University of Tennessee - Knoxville and Auburn University are fairly reasonable driving distance for us.

The Nation's premier "Grande Dame" in liver shunts and liver shunt research and liver shunt surgery is Dr.Karen Tobias, DVM, University of Tennesee! I am thrilled you say you have reasonable access to the University of Tn! THAT is wonderful news for you, especially if your baby does have a shunt! I would advise you to contact her, and go from there. You will be getting the very best advise from the most educated person in this disease, in this country! Good luck to you with this.....you will have all kinds of advise, suggestions, etc....you stick with the professionals and the advise and suggestions you get from them, and you will be less confused and fraught with feelings of confusion and dispair.