Liver Shunt (or related) Survivors? (Yorkie and others)

Question:
I have a question.
How many of you guys have had your pets (Yorkie or not) diagnosed w/ Liver Shunt (or another similar Liver related disease).
And if so, I want to generally know:
1) What costs to expect.
2) The recovery period. How difficult? How much care is needed?
3) Life upon full recovery. How is their personality (back to normal?)? Any precautions that now need to be taken that you didn't before?
I see information on the diagnosis of liver shunt, but NOTHING from an owner's standpoint about recovery.
Thanks.
Dom

Answer:
My yorkie, Miko has a an intrahepatic liver shunt and therefore is inoperable...That's okay though because his diet and medications allow him to live a completely normal life. We give him one pill of denosyl (a liver supplement) per day, lactulose everyday, and he eats Royal Canin Veterinary Hepatic LS 14. It is a low protein diet in which all the protein comes from vegetables/soy... He is very energetic, looks very healthy, and is extremely happy and sweet :)
Miko had ultrasounds and exploratory surgery where they found that he had an intrapatic shunt...The surgery can run anywhere from $1500-$2500 sometimes less, sometimes more...It all depends on where you live and how things are priced there. I have heard that for extrahepatic shunts, the surgery where they place an ameroid constrictor around the shunt is best.
Miko's personality is wonderful, he's the same sweet, playful yorkie!
As far as precautions, you have to make sure the dog doesn't eat anything she/he's not supposed to...He/she shouldn't have protein (other than what's in the food that the vets recommend/prescribe)...Make sure everyone knows not to give the doggie table scraps or anything like that.

Answer:
Kobe had kidney stones at age 4 and was told he has liver problems. They suggested we control it with diet since it was not severe. He is now 7 and has not had a problem since. He still acts as wild as a puppy. Very playful and energetic.

Answer:
Cali was just diagnosed with the internal liver shunt. Since she was having exploratory surgery and stomach biopsies and spayed during heat by a board certified surgeon it cost me 2700.00. prior to that for various tests about 1,000.00. If she would have had the external shunt it would have been another 2,000.00. Cali has a mild case and no further treatment is necessary but I am going to watch her protein intake. She was fine after all of the surgery just tired.

Answer:
max was diagnosed with a liver shunt when he was 4 months old (he is now over a year old). his was an extrahepatic shunt that was operable. the surgery cost ~$1200, plus he is on a prescription food (hills KD) and takes lactulose everyday. you would never know anything was wrong with him....he acts like a happy normal dog!! let me know if i can answer any other questions!!

Answer:
You guys...your responses bring hope for my Mimi...thank you.
So what is the difference between a intrahepatic versus extrahepatic shunt? I would assume one is outside of the liver, while the one is inside?...but I would rather get answers from you guys.
Given that...what tests can help determine what type of shunt (whether intrahepatic or extrahepatic) she has? And how much will this test cost?
I've been given a referral to a vet imaging lab...but want to know what costs to expect.
Thanks guys.
Dom

Answer:
you got it right - intra is inside the liver and extra is outside the liver. the ones outside are easier to operate on. from what i understand the ones inside the liver you can't operate on (please correct me if i'm wrong).
max was having seizures, which is a sign of LS, and all of his liver enzymes and bile acids were very elevated, which are also signs of LS. my surgeon left it up to us to decide if we wanted further testing to determine if it truly was LS. we opted to go straight for the surgery since the sugeon was almost positive this is what it was.
i guess it just depends on the circumstances as to whether you decide to have further testing or not.
has your dog been diagnosed with LS?

Answer:
We first decided to get Miko tested when he was urinating blood and the vet told us that it wasn't a UTI...I had read that might be a symptom of LS, so we made an appt. to have him bile acid tested...The weekend before his appt. he had a bad seizure and we rushed him to the vet. They ran bloodwork and tests and later they did a bile acid test and found that he very likely had LS...We went to another vet that was very highly recommended and he did an ultrasound, but he couldn't pinpoint ONE shunt,so he said he could do further testing or go in for exploratory surgery...Miko's bile acid tests and liver enymes came back very high, so we opted for the surgery also. Like I said before, his liver shunt is intrahepatic and inoperable, so he was put on medicine and special diet.
You can have your vet do an ultrasound to see if he can find the shunt that way...
The following link will give you info on how to diagnose liver shunt, ie. radiography, ultrasound, etc.

This next link gives you a wealth of information on liver shunts...All this information is very important for you to know if your baby has a liver shunt.


Answer:
I have a question.
How many of you guys have had your pets (Yorkie or not) diagnosed w/ Liver Shunt (or another similar Liver related disease).
And if so, I want to generally know:
1) What costs to expect.
2) The recovery period. How difficult? How much care is needed?
3) Life upon full recovery. How is their personality (back to normal?)? Any precautions that now need to be taken that you didn't before?
I see information on the diagnosis of liver shunt, but NOTHING from an owner's standpoint about recovery.
Thanks.
Dom
You guys...your responses bring hope for my Mimi...thank you.
So what is the difference between a intrahepatic versus extrahepatic shunt? I would assume one is outside of the liver, while the one is inside?...but I would rather get answers from you guys.
Given that...what tests can help determine what type of shunt (whether intrahepatic or extrahepatic) she has? And how much will this test cost?
I've been given a referral to a vet imaging lab...but want to know what costs to expect.
Thanks guys.
Dom
Hello Dom-
My name is Kara and my LS survivor is Matise. He was born on 8/16/04 and was diagnosed with a Portosystemic (extrahepatic) shunt in October 2005.
1) What costs to expect.
It is a very, very long road. I speak from experience. Our ordeal started when we got Matise in November 2004, but we didn't really know what it was until 1st week in October 2005. It was a $400.00 diagnosis. They do blood work- including a special test called a bile acid serum test and they also do x-rays to see what the liver looks like. They have to be on special food-like a 1.30$ a can and meds-$30 a month or so. Then they have to decide if they want to do exploratory surgery $1500-$2000to see if it is operable ie: extrahepatic vs. intrahepatic- MVD. If it is operable then while they are in there they will place an Ameroid constrictor on the shunt if it is not then they will take a biopsy to see what it is ie: MVD.
For us it went like this:
~Numerous trips to vet for undiagnosed random vomiting--totaling around $1,500
~Matise started to have seizures so we decided to have the bile acid test--$400
~Test came back positive for a liver shunt
~Result: 68 pre meal and 212 post meal
~so he was put on Hills Science Diet Prescription Diet L/D about $1.30 a can
~and special meds Lactulose and Flagyl--~$30 per month-month and a half
~then he went for surgery $1700
~Then he will go for blood work-$150-250 per time 3 times in the next year.
~not to mention he developed acid reflux b/c of the location/size of his shunt and all the meds that he has to take. so that was another $400 of blood work and x-rays and meds-pepcid $25 and 2 other meds.
I say roughly $2500-$4500 We have spent about $4000 so far. And still have more testing to pay for.
2) The recovery period. How difficult?
It is about 2 weeks for the surgery-no jumping etc.
and for full recovery ie: normal or close to normal bile acids-which they may never have normal bile acids after surgery can be anywhere from 6 months to 1 year
How much care is needed? MORE THAN YOU CAN IMAGINE- you have to be so extremely vigilant with their diet and surroundings so they donít get more protein then they are supposed to have. The special diet-meds all are very specific.
3) Life upon full recovery. Can go on to live a normal life. Sometimes they need meds or a special diet it just depends on the diagnosis and how well they respond to treatment.
How is their personality (back to normal?)? better than normal- more active-cheerful
Any precautions that now need to be taken that you didn't before? Diet-
Protein-protein-protein you have to be careful what you feed until you get the all clear from the vet.
intrahepatic=inside of the liver and can also be called MVD and is not operable it is not necessarily a bad diagnosis it is just treated in a different way and these dogs can and do go on to live normal healthy lives
extrahepatic shunt= outside of the liver and usually is operable with great success rates
THIS LIVER SHUNT SURGERY SHOULD ONLY BE PERFORMED BY A BOARD CERTIFIED SURGEON AND BY ONE WHO HAS PERFORMED THIS SURGERY BEFORE WITH SUCCESS.
And how much will this test cost? it depends the bile acid by itself is around $85.00 but when grouped with the other test they need-x-ray, cbc it is around $400.00
The tests to determine Liver Shunts- a bile acid serum test
They can do other types of testing to deternine whether it is intra or extra ie: angiography, ultrasonography, and scintigraphy but they can not always tell you 100% and are very costly
Here is a great website to get research from.

here are several links to postings I have posts/threads about my ordeal-an owners stand point if you would like to read them



My Matise is doing well and is expected to go in for bile acid test in the next couple of weeks, to see how well his body responded to the Ameroid Constrictor surgery. We are hopeful and our wonderful surgeon is very optimistic. He remains on the Science Diet Prescription Diet L/D with absolutely no deviations from it.
good luck to you. Feel free to PM me and I can give you my phone number and we can talk. I have talked with several other YT members about their LS dogs. Talking helps. We can also go into greater depth and more specifics.

Answer:
We were given a total of 3 prescription meds.
1) Amoxicillin - fights bacteria.
2) Lactulose - primary function is to draw water out of the body into the colon/stools. In this case, it is intended to draw the ammonia out of her blood and move it out of the body. I'm assuming the drawback is that she may increase her water intake.
3) Metronidazole - used to fight infections since we are using Lactulose to create more stools...you need Metronidazole to help regulate the amount of bacteria in the intestines.
Now, our next step is the radio imaging test. This is where they inject Mimi w/ a radioactive liquid and look at the results to determine whether the shunt is inside or outside of the liver.
Anyone have ANY idea how much this will cost? Not only that, but is this method an alternative to the ultrasound method? Maybe the ultrasound method is a bit less expensive? I hate to sound thrifty here regarding the wellness of my sweet little girl...but I have to look at the costs, possible alternatives, and more important than anything else,...her comfort of living after any surgery.
Just trying to be as informed as possible. Just because one vet tells us one thing, doesn't mean that it is the only solution out there (radio imaging versys ultrasound).
Thanks for the info guys. I also hope this thread is as informative to others, as it is for me.

Answer:
Just a small update.
Radio imaging will cost $375.

Answer:
This website might help you-it is supported/linked through YTNR


Answer:
I have had two liver shunt yorkies. One during the early 80's and one a few years back.
The first one lived 14 years and never diganosed because no one knew much about it....other than she had periodic seizures...from the amonium buildup and a "small liver" on x ray.
The other one is inoperable and you would never know she had liver shunt. It is about 30 percent. She is fed a low protein food. Her quality of life is good and just going to take care of this girl as long as she is here.
What happens in these dogs is that the liver is shunting blood away from the liver and the blood never is "cleansed" of toxins and they build up causing seizures.
I think it is possible that there are many Yorkies who never show true symptoms of liver shunt maybe until later in life and why it is important to test, and never breed one until it is tested for LS. It is thought to be genetic in origin and it is one of those things.....just the way genes line up when the egg is fertilized. Just happens. The reason I say that is research has told us that you can breed two LS dogs and not have a LS dog. It is supposedly polygenic. All breeds of dogs have their problems and this is one found in Yorkies and other breeds.

Answer:
An update.
Mimi is doing quite well on her meds. She is not in as much pain. Very much happier. More active like her normal self. But it is something I have to administer regularly in order to keep the pain down to minimal levels.
Currently somewhat playing around w/ the medication levels to see exactly how much to give her to keep her regular/steady.
She is much better. Not as "spacey" as she was before. Will run up to us, but not at full speed yet. Will have to test whether she will run next to us like how she did before.
Will follow up shortly w/ the radio imagery results soon.