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Discussion Starter #1
LIVER SHUNT DISEASE

Maltese are prone to liver shunts.

Don't ever buy a puppy from a breeder who doesn't provide you with a copy of the puppy's bile acid test results.

Testing should be done between 9 and 12 weeks. There should be 2 results, one after a 12 hour fasting period and one taken 2 hours after eating.

The readings should be below 25.

Beware of breeders who tell you that their puppies are healthy and that they don't have liver shunts in their line. There is no way to tell without performing this simple test.

For more information about liver shunts, click here:

http://www.bhejei.com/health-pss.htm
 

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Originally posted by doctorcathy@Nov 9 2004, 02:27 PM
Can they do a liver shunt test on dogs that are 3 and 2 yrs old?
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I believe my vet told me you can test this anytime. I don't see why not.

I don't know if that article says this, but this is one reason not to get a "tea cup" maltese. They are prone to liver shunts. When my vet did an examination for Noriko, he was telling me his worries for her and went into details about liver shunts.
 

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Your vet can do a liver function test at any age with a simple blood test. Lady has to get them several times a year because she takes phenobarbital for seizures which can damage the liver.

The purpose for getting a puppy tested BEFORE you buy it is to avoid choosing one with a liver shunt. Since Maltese and Yorkies (Noriko is a Yorkie, right?) are prone to liver shunts, it is very important to rule that out.
 

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Discussion Starter #6
Lady gets her liver function checked and it's pretty cheap, under $50, I think, for the whole blood panel and vets are expensive here in Raleigh. This what she gets done:

http://www.bichonfriseusa.com/caninebloodwork.htm

She was speciafically tested for a liver shunt when she first started having seizures since that is one of the symptoms. It was right after I adopted her 4&1/2 years ago and I can't remember the cost. They also checked her thyroid function and I don't think my whole bill was over $100.

I have recently heard about urine bile acid testing on the canine epilepsy website. That might be something to look into, also, although the test is geared to assess liver damage from phenobarbital.

http://www.canine-epilepsy-guardian-angels...cid_testing.htm

If your vet is worried about Noriko, has he suggested getting one done?

I didn't realize Noriko was a Maltese also. I'd love to see a picture!
 

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The diagnosis for a liver shunt is done with a sonogram using a radioactive infusion to track the blood flow to the liver.

The bile acid test determines that SOMETHING is wrong with the liver but further testing is required for actual diagnosis. Bile acids can be high as a result of tumor or MVD (microvascular dysplasia) of the liver as well as a shunt.

A shunt is correctible with surgery. MVD may require special diet and supplements if serious enough. Tumor may require surgery as well.

Pico has MVD so we have been through all of these procedures. MVD is diagnosed with a biopsy. In Pico's case, since tumor and shunt were ruled out with the other tests, we just assumed MVD rather than go to the invasion and expense of the biopsy. I just didn't want to put Pico through any more procedures and my vet, the imaging vet and I all agreed on this.
 

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Discussion Starter #8
Thanks for clarifying that, Pico's mom. So the basic liver function test, like Lady has that is pretty inexpensive, would alert the vet to a possible shunt, then further testing could be done?

Have you ever used the supplement Milk Thistle? My sister manages a vet office and she mentioned it to me years ago when Lady started on her seizure meds. I did a little research and checked with my vet who gave me permission to try it. As I said, Lady just had her "liver check" a few weeks ago and it was right at 25, perfect. She's been on Pheno (and a dose higher than we'd like) for close to 5 years now.

I have used it as a preventative, but I have heard it really is recommended in cases where liver disease has already been diagnosed.

SamE is also supposed to be helpful.

I'm so sorry your Pico has liver disease. It's much too common in our Maltese.
 

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Just like Pico... I too have been through all of these tests with Kodie! Kodie also has MVD. I took him to many specialists and finally a university to see a liver specialist (the best on the east coast I was told). Kodie is a "tea cup" size Maltese... I dont usually call him that though..haha.. He's only 3.3lbs, full grown. He was never tested for any liver function before I got him either. I didnt know any of these things were a concern until I went to neuter Kodie and his blood test came back with high liver counts. He does not have any major signs of MVD.. but he does have some physcial symptoms... such as very tiny bone structure.. light weight (does not really gain any weight), He is not a very good eater either... but some Vets tell me thats not a sign... so who knows.. I could go into great detail about how stressful the last 6 months have been for Kodie and I... with all these tests and doctors.. but i'm not, instead i'm going to say that I learned a lesson to always ask for blood work before buying a puppy. That way you could at least know what your dealing with. I had no idea what was going on at first and all the local vets told me it could be a shunt. I also wasted a LOT of money and time taking Kodie around to every type of doctor for opinions and tests.. (not that I mind spending money on Kodie... cause I dont! heck.. I drove 5 hrs away from my house with him just to go to the best university and have him seen by the best liver specialist there! Plus he was neutered at a special 24hr care hosiptal that doesnt even do routin procedures. It was very very expensive.) If anyone wants to know all the tests I had done with Kodie or prices let me know... I have a lot of info on this subject (as you can image!) I even know where and where not to take your dog for testing.
 

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Originally posted by LadysMom@Nov 10 2004, 10:24 AM
The bile acid test determines that SOMETHING is wrong with the liver but further testing is required for actual diagnosis. Bile acids can be high as a result of tumor or MVD (microvascular dysplasia) of the liver as well as a shunt.

If your vet is worried about Noriko, has he suggested getting one done?

I didn't realize Noriko was a Maltese also. I'd love to see a picture!
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Hey Lady'smom! Her picture's in the gallery. He gave me the option but he didn't recommend me doing it. He was being very thorough with everything. She just looked so fragile to him.


I do remember my vet saying that test will show that something is wrong but it doesnt give the diagnosis that it's a liver shunt. It's coming back to me now
. He told me if she sleeps alot, not active, and lethargic then to do the test. She's very active so I figure it's ok.
 

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Kodie--Did you take your baby to UTK? I could have sworn my doctor said that UTK was the best. But that was the begining of this yr. I just dont have good memory
.
 

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Originally posted by ButterCloudandNoriko@Nov 10 2004, 01:50 PM
Kodie--Did you take your baby to UTK?  I could have sworn my doctor said that UTK was the best.  But that was the begining of this yr.  I just dont have good memory
.
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No, I took Kodie to Cornell... and in NJ a specialist hospital called Garden State
Where is UTK
 

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Originally posted by Kodie+Nov 10 2004, 05:18 PM-->
<!--QuoteBegin-ButterCloudandNoriko
@Nov 10 2004, 01:50 PM
Kodie--Did you take your baby to UTK?  I could have sworn my doctor said that UTK was the best.  But that was the begining of this yr.  I just dont have good memory
.
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No, I took Kodie to Cornell... and in NJ a specialist hospital called Garden State
Where is UTK
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Garden State Vet is the best at critical care. We are really lucky to have two very top facilities in Monmouth County...Garden State, and also Red Bank Vet hospital. RBVH is building a brand new state of the art facility. That's where our pup will be going. Garden State is more of a speciality facility, and I believe that the two hospitals work together.
 

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Originally posted by saltymalty@Nov 10 2004, 06:19 PM
Garden State Vet is the best at critical care.  We are really lucky to have two very top facilities in Monmouth County...Garden State, and also Red Bank Vet hospital.  RBVH is building a brand new state of the art facility.  That's where our pup will be going.  Garden State is more of a speciality facility, and I believe that the two hospitals work together.
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Well.... That is a true about Garden State.. but I did go to Red Bank first and I was very disappointed there. My older dog went there for surgery and they found his cancer for us... but with Kodie and his liver problems... horrible. The internal medicine doc was badd... all they kept saying to me was.. "we are going to have to cut Kodie open and take a biopsy" and when I asked questions she acted like it was no big deal! It was called exploratory surgery! IT WAS A BIG DEAL...and very serious surgery for a 3lb dog. The internal medicine doc also told me all this in the waiting room! I was so upset about what she was telling me and she wasnt very informative. She did an ultrasound before she told me about surgery. So I asked her about the ultrasound and she was sooooo unspecific (is that even a word?? haha) it wasnt even funny!!! Shes like i didnt see anything. HEllo! I just paid you over $100 for that ultrasound and you could at least tell me more than that!!!! Kodie also saw a general doctor there at Red Bank.. and she was nice but something just wasnt right there. I called numberous times for kodie's blood work to be faxed to me and left messages for his doctor... and no response!! It got ugly! I had my Father call there and demand to have Kodie's records after I couldnt get any answers from these doctors. I look young... but i'm really 24yrs old.. so my parents think that they just walked all over me... and honestly.. maybe you think i am being paranoid but when I went other places with Kodie they treated me so much better... and actually gave me respect! After I went to Red Bank I took all his results and went for a second opinion at Garden State. Their internal medicine doc was wonderful... (both of their internal medicine specialist were great!) They explained everything and even said to me that I have other opinions before resorting to surgery for this little dog. They refered me to Cornell university... thats in up state NY. I did research and they had the best liver specialist on the east coast. Dr. Center. Anyway... I'm still waiting for the surgan at Red Bank to call me back...hahahahaha... and its been like 6 months and Kodie is already neutered and diagnoised with MVD, NOT A SHUNT(without SURGERY!)! All I have to say is... Garden State was wonderful. They made an exception for Kodie to be neutered there and have his teeth pulled. They are even going to let me get Kodies teeth cleaned with when the time comes. Basically they will do any surgery type precedures for me because hes so tiny. It was more money than you would usually spend for that but well worth it... I only felt confortable there... not at Red Bank after they showed that they really didnt care and werent very helpful. Bottom line is... I was very disappointed about how they handled me when I kept questioning his exploratory surgery they kept pressuring me about. I even asked them about other options instead of surgery and they acted like nah.. dont waste your time... surgery is the only way. I could understand if Kodie was really sick.. but he wasnt.. he had no clincal signs of a shunt. Sorry i'm rambling on here... This is a very baddd subject with me. I really did go through soo much with my poor Kodie... I was so worried and very unhappy with what was going on. -_-
Well... i just hope your experience is a positive one at Red Bank.. let me know how everything goes!
 

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Originally posted by Kodie@Nov 10 2004, 10:05 PM
I look young... but i'm really 24yrs old.. so my parents think that they just walked all over me<div align="right">index.php?act=findpost&pid=15941
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I feel you on that! I'm 24 and depending on my makeup and what I wear, I can look 16. And my VOICE! sheesh! I totally sound like a kid. I hate when ppl TRY to walk all over me.
 
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