Possible Liver Shunt

[jacage]

I have a 5 month old aussie bulldog who has just been diagnosed with a possible liver shunt after suffering a seizure following a bad turn last sunday. He became very disorientated, his jaw clamped shut and he couldnt breathe and was very distressed. Hes also quite small for his age. My vet has put him on metrogyl and clavinox as well as the hills prescription diet l/d. He seems to be responding quite well so far. Im pretty sure the vet wants to do an u/s next to confirm but has also told me that there isnt a vet capable of this surgery in canberra. Can anyone tell mr what the cost is for this surgery?

[persephone]

That sounds awful . I am sorry your pup is so ill .

I can't help you with vets in Canberra ..

You may get some extra info here on the forum .. like these threads

LINK

LINK

[Guest hankodie]

Hi Jacage. So sorry to hear about your little bulldog how awful for him. I'm so glad he is doing a little better on the new diet and meds.

My french bulldog was diagnosed with liver shunts, her type are inoperable though and we are currently managing her condition through diet and meds.

The best way to diagnose a liver shunt is to get him an MRI or scintigraphy as ultrasounds can sometimes be inaccurate and you can't always see the shunt. I would get a referral for a specialist in Sydney. Sydney Uni is probably the best place if he needs surgery followed by SASH but consult with your vet about the surgery options.

I'm afraid the cost of the surgery isn't cheap, I can't remember the exact price as we never got that far with Odie but if I recall correctly is well over the $3000 mark. Do you have pet insurance?

If he does have a shunt and it is operable then I would highly recommend doing the surgery as it's got a great success rate and the dog lives a relatively normal life afterwards.

That's great that he's on l/d as well as meds. Make sure you feed him smaller meals throughout the day if you can, also you need to watch his poo - it needs to be a soft consistency (like soft serve ice cream - bleurgh!) to ensure that everything is moving through his system fast. If his stools are firm then you can add lactulose (it's called actilax at the chemist) or yogurt to soften them (be careful with the lactulose - it is a natural laxative so only add a very small amount and wait until you get the right consistency in poo)

Also don't feed him any treats that are high in protein, this rules out any meat treats as they could send him into a seizure.

If you have any questions feel free to PM me, there's also another member on here JulesP who's dog also has liver shunts, she might be able to add some more info :)

[jacage]

Hi Jacage. So sorry to hear about your little bulldog how awful for him. I'm so glad he is doing a little better on the new diet and meds.

My french bulldog was diagnosed with liver shunts, her type are inoperable though and we are currently managing her condition through diet and meds.

The best way to diagnose a liver shunt is to get him an MRI or scintigraphy as ultrasounds can sometimes be inaccurate and you can't always see the shunt. I would get a referral for a specialist in Sydney. Sydney Uni is probably the best place if he needs surgery followed by SASH but consult with your vet about the surgery options.

I'm afraid the cost of the surgery isn't cheap, I can't remember the exact price as we never got that far with Odie but if I recall correctly is well over the $3000 mark. Do you have pet insurance?

If he does have a shunt and it is operable then I would highly recommend doing the surgery as it's got a great success rate and the dog lives a relatively normal life afterwards.

That's great that he's on l/d as well as meds. Make sure you feed him smaller meals throughout the day if you can, also you need to watch his poo - it needs to be a soft consistency (like soft serve ice cream - bleurgh!) to ensure that everything is moving through his system fast. If his stools are firm then you can add lactulose (it's called actilax at the chemist) or yogurt to soften them (be careful with the lactulose - it is a natural laxative so only add a very small amount and wait until you get the right consistency in poo)

Also don't feed him any treats that are high in protein, this rules out any meat treats as they could send him into a seizure.

If you have any questions feel free to PM me, there's also another member on here JulesP who's dog also has liver shunts, she might be able to add some more info :)

[jacage]

Just today I have been put in contact with a Vet in Canberra that has done this type of surgery before with a good success rate. His name is Dr Jacob Michelsen and he is from Sydney but currently helping out at the Gungahlin Vets. We have an appointment with him on Thursday morning.

Hugo is currently on 5mls of lactulose morning and night as well as Metrogyl and Noroclav 1/2 tablets twice daily. He's been quite good up until today when he seems a bit off and clumsy. not sure if it is just the heat affecting him or something more.

I am currently giving Hugo 4 meals a day. In the morning and night he gets 1/2 up dried food with about 1/4 can of L/D. The other two meals are just 1/4 - 1/2 cup of Dry L/D. Does this sound like enough or too much for a 5 month old? He is always looking for other food as soon as he is finished. The vet wants him on just the L/D but is there any treats that he can have that would be ok for him?

I hadn't gotten around to taking out pet insurance when he had his bad turn. Kept meaning to but never thought it really mattered as he seemed so good. I know the surgery is expensive but if he can have it he will. I'll do everything to fix him.

He had a seizure just over a week ago which is when we found out about the shunt. I really don't want to see him have to go through that again.

[Guest hankodie]

Hi jacage, sounds like you are managing him very well :)another thing that might be beneficial to him is a liver support supplement like Denosyl or Denemarin.

In regards to treats - absolutely no meat treats if he is having seizures. You can give him bits of veggies like carrots (stay away from sweet potato though as it has a high manganese content) or fruit like apple. Tiny bits of cheese are OK. Yogurt drops (in moderation) are ok too. I buy my Frenchie treats called fruitables which are admittedly very expensive but safe for her to eat.

You can add extra veggies and carbs like rice to his l/d if he still seems hungry. But don't add any more meat protein to his meals .

If he is acting clumsy it could be a pre indication of seizure so I would watch him closely. Again, make sure you are watching his poo - it needs to be a soft serve consistency, soft enough that it's hard to pick up but still formed (as in not diarrhea).

Keeping his stools soft is important as you are trying to move the toxins out of his body quickly (not a vet so I hope that's the right way to describe it).

Again PM me if you have any questions :) hope Hugo feels better soon.

[jacage]

We had our appointment with the specialist vet today and he wanted to do the surgery today. They did an ultrasound first and found that Hugo has a extrahepatic shunt but a very big one, he also has a very small liver. They are currently doing the surgery now. I have been told that he due to the size of the shunt he may not respond as well and it may take him longer to recover. Am waiting on further news from the vet.

[perfect partners]

We had our appointment with the specialist vet today and he wanted to do the surgery today. They did an ultrasound first and found that Hugo has a extrahepatic shunt but a very big one, he also has a very small liver. They are currently doing the surgery now. I have been told that he due to the size of the shunt he may not respond as well and it may take him longer to recover. Am waiting on further news from the vet.

It's horrible waiting for news. I hope it's good news and that Hugo makes a speedy recovery.

[jacage]

Hugo's surgery didn't go well. They thought he only had a large extrahepatic shunt but when they opened him up they found several other intrahepatic shunts as well as his liver only being 1/5th of the size it should be. His main vein also doesn't connect with his liver. I have two choices I can put him to sleep now or I can take him home and keep him on medication and diet and he may live for another six months.

[JulesP]

Very sorry. I haven't replied before because to be honest I find it quite painful.

My dog was diagnosed at 11 months with multiple shunts. Not operable. She also had seisures. Amber was given 6 months to live and that was 2 years ago.

It isn't easy to look after her. She has several medications and the l/d food. It is a daily case of monitoring her and adjusting meds and food. I can't board her as I don't trust anyone else to look after her.

She is worth all the above but I wanted you to know what you will be facing if you take him home.

She doesn't know she is sick and is super happy. She has great quality of life.

All the meds and food does get expensive.

At the end of the day it is your choice and I doubt anyone will judge you either way.

[jacage]

JulesP thank you so much for your reply. I am so unsure of what to do right now. In the past week you wouldn't really know that Hugo was so sick. He seemed to respond so well to the diet change and meds. He is only 5 months old but brought so much happiness to me that I can't bear the thought of not having him around. If I don't bring him home I feel like I am giving up on him but I also don't want him to suffer. He is my everything.

Did Amber only have the shunts? or did she have problems with her liver as well?

The fact that he only has 1/5th of his liver? will this affect his quality of life?

[JulesP]

Amber's liver is tiny too.

Amber doesn't suffer at all. She is a super happy little dog. I am making sure that she has a good time even if I can't give her a long time.

I can't give her any meat protein. No bones. This is very important especially if they have had the seizures.

The other thing is that you need to reduce worming, vaccinations, flea treatments. You don't want to be giving the liver too much work to do.

There is also the issue if something else goes wrong how you treat them.

Is he getting fluid build up in his tummy? This is probably the thing I struggle with the most with Amber, keeping that under control.

Bring him home and love him whilst he is here :)

This is Amber at the beach a couple of weeks ago. Just to show you that she is ok.

[persephone]

What a horrible outcome .

I don't envy the decisions you need to make now - and will only remind you that you decide for the pup .. NOT for how you might feel . Weigh up what each decision will mean for you .. and for your boy .... will you wanting to keep him with you be what is the best and most comfortable for him? Will you then try and prolong his life ?

Will painlessly giving him his wings hurt you ? Hell, yes! Will you miss him? Every day .

Hugo is very lucky . he cannot worry about any of this ..he is sore and feels sick - but cannot imagine what may happen - so don't feel guilty, or that you're 'letting him down'- he doesn't think so :) he knows you love him - that's all.

Thinking of you all ....

[JulesP]

If you get their food and medication right they don't feel terribly sore or sick. That is why I put the pic of Amber up.

I asked the vet the other week if he thought I should put her down and the answer was a very strong 'no'.

I don't do this for me. I do it for Amber, because she wants to be here. When she doesn't want to be around anymore, then I will let her go.

[persephone]

jules - yes, you and Amber have done a terrific job :) That is a fantastic photo, too!

[jacage]

Jules. How did you find out exactly what sort of shunt amber had? What yest did they do? I'm worried that because they have opened up hugo that it may impact his outcome? I cant make any decision yet until I see him tomorrow and talk more with the vet when I have a clear head.

[JulesP]

Amber was diagnosed via ultrasound. This was the least invasive way. I was lucky in that the specialist could see the shunts on the ultrasound. Sometimes they can't.

The danger for Hugo would have been the general. He has obviously come out of that ok? Dogs with liver problems can also have problems with bleeding.

[Guest hankodie]

Oh Jacage, so sorry to hear about Hugo I agree with absolutely everything JulesP has said. You will know what's best for your dog and nobody will judge you either way.

We don't quite know exactly what type of shunts Odie has, we only had a liver biopsy that showed macro scoping liver shunting with moderate portal fibrosis, which the vet says is not a good prognosis at all. In January she will be 2. The vet told us we'd be lucky if she made it a year. I don't know how long she's going to be around but we are just trying to give her the best life possible regardless.

Like Jules' dog, Odie lives a relatively normal and happy life too. As I type this I can see her doing crazy zoomies in the yard with her brother. She loves life. Sometimes she does get sick - bouts of diarrhoea, vomiting spells, sometimes just feeling under the weather but she always manages to bounce back. I have been very lucky in that there have been no bad episodes of hepatic encephalopathy or seizures - yet. I'm always prepared and I feed her a protein restricted diet.

The diet and meds are time consuming and often exhausting. My husband and I have also put off our plans for going away and moving out of the country because we would not be able to take her with us and I would never leave her behind. I am at the vet's office all of the time. It won't be easy either way but I know you will choose what's best for Hugo and like Jules said nobody will ever judge you either way. It's awful and heartbreaking.

Please keep us updated jacage - you are in my thoughts.

[persephone]

Jacage - thinking of you today ....

[Xyz]

Thinking of you Jacage. All the best for today.