Possible Liver Shunt

[jacage]

Hugo came home today. The vet assured me that he is not suffering or in pain (apart from his surgery). I feel so bad for putting him through that surgery for nothing! But I guess I can at least say I tried? He gave me the biggest cuddle when I picked him up, so I know bringing him home and continuing his meds and diet is the right thing to do for now. I have to go back to my normal vet tomorrow so we can get his meds right and he can just check him over. Hes been drinking and weeing so much today and his poos have been quite runny. So another thing to discuss with the vet tomorrow. This little boy is quickly sending me broke and I know its going to be expensive for a while yet. Ive noticed today he has had a lot of facial twitches, is this normal?

[Xyz]

Glad he's home and enjoy the cuddling!!!!!

Don't feel bad about the surgery, it got you the answer you needed, and he'll bounce back fairly quickly!

The extra fluid he's loosing are probably just because he would have been on a drip at the vets.

Can't answer about the facial twitches, hopefully your vet will give you some ideas. :)

[persephone]

I bet you are all so pleased to be back together :)

[JulesP]

The twitching might be Hepatic Encephalopathy. Toxins build up (ammonia etc) because the liver can't process them. This can effect the brain. Hopefully the meds and diet will help this.

Runny poos are ok. You want the poos looking like soft serve icecream. You don't want food sitting too long in the gut because of the toxin problem.

[Guest hankodie]

So glad to hear Hugo is home! You must be so relieved.

Like Jules said the twitching can be a sign of HE, your vet can maybe give you some more insight. When the stools sit too long in the gut in can cause the dog to get agitated due to the toxin build up like Jules said. Depending on how firm or loose they are regularly you may need to add lactulose but some liver dogs have soft poos anyway due to their diet (I rarely have to add any lactulose to Odie's meals as her poos tend to be quite soft without it). You want him to do poos regularly as this helps with speeding things up through his system and avoids the risk of a seizure. Odie tends to poo 2-3 times a day.

Did your vet give you anything to help with the seizures?

[jacage]

We went back to the vet yesterday and he has put hugo on 200mg amoxycillin daily as well as 10mls of lactulose daily and just feeding him the l/d diet. Can I ask what kind of meds your dogs are on? Also what are you feeding them? He mentioned that later I might be able to give him some other low protein foods?

[Guest hankodie]

Hope Hugo is recovering OK from his surgery jacage :)

I feed Odie a special homecooked diet that was formulated by a specialist. It's mainly just chicken, veggies and rice as well as supplements. I would strongly advise you to stay on the l/d especially since Hugo has had a history of seizures. Odie has not had any issues with seizures (yet), if her symptoms start to get worse then I will be switching her onto l/d as per my vet's advice.

It's very hard to get the protein levels just right using a home cooked diet, with the l/d you don't have to worry about this. If you do try Hugo on another low protein diet, run it by your vet first and wean him off slowly as any change in food might trigger seizures. I would stay away from any and all food with red meat content, this can trigger seizures. Stick to white meat only - chicken, fish or vegetarian diets (again, consult with your vet)

Odie isn't on any long term medication at the moment. She is sometimes on metronidazole if her tummy issues flare up. I also have her on a daily liver support supplement called denosyl.

I make her homemade treats that are low in protein and vegetarian based. You can try giving hugo bits of apple, potato, sweet potato, natural yogurt, goat's cheese/cottage cheese/ricotta, pasta and egg whites. You can also give him commercial treats but these need to be low in protein (less than 9%) and can't be meat based. I buy Odie fruitables as well as those milk bones. She also gets frozen chicken stock blocks on hot days. You learn to be quite creative with treats, I know it will be hard to resist giving him yummier treats but just remember it's for his own good and his health :) Following a very strict diet protocol is going to be the only way you ensure that you can keep Hugo seizure free and prolong his life.

I also buy nylabones to chew on for Odie's teeth. Deer antlers are also OK - they're safe to give as they have very little protein content and if your dog is a big chewer he'll love them.

Edit: just wanted to add that this is all from my experience as well as my vet's advice - it's different for all dogs who have liver issues, some do better than others in terms of diet and meds. The trick is to adjust things slowly and find the right combination that works for Hugo :)

Edited December 22, 2013 by hankodie

[JulesP]

Amber is on l/d tinned and k/d dry. l/d dry can be a pain to get hold of. She is on metronidazole and 2 diuretics.

You don't need a super low protein diet for dogs with liver shunts, they actually need decent levels of protein. What you need is easily digestible protein. Vegetable protein sources are easier to digest. Dogs with liver conditions are also prone to urinary stones so a low purine diet helps. The other thing to watch is sodium, this needs to very low.

I sometimes feed Amber Pediasure, this is like Ensure for children. Amber also has vego doggy biscuits.

[jacage]

Hugo is currently on 5mls of lactulose 2 times a day. His poos are soft but not anywhere near soft serve consistency. Should I be upping the lactulose? Since changing his meds to the long term antibiotic he's become very boisterous, very cuddly and his facial twitches have almost stopped. :) I feed him 4 times a day of half cup of l/d dry food and with his morning and night meal I mix in 1/4 can of I/D but he still seems hungry? Hes just gone 11 kilos, is this enough food for him?

[JulesP]

That is a fair amount of food for a little dog. Amber gets a cup of dry and half a tin of wet. So I would say plenty for your dog. Aren't those dogs little greedy guts anyway? :)

If he is improving I would leave everything as it is.

You might want to speak to your vet about changing to metronidazole for the antibiotic as it works out heaps cheaper.

[jacage]

Hi Jules. Yes bulldogs are hoovers with food. I was thinking I'm not giving him enough as he is always looking for more. Is it true that smaller more frequent meals are better for them? I've been feeding him 4 times a day but not sure how to keep this up when I am back at work and the kids are at school? I paid $24 for 30 amoxycillin tabs, would the metronidazole be cheaper than this? Does amber also have to take the lactulose?

[JulesP]

Yes smaller, more frequent meals are best. You don't want to give the liver too much to process at once. You could do a meal when you first get up, one when you leave and then 2 in the evening. Some people use the automatic feeders for the kibble too.

I pay about $40ish for 60 of the metrogyl. I was giving Amber the amoxycillin at the beginning too. I guess your dog is smaller so needs less of the drugs. $24 actually sounds quite reasonable. I was paying more than that. A tip is to get the drugs in larger quantities as some vets charge a dispensing fee.

I don't give Amber the lactulose because her poos are really soft anyway. I wanted to keep some stuff for if things got worse too.