Liver Shunt in Young Dog- Anyone Have Experience? Meds? Diet? Surgery? - Page 1

My almost 2 yr. old appears to have a portosystemic shunt. I have no experience with this. We haven't done the bile acid tests yet, but the blood panel showed elevated liver enzymes and a multitude of other consistent symptoms are present, so the bile acid test is more of a formality at this point.

Any personal info or suggestions as to a next step, etc. are appreciated. I don't see much hope for a great outcome, regardless. 

Thanks in advance.

Nothing personal to add but here is a suggestion to read. I'm sure you googled it like I just did. Congenital most likely at that age, and depending on how many and where the shunts are, surgery has the better statistics. This might interest you if you haven't already read it.

http://veterinarymedicine.dvm360.com/vetmed/article/articleDetail.jsp?id=712027

 Five of 99 (5.1%) surgically treated dogs died of complications secondary to their surgical procedures; however, deaths associated with the portosystemic shunt but unrelated to the surgical procedure were more common in medically treated dogs (8 of 27 [29.6%]) than in surgically treated dogs. Thus, this study's results show that while both surgical and medical management may result in long-term survival in a subset of dogs, surgical treatment is associated with improved survival in the first three years and with overall significantly longer survival times.

You are correct, poor dog has a rough road. 

I have experience,but too late , he pass the golden time to do the surgery.
The next step should do the Digital Vascular Image DVI,found out which part shunt,some location cannot have surgery.

There is so much conflicting information out there. I have been so fortunate with health. I have never seen anything like this firsthand. I don't know what to believe, which path to take, whether surgery is even worth it when you look at what percentage experience little improvement, but have an increase in neurological symptoms...

What is the "golden time" to do surgery? I don't know how long mine has had it, really- assuming congenital, so it's always been there, but he hasn't had symptoms that long. Of course, they weren't that noticeable and were chalked up to other problems at the time. It wasn't until today, when he was soooo bloated, that I finally got a vet to say "whoa, yeah...you're right; there is definitely something wrong with this dog."

FRUSTRATED.

Only one person has experience w/this out of 680 views? 

Two years old is a golden time.It will damage the brain cell if the toxic continuous .Definitely do the DVI first.

Thank you. I have not noticed many neuro symptoms at all- little, transient things that happen so fast I can't be sure I didn't imagine them, but now that I have the missing puzzle piece, a lot of other things are falling into place, like why the other one the same age, fed exactly the same, down to the amount, is gorgeous and healthy and robust, and he just seems frail and diminutive, despite a ravenous appetite.  

My experience with liver shunts has mostly been in small breed puppies which we have gotten from mills or brokers when the puppy failed health clearances.  I can tell you Michigan State is wonderful with them.  
The only absolutely definitive method for diagnosing a liver shunt, and to determine whether it is intra- or extra-hepatic, is through an MRI, CT scan, portography (a test which looks at blood flow to and through the liver), ultrasound, or exploratory surgery.
Try this site and listen to the vet who is talking.
http://healthypets.mercola.com/sites/healthypets/archive/2011/02/01/liver-shunts-disease-in-pet-dogs.aspx 

   Because        

I'm afraid I've read everything. His ultrasound is scheduled for after his bile acid test. Have you had any experience with older dogs? I mean, he's not old, but he's not a puppy that this was immediately evident in. What concerns me is the neurological aspect- so many seem to get worse once the shunt is fixed because their tiny livers can't handle the increased circulation. Kind of a rock and hard place, it seems like. I don't mean to be cheap or cold, but if spending thousands could very well make him worse, I'm inclined to medically manage it as long as possible and consider surgery if his quality of life is really diminished at some point. 90% of the time, he is the happiest, bounciest little guy you could ever hope to meet. 

I was really hoping someone out of the thousands and thousands of posters here would have a dog w/the same issue. I guess this is still pretty much a GSD board and I would be better off posting on a Chihuahua board.

Thanks very much to those who responded. 

Judy, I was planning on taking him to Dr. Becker anyway if I can get him in fast enough. Her wait is sometimes ridiculous. I always take tricky medical issues to her. Thanks for the link.

Only dog I know of that was first suspected of a liver shunt
turned out to have EPI and IBD.
Lab results were confusing at first.

Symptoms set in suddenly at about 15 mos, and the dog
was euthanized by the owners.

Prior to any of this, the dog appeared to be 'normal' and
although lean, overall seemed healthy.