View Full Version : Dog question re: liver shunt
Jan. 10, 2009, 09:37 AM
I am not sure if this is an ok question to ask here, but have seen lots of dog posts and figured I'd give it a try. Mod, feel free to pull if this isn't ok here.
I have a little dog. He is my barn companion. He's 4 years old. He has a liver shunt, was diagnosed at age 1 year. His liver function tests have been normal over the past 3 years, but he has not been without health issues. He has had a couple of seizures in his lifetime. He also has chronic bladder issues. He did really great for the past 18 months, but we were back int he vets yesterday with a UTI...and I know this is just the start of another battle with his health.
I know there is a surgery that could be performed, but my vet doesn't feel it's a good option for him and never has. She said it's too risky and the chances of it actually benefitting him more than harming him is very slim. So we just take things as they come.
I have done lots of research and it seems a low protein diet is one of the most beneficial treatment options, so I am investigating the options for him. The vet says that aside form these little hiccups, he should live a rather long and productive life.
Anyone else dealt with one or have any suggestions for us as far as diet to try? He has been to see a specialist, and they did agree with my vet's recommendation of no surgery... so I"m not looking for radical treatment or a fix, just maintenance.
Jan. 10, 2009, 09:55 AM
Since your dog has had a couple of seizures over his 4 years, you could join the Epil-K9 email group. Although it's mainly an epilepsy support group, there is always a lot of discussion on causes of seizures and how to manage those causes - one of which is liver shunts. Lots of special diet info. Great support too. Someone might know of a liver shunt group to join.
I'm a member because my dog has primary epilepsy.
Jan. 10, 2009, 06:37 PM
he's a maltese/poodle mix. I noticed the maltese link in your post. :winkgrin:
He has had a couple of seizures. We got him really well stabilized and until yesterday, he'd been off of all meds for 18 months. But we're back here again. I will definitely check that out!
Jan. 10, 2009, 06:55 PM
I cannot help with his liver problems other than to say that less protein is best, but his bladder problems can also be helped with diet. If he has kidney stones or "sand" you can limit milk, processed dry dog feeds and anything that can contribute to the formation of "sand" such as butter and milk. And there is an operation where the urethra can be pulled down to let the "sand" go thru with less irritation of his bladder. Also the more water he drinks the better, as it will flush his kidneys and bladder.
He is lucky to have you to help him out.
PS Let me know when you and your mother are ready to take care of that SC problem.
Jan. 10, 2009, 07:04 PM
I have a liver shunt Pug. My guy was diagnosed at 1 year and I took him to The Unitversity of PA where he had liver shunt surgery. He is now 7 years old and has been fine since the surgery. I do take him back for periodic blood work and with liver shunt dogs you need to be aware that they produce a specific type of bladder stone that the normal bladder stone diets dont work with. I got my little guy as a rescue when he was 11 months old, and at that time he had a history of bladder stones but they didnt know he had a liver shunt at that time so they were treating him for the wrong type of stones. Im a former vet tech and when I saw his medical history I wanted to see the lab report on the stones to see what kind they were because I knew that liver shunt dogs made a speficic type and I was suspicious of an 11 month old dog having bladder stones. When I got the report from the rescue group, my vet referred me to the U of Pa. His surgery went very well for such a sick dog. I have had him on a low protein diet ever since, no meat at all, he has been eating Hills Prescription Diet UD and has done very well on it with no further episodes and good blood work. Some people swear by Milk Thistle which is supposed to cleanse the liver toxins but when I tried it on my guy he seemed to get worse. Metronidazole is also prescribed for some dogs.
Maltese are predisposed to liver shunts. There is a support group on Yahoo for liver shunt dogs, its very good and full of good info. Google it or go to Yahoo and do a search. I learned alot from there.
If you havent already had pre and post bile acids blood drawn or blood ammonia, that should be done as well as testing any urinary stones or crystals to see what kind they are. With liver shunt dogs they will make ammonium acid urate stones which can only be fixed thru surgery (they cant be disolved with prescription diets) and then maintined on a low protein diet such as U/D. Hope this helps!
Jan. 11, 2009, 10:10 AM
I have Ginger (aussie shepherd) on milk thistle for liver support because she is on phenobarbitol for seizures. Not sure if it's helping, but doesn't seem to be causing problems.
Seems like there's a Yahoo group for everything :) It's nice to be able to find some on-line support from people who are going through what you are.
Didn't realize your pup is a maltie when I posted the link. Must be some psychic vibe :lol:
Sing Mia Song
Jan. 11, 2009, 03:14 PM
Sounds like your dog has an intra-hepatic shunt, which is much more difficult to fix than an extra-hepatic shunt.
I think an internal medicine consult would be a very good idea for your little guy. We've had luck with milk thistle in some of our patients, but not all. I have been out of specialty practice for too long to be current, and the field is changing all the time. While you aren't close to a university, you're in a major city, and I'm sure there's a good specialist locally.
Jan. 11, 2009, 10:17 PM
If he has lived that long okay, it's probably something that can be handled with diet. Do a Google search and you should find plenty of information.,
Jan. 11, 2009, 10:54 PM
I had a doberman with a liver shunt. I also took him to a University, and was told he was inoperable. He also had seizures until he was diagnosed. After we got his diet straightened out, no more seizures!
He was on a prescription diet for low protein, I believe it was KD. He also got lactulose every day.
He was diagnosed at about 9 months, and the vet said he would be lucky to live until 3. He lived to be 9!! The vets don't always know!
May. 18, 2009, 12:28 AM
My lab also has a liver shunt and he is a little over a year now. WE took him to the University of Tenn for surgery, but it had a high mortality rate so we back out as soon as he started bleeding. Our next option is taking him to U. Penn to get coils to block the liver shunt. WE didn't do this procedure to begin with b/c it is far more expensive, around 5,000 each time depending on how many coils he needs. He was doing great for about 5 months on medication and hills L diet, however he just recently started having problems urinating again and will have to go under to remove the stones. By the way, does anyone know of any treats to give dogs with liver shunts that are low in protein? Thanks
May. 18, 2009, 09:59 AM
A couple of feeding tips for this...
1) multiple smaller feedings so that the liver has more "time" to process the daily intake
2) lower protein diet--they think that the seizures are caused because of toxins that build up due to excess protein
3) keep dog at healthy weight
For the lower protein diet, you may have to do a lot of label reading. Your vet should be able to direct you somewhat. You may need to move to a senior feed--those are typically MUCH lower in protein.
I work with Hills/Science Diet so off the top of my head....
Over the counter, a food like SD mature adult is going to have about 6% protein but higher fat levels than say an adult formula which will be anywhere from 16-22%.
There is a prescription diet just for liver issues. Hills RX L/D. That may be another option for you.
Note: A lot of the other high end foods have even higher levels of protein since a lot of folks are on a protein kick right now for their dogs. In an otherwise healthy dog, that excess protein can be excreted. But in a dog who is already compromised w/ liver or kidney issues, it's just too much.
Good luck....I know how frustrating it can be.
Ben and Me
May. 18, 2009, 11:13 AM
Some of the kitty allergy foods are lower in protein. LB (Iams) and D/D (Hills) come to mind. Might be the same for the dog versions.
May. 18, 2009, 08:25 PM
The key for liver shunts is to keep the protein minimized just as much as necessary. This means making sure there are no clinical signs and keeping that the lowest amount of protein fed. Also, has it been determined that the seizures are not a result of the liver shunt? If so, then the diet needs to change drastically.
What is your dog's weight? Overweight, underweight, just right?
I have a list of foods but the calorie content varies.
Some lower-protein foods include:
Royal Canin Renal MP (wet or dry)
Hill's d/d (dry, all formulas)
Science Diet Mature gourmet beef
Hill's t/d (dry)
Hill's l/d (wet or dy)
Hill's z/d ultra (wet or dry)
Purina NF (wet or dry)
Science Diet Mature Original (dry)
Hill's g/d (wet or dry)
Royal Canin Hepatic LS (dry)
If you really really hate the vet-recommended diets, and there is not much of a reason to not try them to start, most senior diets are acceptable. The AAFCO minimum for protein is 5.1 grams, and the diets I have listed vary from 4.9-3.6 grams. The amoutn of protein and calories, of course, vary between wet and dry (per can wet and per cup dry).
May. 19, 2009, 11:52 PM
There are two main types of shunts. Intrahepatic( within the liver) which are seen primarily in large dogs and extrahepatic (outside of the liver) which are primarily seen in small dogs. The main difference is that intrahepatic are difficult to correct surgically and have a high mortality rate. The extrahepatic are more likely to b able to be surgically corrected. However, if your dog has done fine for this period of time then he most likely has a small extra (outside ) hepatic shunt and it is not life threatening. Many of these dogs will live out their normal life span with diet treatment (low protein) also a product called lactulose which helps with the toxin buildup in the gut. The stones and bladder infections are annoying but most likely not life threatening. I would listen to your vet and treat conservatively as the surgery is not necessarily without problems. Meaning that it could cause more problems than what you have now.