Portosystemic shut

[DogsSmarterThanMe]

5 month cairn female with possible diagnosis of Portosystemic Shunt.  Your experience and guidance please!

[bradl]

No *personal* experience but based on exposure through friends and colleagues I believe that if confirmed and depending on its nature, surgical intervention can be helpful (very) for dogs with shunts. The US national club has some resources: 

• https://cairnterrier.org/index.php/Static/health#PVSA
• https://cairnterrier.org/index.php/Static/liver-portosystemic-vascular-anomaly-psva-and-microvascular-dyplasia-mvd
• https://cairnterrier.org/index.php/Static/health#Contacts

From the Canadian national club:

Quote

When present at birth, both conditions are thought to be genetic, although the exact mode of inheritance is not clear. Research to determine a genetic marker is ongoing. Shunts may be acquired later in life as a result of another illness, therefore it is recommended that dogs should be screened early in life with a simple test which measures the level of bile acids in the blood stream. Those with elevated levels may then require further investigation by means of a urine test and an ultrasound of the liver to determine if the dog has either PVSA or MVD and a recommended course of treatment.

 

 

 

[pkcrossley]

a frequently (I don't mean commonly) encountered condition in Scottish terriers. vets have long experience with it and surgery seems the normal remedy. sounds like your puppy will need a bit more diagnostic work, but if positive, the protocols are known and effective. hope you make progress on it soon!

[Sam I Am]

Just a bit more info from Tuffts. PK I am not aware that liver shunts are more common in Scottie’s? Certain liver enzyme issues In Scottie’s is very common. https://vetnutrition.tufts.edu/2018/07/liver-shunts/

 

Edited June 14, 2020 by Sam I Am

[pkcrossley]

no, I'm not saying Scotties. Scottish terriers. terriers from Scotland. all the breeds show up with higher-than-chance occurrences of shut, von Willebrand's, a few eye conditions. 

 

 

 

[DogsSmarterThanMe]

Despite the surgery Dixie had, her bile acid tests are coming back at levels double higher that pre-surgery.  After spending $8000 we really can't afford to do more and yet the vets are guilting me. They want to do another ultrasound (another $500) and to find out what I wonder.   Dixie seems completely fine - high energy, good diet, putting on weight at normal levels, normal stool etc.  She is just over a year old.  Looking for advice....

[Sam I Am]

 Jock our previous Cairn did not have a liver shunt however he lived till he was almost 13yrs old when diagnosed with Chronic Active  Hepatitis. He had no symptoms except a blood panel at six years of age prior to dental surgery. His liver enzymes were off the map!  A liver biopsy was done showing a normal liver . My vet put him on these three supplements. His liver enzymes plummeted to not a normal reading but enough that the vet felt comfortable. He lived happily for another 6.5 years with no symptoms, till cancer killed him shy of a few month on his 13 Birthday.

These are what he was on.

Milk Thistle, Denamarin and the one that really caused a huge difference, Ursadol. You might want to ask your vet and give it a try.

I also want to add that I have no idea if liver enzymes are even remotely connected  to bile acid issue, but if the liver is stressed I wonder if the above would help?

 

Edited April 2, 2021 by Sam I Am

[bradl]

That's a bummer but glad Dixie seems to be going strong regardless. 

The national club has contacts for health related concerns, organized by various issues. 

https://cairnterrier.org/index.php/Static/health#Contacts

You might write the liver shunt contact for some possible ideas, other contacts, avenues to investigate, etc.  For example, if there is still shunt or MVD research going on sometimes the investigator can be very helpful. Many years ago I got some useful counseling from the investigator on a renal dysplasia program based on some biopsy results I had received locally and sent her.

If nothing else the contact serves as a clearinghouse (not necessarily an expert themselves) so they ARE much more likely to be aware of others who may have had similar or related experiences.

[pkcrossley]

do not be guilted by your vet. you have done a lot of intervention, obviously necessary, and it may even be too early to tell the effects. if Dixie is doing fine, you can wait till (or if) she shows some kind of signs of illness and then decide what to do. test results, with no symptoms, are very difficult to decide what to do. it isn't just your wallet that is a concern; keeping a lot of medical stuff going on in your dog's life can be a serious source of stress and worry for the dog. if she shows symptoms, your path will probably look clearer to you.