# Eva is back from the internist..



## aprilb (Jul 9, 2010)

The internist did an ultrasound and a platelet count..Eva's platelets are normal!:chili::chili: The ultrasound showed a normal-size liver except that one side did not show as many vessels.. A shunt could not be found..they say that her bile acids are consistent with MVD ..but they want to do surgery to be 100% certain..as the low Protein C was a concern.. ...also they recommend that I keep her on a hepatic diet..the reason for the ultrasound is that they wanted to see all of her internal organs to make sure that nothing else was going on..all normal..I really do not want to do surgery right now...I'm thinking of repeating the Protein C test at another facility...it has to be done a certain way and it is very complicated, and if not done exactly right, can give false results..and how can her platelets be normal this week and not normal last week? I don't think I want the vet tech that took Eva's blood near her again with a needle..:angry: She did not bruise at all when they took her blood today, but they did say her skin is quite thin.. anyway..I am happy Eva is feeling good and her platelets are up..this is great news for sure!:wub:


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## sherry (Jan 4, 2013)

So happy for the good news! Hopefully surgery will not be necessary!


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## IvysMom (Dec 24, 2012)

Glad to hear things are looking up for little Eva! YAY!


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## CloudClan (Jan 31, 2007)

Surgery? Are they talking exploratory surgery? That seems pretty drastic for suspected MVD. I agree another protein C makes a lot more sense. 

I hope they are not conflating two issues and can focus on what caused the platelet count to drop. So very glad her platelet count is normal today. Is she on prednisone for the Thrombocytopenia? Are they going to keep her on it? 

So glad that the news was good today and we will continue to keep Eva in our prayers.


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## Maisie and Me (Mar 12, 2009)

CloudClan said:


> Surgery? Are they talking exploratory surgery? That seems pretty drastic for suspected MVD. I agree another protein C makes a lot more sense.
> 
> I hope they are not conflating two issues and can focus on what caused the platelet count to drop. So very glad her platelet count is normal today. Is she on prednisone for the Thrombocytopenia? Are they going to keep her on it?
> 
> So glad that the news was good today and we will continue to keep Eva in our prayers.


 
:goodpostraying that the Protein C was off too!!


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## elly (Sep 11, 2006)

aprilb said:


> The internist did an ultrasound and a platelet count..Eva's platelets are normal!:chili::chili: The ultrasound showed a normal-size liver except that one side did not show as many vessels.. A shunt could not be found..they say that her bile acids are consistent with MVD ..but they want to do surgery to be 100% certain..as the low Protein C was a concern.. ...also they recommend that I keep her on a hepatic diet..the reason for the ultrasound is that they wanted to see all of her internal organs to make sure that nothing else was going on..all normal..I really do not want to do surgery right now...I'm thinking of repeating the Protein C test at another facility...it has to be done a certain way and it is very complicated, and if not done exactly right, can give false results..and how can her platelets be normal this week and not normal last week? I don't think I want the vet tech that took Eva's blood near her again with a needle..:angry: She did not bruise at all when they took her blood today, but they did say her skin is quite thin.. anyway..I am happy Eva is feeling good and her platelets are up..this is great news for sure!:wub:


They always want to do surgery:angry:did they want to do it today or tomorrow? Have you looked into having a scintigraphy? That will tell them for sure if she has a shunt or not. Liver disease sadly is not one size fits all. My Ellie did not have a shunt but had many problems liver related. I think diet is very important and liver support. I would keep a journal of anything you think is odd about her behavior. If she seems sad, has trouble walking on slick surfaces anything that is not her normal. I am glad things went well today and hope that she continues to improve.


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## LuvMyBoys (Jan 2, 2012)

What a roller coaster ride you have been on April! Glad for the good results and no bruising this time!


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## Zoe's Mom88 (Apr 25, 2011)

:chili: Go Eva....so far so good. April, I am so happy for you!! :chili:


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## Snowball Pie's Mommi (Oct 16, 2008)

CloudClan said:


> Surgery? Are they talking exploratory surgery? That seems pretty drastic for suspected MVD. I agree another protein C makes a lot more sense.
> 
> I hope they are not conflating two issues and can focus on what caused the platelet count to drop. So very glad her platelet count is normal today. Is she on prednisone for the Thrombocytopenia? Are they going to keep her on it?
> 
> So glad that the news was good today and we will continue to keep Eva in our prayers.





Maisie and Me said:


> :goodpostraying that the Protein C was off too!!


Ditto. 

In addition, April ... I hope you are not afraid to ask the doctor to draw the blood the next time. 

Hugs for you and Eva. :wub::wub:


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## Sylie (Apr 4, 2011)

That sounds good, April. But why do they want to do surgery? I agree that you should do another test later, before something so drastic. Did they want you to buy prescription food? Do a lot of research on that. I recently read a long medical article on special diets for kidneys, that is based on custom, with no real proof that is of any benefit. Vets keep prescribing this bland diet that isn't nutritious enough for a young dog. Just saying...do your own research.

I'm just glad that Eva is better.


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## aprilb (Jul 9, 2010)

CloudClan said:


> Surgery? Are they talking exploratory surgery? That seems pretty drastic for suspected MVD. I agree another protein C makes a lot more sense. Yes...thanks..I agree
> 
> I hope they are not conflating two issues and can focus on what caused the platelet count to drop. So very glad her platelet count is normal today. Is she on prednisone for the Thrombocytopenia? Are they going to keep her on it? No, they are not giving her anything..I did not get a good explanation on that..I am confused about how it could be fine today and not fine last week..?:blink::blink: When I asked, the Dr. said,"Sometimes that can happen."
> 
> So glad that the news was good today and we will continue to keep Eva in our prayers.


Thank you...I'm glad, too..


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## pammy4501 (Aug 8, 2007)

DO NOT agree to do surgery until they can confirm a liver shunt. They need to do the scintiography first! This will be a needless invasive procedure with all of the risks, and little of the benefit. Did they put her on Prednisone?


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## LuvMyBoys (Jan 2, 2012)

Oh, and about them immediately wanting to do surgery, if this specialist was anything like the neuro specialist I saw at the same practice, they immediately jump to whatever will find out what is wrong, with out considering price or age or anything else.



We took Alvin there and after an examination the neuro vet decided it was either "A" or "B" but wanted to do an MRI to find out conclusively. I asked what the treatments would be for both "A" and "B" and he said X medicine. My response was, could we just have X medicine then and not put our sick, 12 year old dog with a heart problem and collapsed trachea thru the $2,000 MRI. He was almost dumbfounded at that and said, "Well, yeah, I guess we can do that." Reported this all back to my regular vet who said he had heard before that this neuro didn't have the greatest bedside manner, but was a genius. He just wants to know for absolute sure, even though the treatment would be the same.


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## aprilb (Jul 9, 2010)

elly said:


> They always want to do surgery:angry:did they want to do it today or tomorrow? Have you looked into having a scintigraphy? That will tell them for sure if she has a shunt or not. Liver disease sadly is not one size fits all. My Ellie did not have a shunt but had many problems liver related. I think diet is very important and liver support. I would keep a journal of anything you think is odd about her behavior. If she seems sad, has trouble walking on slick surfaces anything that is not her normal. I am glad things went well today and hope that she continues to improve.


Thanks, Cathy..good idea..I will look into the portal scintigraphy..and I will keep a journal.


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## edelweiss (Apr 23, 2010)

April, I am not saying I know better than your vet, but I would be willing to bet that you got a false report on platelets due to a bad draw. Could the protein C (which was probably the same draw?) have been due to the same issue? Did Cornell do the protein C? I would follow Cathy's wise suggestions. JMHO
I AM glad your baby is doing well!!!!!!!


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## aprilb (Jul 9, 2010)

edelweiss said:


> April, I am not saying I know better than your vet, but I would be willing to bet that you got a false report on platelets due to a bad draw. Could the protein C (which was probably the same draw?) have been due to the same issue? Did Cornell do the protein C? I would follow Cathy's wise suggestions. JMHO
> I AM glad your baby is doing well!!!!!!!


I am wondering the same thing..Dr. Sandi...that's why the vet will have to draw the blood, not the tech..the Protein C was the same draw..so it may not have been done exactly right..I am going to have it done over at a later date..


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## aprilb (Jul 9, 2010)

pammy4501 said:


> DO NOT agree to do surgery until they can confirm a liver shunt. They need to do the scintiography first! This will be a needless invasive procedure with all of the risks, and little of the benefit. Did they put her on Prednisone?


 I agree.. I won't..no to the prednisone..her platelets are normal today...wondering if the tech got a bad draw last week...


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## aprilb (Jul 9, 2010)

LuvMyBoys said:


> What a roller coaster ride you have been on April! Glad for the good results and no bruising this time!


Thanks, Laura:wub:


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## Furbabies mom (Jul 25, 2011)

I agree do the Protein C later, and def no surgery!! I'll bet it was a bad draw too! I mean She was acting fine, eating , playing not your typical behavior for a shunt!!I think that you got some good news April.


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## Ladysmom (Oct 19, 2004)

pammy4501 said:


> DO NOT agree to do surgery until they can confirm a liver shunt. They need to do the scintiography first! This will be a needless invasive procedure with all of the risks, and little of the benefit. Did they put her on Prednisone?


I agree! :thumbsup: Ultrasounds are not that reliable in diagnosing liver shunts in small dogs. Scintigraphy is much more reliable. 

From Dr. Center:Definitive determination of PSVA can only be made using specialized imaging studies. These include:

Colorectal scintigraphy, involving deposition of a safe isotope in the rectum and evaluation of isotope distribution via the portal vein to the liver and heart. Scintigraphy does not discern whether shunt vessels are within or outside the liver or whether the shunt is congenital or acquired.

Radiographic portography, which uses imaging with an iodinated dye to show blood flow in the portal vein, producing a “map” of the portal vein blood as it flows into and within the liver.

*Abdominal ultrasound with color flow doppler is one of the least invasive imaging techniques, but also one of the most difficult to perform and interpret. Ultrasound requires an experienced ultrasonographer as shunts can be easily missed, especially if the dog is small or uncooperative.*

Computer tomography (CT) and magnetic resonance imaging (MRI) are being used more frequently in combination with vascular contrast agents. However, they require expensive equipment and special expertise.

Canine Liver Shunt Research Project | American Shih Tzu Club​


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## MoonDog (Jun 6, 2011)

:chili: Yes!!! :chili: Another prayer answered!


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## Snowbody (Jan 3, 2009)

Very relieved. I wouldn't be surprised if it was the blood draw or lab. My (human) friend had blood drawn last year and numbers for a test that should have been around 6 were 120! It wasn't even on the charts as a possibility and she always was normal on tests before. She went to another lab and was totally normal. Praying that's it for Eva since she was acting normal. I would retest in a few weeks and see what's up. Can't imagine them wanting to go for surgery and not scintigraphy first.


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## Lacie's Mom (Oct 11, 2006)

April -- I'm so glad that Eva's platlets are normal. That's a huge relief. I don't know how many times we find that the blood draw or the lab work was at fault for the readings we get. Protein C Tests are not performed properly by the majority of the Vets. They really don't know what they're doing when it comes to this test, imho.

I'm sure that I would not do surgery -- at this at this point. I don't believe that Eva has a stunt. She may have some MVD issues, but I'm even suspect of that.

At this point, I would continue to watch her, chang eher diet and go from there and see what happens.

Continuing to send prayers and hugs your way.


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## Maidto2Maltese (Oct 19, 2004)

Soo happy the platelets are fine... I'd bet anything it was like I stated earlier with Naddie... a 'fluke' in the draw or smear.
I'm in agreement.... the less invasive approach first!!


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## harrysmom (Sep 28, 2007)

Sooooo glad to hear that Eva's results are good. I feel (and hope), like the others, that the platelet issue may have been a misdraw or a misread. 

I would NOT let anyone perform surgery on Eva! When Harry was first diagnosed, the internal medicine doctor here in NJ and the resident at Cornell both wanted to do exploratory surgery. They wanted a "definitive answer" as to what was going on with Harry. I asked if the course of treatment would change if they found a "definitive answer" and they said no, so I said no surgery. And, in Harry's case, Dr. Center agreed with me. I know that in some cases surgery is warranted, but I don't believe in "exploratory surgery" unless the problem is urgent and life threatening. In my opinion there are just too many less invasive ways to determine what's going on.

Harry also never had scintigraphy. The results of the ultrasound were good enough for Dr. Center to work with and I was very happy about that. 

I would just monitor Eva and if there are no further symptoms, I wouldn't do anything. 

So glad that Eva is feeling better!!! And I hope that you are feeling relieved too.

Hugs to you and Eva. :wub:

Debbie


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## Tanner's Mom (May 27, 2005)

Glad that sweet little girl is doing well.


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## silverhaven (Sep 6, 2009)

Wow! I am surprised they want to do surgery. I would absolutely not do it. I would also feel rather untrusting of anyone who suggested it without her having severe symptoms. I am happy to hear that Eva is doing a lot better. The clotting thing is weird, interesting that that has cleared on it's own. Tests can often be flawed I think, sometimes we seem to go through way more than we need to by doing extensive testing when the dog seems well and has no obvious issues.


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## poochie2 (Jan 14, 2010)

Happy to hear her platelets are good but don't understand how the numbers would be off last week and normal this week. I would still be concerned on which ones are correct.
I am glad Eva is feeling better :wub:


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## aksm4 (Nov 28, 2011)

I agree with others that US is a waste of money when it comes to small dogs and shunting Becky had results normal liver , normal portal vein NO SHUNT !!!! then she started getting real sick because of protein intake no liver diet .... months later as you all know and $$$$ spent i pushed the cy scan and there it was portal systemic exta hepatic shunt ..... dont rely too much on those ultrasound results and yes get her on hepatic diet prescription hill's L/D is designed by university of tenesse dr .tobias the guru of liver shunts


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## jmm (Nov 23, 2004)

I was honestly surprised your vet didn't recheck the platelets on a really good stick first. Many things can affect the platelets from a traumatic blood draw to not putting enough blood in the tube. 

I can't say I'd pursue anything in a normal, healthy dog with suspected MVD.


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## Grace'sMom (Feb 22, 2012)

Hugs for Eva... glad the visit went well 

I'd also repeat the test before doing any kind of surgery.

And I think I'd also try treating for MVD with diet and milk thistle before trying surgery, as well. That just seems so drastic.


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## aprilb (Jul 9, 2010)

sherry said:


> So happy for the good news! Hopefully surgery will not be necessary!
> 
> 
> Sent from Petguide.com Free App


Thanks!



IvysMom said:


> Glad to hear things are looking up for little Eva! YAY!


Thank you



Maisie and Me said:


> :goodpostraying that the Protein C was off too!!


Thanks



Zoe's Mom88 said:


> :chili: Go Eva....so far so good. April, I am so happy for you!! :chili:


Thank you, Barbara



Snowball Pie's Mommi said:


> Ditto.
> 
> In addition, April ... I hope you are not afraid to ask the doctor to draw the blood the next time.
> 
> Hugs for you and Eva. :wub::wub:


Thanks Marie..nope, I'm not afraid to ask her to do it..:rockon:



Sylie said:


> That sounds good, April. But why do they want to do surgery? I agree that you should do another test later, before something so drastic. Did they want you to buy prescription food? Do a lot of research on that. I recently read a long medical article on special diets for kidneys, that is based on custom, with no real proof that is of any benefit. Vets keep prescribing this bland diet that isn't nutritious enough for a young dog. Just saying...do your own research.
> 
> I'm just glad that Eva is better.


They want to do surgery so they can be 100% certain instead of 90% certain..no worries..I will not feed prescription food..it's yucky..:yucky:



Furbabies mom said:


> I agree do the Protein C later, and def no surgery!! I'll bet it was a bad draw too! I mean She was acting fine, eating , playing not your typical behavior for a shunt!!I think that you got some good news April.


and still doing great Auntie Deborah..no surgery for my Eva..she doesn't need it..



MoonDog said:


> :chili: Yes!!! :chili: Another prayer answered!


Praise the Lord..and thank you so much for your prayers, Robin:wub:



Snowbody said:


> Very relieved. I wouldn't be surprised if it was the blood draw or lab. My (human) friend had blood drawn last year and numbers for a test that should have been around 6 were 120! It wasn't even on the charts as a possibility and she always was normal on tests before. She went to another lab and was totally normal. Praying that's it for Eva since she was acting normal. I would retest in a few weeks and see what's up. Can't imagine them wanting to go for surgery and not scintigraphy first.


I totally agree Auntie Sue



Lacie's Mom said:


> April -- I'm so glad that Eva's platlets are normal. That's a huge relief. I don't know how many times we find that the blood draw or the lab work was at fault for the readings we get. Protein C Tests are not performed properly by the majority of the Vets. They really don't know what they're doing when it comes to this test, imho.
> 
> I'm sure that I would not do surgery -- at this at this point. I don't believe that Eva has a stunt. She may have some MVD issues, but I'm even suspect of that.
> 
> ...


Thanks, Lynn..I agree... thanks so much for your prayers-{{Hugs}} back!:wub:



Maidto2Maltese said:


> Soo happy the platelets are fine... I'd bet anything it was like I stated earlier with Naddie... a 'fluke' in the draw or smear.
> I'm in agreement.... the less invasive approach first!!


Amen! Thank you dear Terry



harrysmom said:


> Sooooo glad to hear that Eva's results are good. I feel (and hope), like the others, that the platelet issue may have been a misdraw or a misread.
> 
> I would NOT let anyone perform surgery on Eva! When Harry was first diagnosed, the internal medicine doctor here in NJ and the resident at Cornell both wanted to do exploratory surgery. They wanted a "definitive answer" as to what was going on with Harry. I asked if the course of treatment would change if they found a "definitive answer" and they said no, so I said no surgery. And, in Harry's case, Dr. Center agreed with me. I know that in some cases surgery is warranted, but I don't believe in "exploratory surgery" unless the problem is urgent and life threatening. In my opinion there are just too many less invasive ways to determine what's going on.
> 
> ...


 Thank you so much Debbie...I am relieved..



Tanner's Mom said:


> Glad that sweet little girl is doing well.


Thank you, Auntie Marti..



silverhaven said:


> Wow! I am surprised they want to do surgery. I would absolutely not do it. I would also feel rather untrusting of anyone who suggested it without her having severe symptoms. I am happy to hear that Eva is doing a lot better. The clotting thing is weird, interesting that that has cleared on it's own. Tests can often be flawed I think, sometimes we seem to go through way more than we need to by doing extensive testing when the dog seems well and has no obvious issues.


 I agree...no surgery.. 



poochie2 said:


> Happy to hear her platelets are good but don't understand how the numbers would be off last week and normal this week. I would still be concerned on which ones are correct.
> I am glad Eva is feeling better :wub:


I believe the one done today is correct because there was no bruising or bleeding where she was stuck..



aksm4 said:


> I agree with others that US is a waste of money when it comes to small dogs and shunting Becky had results normal liver , normal portal vein NO SHUNT !!!! then she started getting real sick because of protein intake no liver diet .... months later as you all know and $$$$ spent i pushed the cy scan and there it was portal systemic exta hepatic shunt ..... dont rely too much on those ultrasound results and yes get her on hepatic diet prescription hill's L/D is designed by university of tenesse dr .tobias the guru of liver shunts


Thank you for your input, Anna...this diet would not be good for Eva because she is not deficient in vitamin K ...and she has not been sick...no vomiting, no loose stools, has always eaten well..nothing to make me think she has a liver problem..and she is a hefty 5 pounds..however I do watch her protein..

QUOTE=jmm;2299410]I was honestly surprised your vet didn't recheck the platelets on a really good stick first. Many things can affect the platelets from a traumatic blood draw to not putting enough blood in the tube. 

I can't say I'd pursue anything in a normal, healthy dog with suspected MVD.[/QUOTE]Thanks, Jackie..



Grace'sMom said:


> Hugs for Eva... glad the visit went well
> 
> I'd also repeat the test before doing any kind of surgery.
> 
> And I think I'd also try treating for MVD with diet and milk thistle before trying surgery, as well. That just seems so drastic.


I think so, too...I am not planning on doing any surgery...thanks for your input


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## mysugarbears (Aug 13, 2007)

elly said:


> They always want to do surgery:angry:did they want to do it today or tomorrow? Have you looked into having a scintigraphy? That will tell them for sure if she has a shunt or not. Liver disease sadly is not one size fits all. My Ellie did not have a shunt but had many problems liver related. I think diet is very important and liver support. I would keep a journal of anything you think is odd about her behavior. If she seems sad, has trouble walking on slick surfaces anything that is not her normal. I am glad things went well today and hope that she continues to improve.



So happy to hear that Eva's platelets are up but don't quite understand what they want to do surgery for, i have to agree with Cathy about the scintigraphy and diet and liver support. I'm glad that your taking her elsewhere to get another Protein C test done. Hugs to you and Eva.


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## hoaloha (Jan 27, 2012)

That's great news about the platelets, April!!! I definitely would NOT jump to exploratory surgery. Scintigraphy is the next step to evaluate for shunt as mentioned. You are a great mommy. Kisses to Eva :wub:


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## Sparkle'sMom (Feb 2, 2013)

aprilb said:


> The internist did an ultrasound and a platelet count..Eva's platelets are normal!:chili::chili: The ultrasound showed a normal-size liver except that one side did not show as many vessels.. A shunt could not be found..they say that her bile acids are consistent with MVD ..but they want to do surgery to be 100% certain..as the low Protein C was a concern.. ...also they recommend that I keep her on a hepatic diet..the reason for the ultrasound is that they wanted to see all of her internal organs to make sure that nothing else was going on..all normal..I really do not want to do surgery right now...I'm thinking of repeating the Protein C test at another facility...it has to be done a certain way and it is very complicated, and if not done exactly right, can give false results..and how can her platelets be normal this week and not normal last week? I don't think I want the vet tech that took Eva's blood near her again with a needle..:angry: She did not bruise at all when they took her blood today, but they did say her skin is quite thin.. anyway..I am happy Eva is feeling good and her platelets are up..this is great news for sure!:wub:



Happy news!! Glad for you, Eva will be in my prayers and thoughts. And you too!


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## Yogi's Mom (Jan 6, 2013)

*Dear April & Eva I Cant chime in on all this medical Stuff.*
*But it sure seems like some Fantastic posts you have had.*

*I Just Want to say I Wish all the best for the both of you. I See this has been alot to deal with for Eva and You. Best Wishes And Hope Nothing but positive results will be all you get from here on, Nickee**


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## Rocky's Mom (Apr 10, 2010)

Sounds like good news April!


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## aprilb (Jul 9, 2010)

mysugarbears said:


> So happy to hear that Eva's platelets are up but don't quite understand what they want to do surgery for, i have to agree with Cathy about the scintigraphy and diet and liver support. I'm glad that your taking her elsewhere to get another Protein C test done. Hugs to you and Eva.


Thanks, Debbie..me, too



hoaloha said:


> That's great news about the platelets, April!!! I definitely would NOT jump to exploratory surgery. Scintigraphy is the next step to evaluate for shunt as mentioned. You are a great mommy. Kisses to Eva :wub:


Thanks, Marisa! 



Sparkle'sMom said:


> Happy news!! Glad for you, Eva will be in my prayers and thoughts. And you too!


Thank you so much



Yogi's Mom said:


> *Dear April & Eva I Cant chime in on all this medical Stuff.*
> *But it sure seems like some Fantastic posts you have had.*
> 
> *I Just Want to say I Wish all the best for the both of you. I See this has been alot to deal with for Eva and You. Best Wishes And Hope Nothing but positive results will be all you get from here on, Nickee**


Thank you..


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## aprilb (Jul 9, 2010)

Rocky's Mom said:


> Sounds like good news April!


Thank you, Dianne..I think so, too.


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## elly (Sep 11, 2006)

I just want to add that Ellie appeared to be a healthy, active, happy puppy and young adult. I never had any problems with eating or weight. I am not trying to scare you I just want you to keep a very close eye on her. She was dx with MVD after her Scintigraphy. Her liver and other organs were normal size on ultrasound. She started to have problems at the age of 3 and they came on really fast. I hope and pray that Eva will not have any more problems.


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## edelweiss (Apr 23, 2010)

Cathy, what kind of issues did she have and was it a shunt after all? 
My concern w/Eva is the ALT results---but maybe that was from the chicken. I think they were high before this last batch though, not sure how high. But rising ALT is indicative of something that needs to be kept under control.


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## donnad (Aug 22, 2006)

Glad all went well...kisees to Eva.


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## elly (Sep 11, 2006)

edelweiss said:


> Cathy, what kind of issues did she have and was it a shunt after all?
> My concern w/Eva is the ALT results---but maybe that was from the chicken. I think they were high before this last batch though, not sure how high. But rising ALT is indicative of something that needs to be kept under control.


Ellie did not have a shunt. I really do not know exactly what was wrong with her liver. She always had high ALT and Bileacids. She had a portal scintigraphy and it did not show a shunt. I was told by the doctor she would live a normal life, she had MVD? Her other organs all appeared normal in size on ultrasound. At the time of the scintigraphy she was eating well and appeared healthy. My plans were if she had a shunt to have the surgery and spay at the same time. She was almost 3. I scheduled the spay and her ALT was close to normal, I was so happy. The doctor did her spay and found fluid in her tummy this was the start of all the other problems. After the spay the she started a decline, losing weight she was dx with pancreatic insufficiency. We got that under control and than I noticed her urine was orange. I took her in and she was also jaundice. They tested and her ALT was over 1000. She had also started vomiting. We went right over to the specialist, they did an ultrasound and again everything looked mostly ok. She was also having trouble walking on slick floors and she could not judge distance. She had a seizure a few weeks later and it was a long one. I had her PTS a couple days later.


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## aprilb (Jul 9, 2010)

elly said:


> Ellie did not have a shunt. I really do not know exactly what was wrong with her liver. She always had high ALT and Bileacids. She had a portal scintigraphy and it did not show a shunt. I was told by the doctor she would live a normal life, she had MVD? Her other organs all appeared normal in size on ultrasound. At the time of the scintigraphy she was eating well and appeared healthy. My plans were if she had a shunt to have the surgery and spay at the same time. She was almost 3. I scheduled the spay and her ALT was close to normal, I was so happy. The doctor did her spay and found fluid in her tummy this was the start of all the other problems. After the spay the she started a decline, losing weight she was dx with pancreatic insufficiency. We got that under control and than I noticed her urine was orange. I took her in and she was also jaundice. They tested and her ALT was over 1000. She had also started vomiting. We went right over to the specialist, they did an ultrasound and again everything looked mostly ok. She was also having trouble walking on slick floors and she could not judge distance. She had a seizure a few weeks later and it was a long one. I had her PTS a couple days later.


Gosh Cathy, how awful and scary...I'm so sorry..according to my research, MVD will usually begin to show symptoms around age 3-4 if it is a more severe case. I do not want to scare anyone, because some of them never have symptoms..I am waiting to hear from my vet regarding what we will do next...you can be sure I am watching Eva...I am waiting to hear from my vet about diet and liver support for her..and then I will repeat blood/chem panels and protein C tests at a later date to see how she is doing...will probably have to do the panels from now on...to monitor her... portal scintigraphy would be next if we cannot get her ALT under control,  it continues to rise, and/or she becomes symptomatic..My first Maltese had terrible liver disease..not sure exactly what...we did not have the tests we do today...even so, he lived to be 10 years old... much longer than any of the vets thought he would...Noah was a sweet boy...I still miss him...we just do the best we can for them..there are no guarantees, unfortunately..((hugs))


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## aprilb (Jul 9, 2010)

edelweiss said:


> Cathy, what kind of issues did she have and was it a shunt after all?
> My concern w/Eva is the ALT results---but maybe that was from the chicken. I think they were high before this last batch though, not sure how high. But rising ALT is indicative of something that needs to be kept under control.


Her last ALT was 154....I am wondering if feeding the chicken contributed to the jump to 335..that is if this reading was correct..same draw as the platelets and these tests were done in the office..next time, I will have them sent out..


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## MalteseJane (Nov 21, 2004)

So glad the platelets are okay now. If it would not be for the bruising, I would say it was a fluke. But with bruising, not so sure. And they can go up and down. Just watch her closely for signs. As for the surgery, I agree with everybody else.


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## ckanen2n (Jan 2, 2012)

Hi! April, 
I too think you should dig deeper and resist surgery until this is thoroughly sorted out. I'm so glad Eva is feeling fine and her platelets are back up!


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## Snowbody (Jan 3, 2009)

Just checking in today...btw, April, I seem to recall you were sending some test results to Dr. Center at Cornell. Are you having copies of the ultrasound sent to her too just to run it by them?


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## aprilb (Jul 9, 2010)

donnad said:


> Glad all went well...kisees to Eva.


awe..thank you, Donna



Snowbody said:


> Just checking in today...btw, April, I seem to recall you were sending some test results to Dr. Center at Cornell. Are you having copies of the ultrasound sent to her too just to run it by them?


 I have not sent any test results to Dr. Center...I will give it some thought...thanks for checking in:wub:


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## Tanner's Mom (May 27, 2005)

aprilb said:


> Her last ALT was 154....I am wondering if feeding the chicken contributed to the jump to 335..that is if this reading was correct..same draw as the platelets and these tests were done in the office..next time, I will have them sent out..


April, Tanner only eats chicken--canned Holistic Select Chicken & a handfull of boiled chicken breast. His ALT has been as high as the 900's and was normal back in September. I wouldn't think chicken would cause an ALT jump.


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## aprilb (Jul 9, 2010)

MalteseJane said:


> So glad the platelets are okay now. If it would not be for the bruising, I would say it was a fluke. But with bruising, not so sure. And they can go up and down. Just watch her closely for signs. As for the surgery, I agree with everybody else.


Thanks, Janine...I will definitely watch her...



ckanen2n said:


> Hi! April,
> I too think you should dig deeper and resist surgery until this is thoroughly sorted out. I'm so glad Eva is feeling fine and her platelets are back up!


Thanks, Carole..



Tanner's Mom said:


> April, Tanner only eats chicken--canned Holistic Select Chicken & a handfull of boiled chicken breast. His ALT has been as high as the 900's and was normal back in September. I wouldn't think chicken would cause an ALT jump.


Thank you, Marti..I was wondering about that..:wub:


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## elly (Sep 11, 2006)

Tanner's Mom said:


> April, Tanner only eats chicken--canned Holistic Select Chicken & a handfull of boiled chicken breast. His ALT has been as high as the 900's and was normal back in September. I wouldn't think chicken would cause an ALT jump.


When Ellie was dx with PI and Liver Disease feeding her was a challenge. My vet contacted UC Davis and they created a diet based on her needs. It was chicken thighs, white rice, peas and supplements. I know many people do not like Hills L/d but Ellie loved it and did well on it until she had the problems with PI.


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## Ladysmom (Oct 19, 2004)

aprilb said:


> Her last ALT was 154....I am wondering if feeding the chicken contributed to the jump to 335..that is if this reading was correct..same draw as the platelets and these tests were done in the office..next time, I will have them sent out..


I agree with Marti. Chicken wouldn't make her ALT rise. Red meat is the one that contains so much ammonia and is hard for a dog with a compromised liver to process. Lady did fine with chicken after she developed liver damage from years of phenobarbital for seizures.

I'd just have the specialist redo the bloodwork to see if maybe the draw itself caused the skewed results, then proceed from there.

If Eva's ALT is still high, I'd ask your vet about adding milk thistle and/or Denosyl along w at one point, but after just six months on a homecooked diet for dogs with liver disease and both Marin (milk thistle) and Denosyl, it went back down into the normal range! :chili:


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## harrysmom (Sep 28, 2007)

Ladysmom said:


> I agree with Marti. Chicken wouldn't make her ALT rise. Red meat is the one that contains so much ammonia and is hard for a dog with a compromised liver to process. Lady did fine with chicken after she developed liver damage from years of phenobarbital for seizures.
> 
> I'd just have the specialist redo the bloodwork to see if maybe the draw itself caused the skewed results, then proceed from there.
> 
> If Eva's ALT is still high, I'd ask your vet about adding milk thistle and/or Denosyl along w at one point, but after just six months on a homecooked diet for dogs with liver disease and both Marin (milk thistle) and Denosyl, it went back down into the normal range! :chili:


Chicken actually causes Harry to have a lot of issues. Last summer when, for some reason :blink:, I decided to add a little chicken to his food, we had a very serious problem with him because of the ammonia. The doctor said it was hepatic encephalopathy due to the chicken, so I believe that chicken can cause problems for these little guys who are liver compromised. Harry has a special diet and for the last year he has also been eating Royal Canin Hepatic L/S and he's doing well on it.


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## Ladysmom (Oct 19, 2004)

harrysmom said:


> Chicken actually causes Harry to have a lot of issues. Last summer when, for some reason :blink:, I decided to add a little chicken to his food, we had a very serious problem with him because of the ammonia. The doctor said it was hepatic encephalopathy due to the chicken, so I believe that chicken can cause problems for these little guys who are liver compromised. Harry has a special diet and for the last year he has also been eating Royal Canin Hepatic L/S and he's doing well on it.


Thanks for clarifying that! What do you feed Harry then? Just fish and dairy? Lady ate mostly cod or pollack, cottage cheese and eggs, but did fine when I used chicken occasionally.


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## aprilb (Jul 9, 2010)

Ladysmom said:


> I agree with Marti. Chicken wouldn't make her ALT rise. Red meat is the one that contains so much ammonia and is hard for a dog with a compromised liver to process. Lady did fine with chicken after she developed liver damage from years of phenobarbital for seizures.
> 
> I'd just have the specialist redo the bloodwork to see if maybe the draw itself caused the skewed results, then proceed from there.
> 
> If Eva's ALT is still high, I'd ask your vet about adding milk thistle and/or Denosyl along w at one point, but after just six months on a homecooked diet for dogs with liver disease and both Marin (milk thistle) and Denosyl, it went back down into the normal range! :chili:


Thanks, Marj...even if the ALT is not accurate, remember Eva already has a history of ALT elevations...so my vet is working on this even as we speak... she is talking to someone now at University of Tenn ...I will probably do a homemade diet for her..she's only 5 pounds, so I wouldn't have to cook that often...I have already told the vet that I am not open to prescription food... my first Malt had chronic hepatitis and was on prescription food for awhile..but when he started to go downhill, a homemade diet formulated just for him made all the difference...I have decided to begin treating her with diet and liver support, and then check her levels again in 2-3months..btw, she has been a "wild thing" this morning..:HistericalSmiley::wub:



harrysmom said:


> Chicken actually causes Harry to have a lot of issues. Last summer when, for some reason :blink:, I decided to add a little chicken to his food, we had a very serious problem with him because of the ammonia. The doctor said it was hepatic encephalopathy due to the chicken, so I believe that chicken can cause problems for these little guys who are liver compromised. Harry has a special diet and for the last year he has also been eating Royal Canin Hepatic L/S and he's doing well on it.


Thank you, Debbie...I will mention this to my vet..


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## Ladysmom (Oct 19, 2004)

aprilb said:


> Thanks, Marj...even if the ALT is not accurate, remember Eva already has a history of ALT elevations...so my vet is working on this even as we speak... she is talking to someone now at University of Tenn ...I will probably do a homemade diet for her..she's only 5 pounds, so I wouldn't have to cook that often...I have already told the vet that I am not open to prescription food... my first Malt had chronic hepatitis and was on prescription food for awhile..but when he started to go downhill, a homemade diet formulated just for him made all the difference...I have decided to begin treating her with diet and liver support, and then check her levels again in 2-3months..btw, she has been a "wild thing" this morning..:HistericalSmiley::wub:


Glad she's been a wild thing! :aktion033:

University of Tennessee is a fabulous resource for dogs with liver issues. :thumbsup:

I feel the same way about prescription food. I refused to feed it to Lady so I started homecooking for her. Now I am homecooking for Bailey because he had colitis a couple of times. :smpullhair: The next step was tests and a prescription diet so I tried homecooking and probiotics to see if that helped. He's been fine ever since so I guess I am stuck with homecooking for him, too. It's a real PITA, but worth it.


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## aprilb (Jul 9, 2010)

For those that are interested, I talked to my vet today about the chicken I was feeding Eva, and she said that the extra protein could have influenced her labs...interesting...


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## Super3*k (Feb 26, 2013)

Sorry April..didn't see this post...good luck to you. I hope you keep us posted as to how Eva does with your cooking. I just lost my Kirby..he wasn't even 5... He had urate stones and a liver shunt...so very interested in food for a new puppy. Take care.


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