# has anyone NOT spayed? - Gracie's test is back :(



## Grace'sMom (Feb 22, 2012)

Gracie's test is back - they rushed it for me. Dr. Julie called because it just came in...

Her levels were 3 times what they should be.... Even pre-feed they were 3 times higher. And she hadn't eaten all day.

The vets are talking together - to discuss options. Since they agree a biopsy at this point with all the tests and the ultrasound wouldn't change the diagnosis- MVD - they said they could have her in and out in 20 minutes with the spay and dew claws.

But at this point - I'm freaking out. This is her highest test. I know it's because for awhile she was eating way too much protein because my sister was feeding her things without asking. Bacon and french fries and grilled cheese. Sigh.

 Could kick myself for not yelling at her.

I don't know what to do now. My mom and I don't want Grace to not survive surgery.

If this is too big of a risk... I don't want to do it.

Has anyone NOT spayed? And not just for breeding purposes or showing, but for a pet - not spayed.

If so - how hard was it, really? Like honestly - how hard was/is it?

Did your dog get infections?

What are the risks of not spaying?

Grace isnt' around strange dogs - thanks to her inability to have vaccines. The only dogs she is around are fixed. So puppies are not an issue.

Would having her not spayed cause problems between her and Gus?

Or would it just be her wearing a diaper for a few days a month?

I don't even know how long a heat lasts or how often it happens!!

Are there any health issues that spaying prevents that she'd be at risk for? Things that would shorten her life?

At this point I don't know what to do.

Dr. Julie is calling the specialist someone gave me here to talk to them.

But she says her levels may never go down much. But that with diet and treatment she can be symptom free and still live a long life.

So if her levels never go down.... we either risk the spay now and just pray she makes it through. Or we don't spay her.

Need some thoughts on this....

Thanks.
Tori


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## shellbeme (Mar 1, 2011)

Tori it does not make you a horrible person if you don't get her spayed. It won't make you evil, or irrisponsible, she's your pup and you have her best interests at heart, I support whatever you decide.

If I were in your position, I would take to heart what the specialist says and go from there. People have all kinds of opinions on spaying and neutering, and I am strong supporter of having it done-however if it poses health risks you have to weigh that yourself. If she was mine, I am not sure I would have it done with her current state of health. (having said that, it doesn't make you bad or evil or irrisponsible if you DO decide to go forward with it)

If and when things normalize for her, you can always do it later if you feel the need.


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## Furbabies mom (Jul 25, 2011)

If it were too big of risk to have her spayed, I would not do it.


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## Grace'sMom (Feb 22, 2012)

I guess I need to know what to expect....

Because I've never had a dog who wasn't fixed. Ever.

How long is a heat?

how often?

How long do does have heats? All their lives? or do they stop when they are older?

Will she develop cancer?

Would a bacterial infection be just as risky and hard on her system as a spay?

Is there a book anywhere that explains this LOL

Thank you for the kind words, Shelly.



And yes - if they do normalize we could spay her then.... you are right.

Tori


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## zooeysmom (Aug 1, 2011)

Because of Grace's health, I don't blame you a bit for being nervous about the spay. What does the vet say? How risky does she feel it is? 

Female dogs who are not spayed run a much higher risk of reproductive cancers/mammary tumors--the risk goes up even if they have one heat, and it increases with subsequent heats. 

Gus may try to mate with her when she's in heat. The heat lasts about a month, and they go into heat twice a year. So yes, she'd have to wear a diaper during that time.

If you do decide to go ahead and spay her, I would do it ASAP. Otherwise, if you're not comfortable with it, don't do it. You have to make the right choice for you and Grace--not an easy one, I know.

Hugs,


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## zooeysmom (Aug 1, 2011)

Dogs go into heat their whole lives. Humans are the only species to go through menopause.


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

I know it's because for awhile she was eating way too much protein because my sister was feeding her things without asking. *Bacon and french fries and grilled cheese*. Sigh.

Holy Cow! It's a wonder Gracie didn't get pancreatitis eating that stuff. You need to have a looong talk with your sister, that is simply horrible in my book. For heaven's sake get Gracie away from your sister. She is dangerous to that baby's life!

I have an MVD dog, he is 8 years old, he eats a low protein canned food, and he is doing fine. He is also neutered. I imagine that once you start feeding Gracie good food, her bloodwork may be better. Tanner's ALT has ranged from a high of 900 several years ago to a low of 119.


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## edelweiss (Apr 23, 2010)

Grace'sMom said:


> Gracie's test is back - they rushed it for me. Dr. Julie called because it just came in...
> 
> Her levels were 3 times what they should be.... Even pre-feed they were 3 times higher. And she hadn't eaten all day.
> 
> ...


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## Sylie (Apr 4, 2011)

I'm not clear on what your vet advised you to do about the spay. Do the vets believe it to be life-threatening.
A couple of other things to consider: an estrus cylcle is VERY uncomfortable for the girl. To put it bluntly, she gets so horny she is nuts.
The other is the possibility of pyometra. A very serious uterine infection which requires an immediate hysterectomy IF it is diagnosed in time. MiMi's breeder almost lost MiMi's beautiful grandmother to pyometra.
So, weigh the pros and cons and make the best educated decision for you and sweet Gracie.


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## hoaloha (Jan 27, 2012)

Tori, I am so sorry that Grace's BAT results were elevated  I read your update in the other thread as well--- from my understanding, canine hepatic MVD is usually a congenital issue. I know that acquired shunts can develop but I'm not sure of acquired MVD. How do they know it's MVD and not another source liver dysfunction? Bile acid test is a sensitive test but is not specific just to MVD or shunts. I don't think MVD itself is a contraindication to surgery-- what specific values are the vet surgeon concerned about in her bloodwork? It's your choice because you're her mama. I'm one of those people who want to know answers, so if she is able to have surgery and the biopsy is safe, I'd opt to do it because it seems like we don't have a complete answer yet. But, I can definitely understand the thought not to do the procedure. Have they thought of doing scintigraphy and protein C test? I'll keep you both in my thoughts and prayers :hug:


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

Tori -- to answer some of your questions:

1. A heat cycle lasts approximately 30-32 days with bleeding lasting about 10 days in the middle of the heat cycle.

2. Most females come into heat twice a year -- approximately every 6 months.

3. Gracie would be at risk for Pyometria - this is an infection to her uterus that would come right after she is in heat and is life-threatening. It can be addressed with anti-biotics most of the time.

4. Gracie would be at risk for breast cancer. The risk is almost totally eliminated if she is spayed prior to her first heat. If she is spayed after that, the risk goes down significantly.

5. Gracie would also be at risk for uterine and ovarian cancer and that risk would be totally eliminated if she was spayed.

With that said, however, I have had a number of females that weren't spayed until they were 7-8 due to breeding and NONE ever got cancer of any type or Pyometria. The risk of contracting Pyometria is higher after a litter is born and there is possibility of infection in the uterus. It is not as high of a risk simply from a heat cycle.

As everyone else has said, I would wait and see what the Specialist says regarding the risk of spaying and go from there. 

Sending prayers for Gracie.


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## Grace'sMom (Feb 22, 2012)

What is scintigraphy?

I'll meet with them sometime next week to discuss things.

Our vet and the vet who does the surgeries need to talk things over, and decide how to proceed.

If the vet who does the surgeries says it is still safe, we will spay her.

So the last draw - she is 49.8 - vet says the "normal" should be 14.9

Her one before this test was in the high 30s, so this BAT is worse than the last one.

Her ALT was 387, which hasn't changed.

But her kidney levels are much better.

I don't want a biopsy done.

Grace is a bleeder. And her vet and I talked it over... she was concerned about doing it yesterday because it took Grace forever to stop bleeding from the draws. When they do the biopsy they wait until the holes stop bleeding, I guess.... and that may take a long time for Grace which means a longer time under.

She has liver damage. If it is HMD or MVD... . or just liver damage - her treatment won't change. So I don't feel a biopsy is worth the risk.

She had an ultrasound done in May - everything looked normal. Her liver was normal size, looked fine. Her kidneys were okay. Nothing he could see.

It's her blood work and her symptoms - lack of appetite, lethargy, problems with too much protein - she stops eating if I feed her too much protein. We've known from early on after the vaccine accident happened that Grace had liver problems due to that.... We just didn't know the extent of the damage. And if she was predisposed to a liver problem - it may have just made it worse.

I don't know.

I'm just trying to figure things out.

If we don't spay her - what am I looking at?

Because I honestly don't know if right now is the right time.

Maybe we wait a year.... spay her when she's closer to 2 years.

She hasn't gone into heat yet.

I just want to be informed. I don't want to do the surgery if the risk of her not waking up is too high.

I just wanted to know the risks and realities of a dog going in heat - because I've never dealt with it before. So until after I talk to the vets.... I just need to educate myself.

Tori


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## Grace'sMom (Feb 22, 2012)

Lacie's Mom said:


> Tori -- to answer some of your questions:
> 
> 1. A heat cycle lasts approximately 30-32 days with bleeding lasting about 10 days in the middle of the heat cycle.
> 
> ...


Thank you Lynn.

I was wondering that - just postponing her spay until we know more and she is older. I did think: Breeders wait all the time to breed puppies....

I will wait to hear what the vets say and figure out where to go from there.

So one month - 10 days bleeding, twice a year.... 

Wish we could have it that way LOL

thanks again


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## edelweiss (Apr 23, 2010)

Tori, your vet will help you decide but those values are not bad for BAT---for a maltese anything over 25 is considered a liver issue---mostly w/this it would be MVD. It isn't that different from Lisi's. The ALT could just be from some of the meds she has been on, or supplements or ??? Many things affect ALT---I would be more concerned that she has had way too much protein, to be honest. 
If it were me I would not do the biopsy but would definitely consider the Protein C. JMHO


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## Grace'sMom (Feb 22, 2012)

Sandi,

Do you know how much the Protein C test costs?

And how long does it take to get back, usually?

Anything over 25 is a liver issue for a malt.... Grace's is double that.

She's been back on her other diet for awhile now. High carb, low protein. And keeping her away from my sister's house, so hoping that minimizes table scraps.

She still has "bad days" - not eating, refluxing, really red eyes, no energy, etc.

She is on supplements for her liver and kidneys - Hepatic support, Milk Thistle. They should be helping her liver not making it worse....



Thanks


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## harrysmom (Sep 28, 2007)

Tori,

I was relieved to read in your last post that you're not doing a biopsy. I understand that a biopsy may be warranted in some cases, but if the liver has a ton of veins in it (as my Harry's does), a biopsy may cause the dog to bleed to death. And you're also right about the treatment not changing.... so there is little benefit to a biopsy at this point.

Harry's ALT in May was 233 and that's the best it's ever been. Since Harry's liver is so messed up, the vets at Cornell thought it would be best not to neuter him. However, 3 or 4 years ago, he got a prostate infection that went systemic and he had to be neutered. And even with all of that going on he came through the surgery with flying colors. He also had a dental the following year and had no problem with that either. 

I hope that the specialist your vet is going to call is Dr. Sharon Center at Cornell. She is the expert that I would want my vet to consult and she is the doctor that initially treated Harry. 

You don't have an easy decision to make, but hopefully your vet or a specialist will have some answers for you to help you out. 

Please keep us updated.
Hugs.
Debbie


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## Grace'sMom (Feb 22, 2012)

Debbie,

I gave her Dr. Center's number. And I just emailed her about the Protein C test.

Thanks 

May wait a year.... will see what the vet says. But may wait a year.

Thanks everyone for the support and kind words...

Tori


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

I think you should take one step at a time and not go ahead right now. My previous furbaby was not spayed. She also had MVD. But waiting for now seems to be the right thing for you to do. You can do it next year or so....if things work out that way. There is no right or wrong so whatever is in Grace's best interest is the way to go. :thmbup:


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## jmm (Nov 23, 2004)

If my dog had those bile acids numbers (and heck that ALT) I'd be throwing myself a party. Those are very reasonable and I would not be pursuing a GENETIC shunt based on those. I would, however, be getting an internal medicine consult before any further decisions. You need a real sit-down with an expert about liver damage, other possibilities (acquired shunts), and treatment. If your dog truly has clotting issues, that needs to be looked into. Has she had a PT/PTT done?


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## Grace'sMom (Feb 22, 2012)

Thanks Barbara


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## jmm (Nov 23, 2004)

BTW, it is a fallacy that only the post # matters. About 30% of dogs may have their numbers reversed, so the pre may be elevated. Paired samples for bile acids are essential.


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## Grace'sMom (Feb 22, 2012)

jmm said:


> If my dog had those bile acids numbers (and heck that ALT) I'd be throwing myself a party. Those are very reasonable and I would not be pursuing a GENETIC shunt based on those. I would, however, be getting an internal medicine consult before any further decisions. You need a real sit-down with an expert about liver damage, other possibilities (acquired shunts), and treatment. If your dog truly has clotting issues, that needs to be looked into. Has she had a PT/PTT done?


Thanks jmm.

I don't feel it is genetic, and the vets don't either.

One of the side effects of the vaccine accident - accidental injection of intranasal bordetella - IS liver damage. It's just we didn't know to what extent or if it would get better over time...

So they aren't looking for a shunt. The HMD/MVD diagnosis is just... the easiest thing the vet could relate it to.

What is a PT/PTT?

A Protein C test wouldn't be helpful for Grace since her issue is liver damage - whatever is going on is caused by that damage.... would it?

Really- I know it is not a shunt. And it isn't genetic.

This is a result of that incident. And so yeah.

I will wait on the vets - spay is canceled for now.

I will ask for a referral to a specialist in the area while there....

Thanks again,
Tori


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## jmm (Nov 23, 2004)

PT/PTT are two important clotting tests. Your vet draws blood in a blue top tube (filling it completely) and sends it to an outside lab (though some large referral centers may be able to do this in house). 

MVD the dog is born with. It is basically microscopic "dead ends" in the liver. 

Liver damage from other things can cause fibrosis, inflammation, etc. These need to be addressed. IMO it sounds like your vet has done what they can. It is time for a specialist. 

Dogs with liver damage can get acquired shunts. 

I see no reason to rush into any surgery until your dog is properly worked up. 




Grace'sMom said:


> Thanks jmm.
> 
> I don't feel it is genetic, and the vets don't either.
> 
> ...


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## Ladysmom (Oct 19, 2004)

Tori, those are not terrible numbers. Anything less than 25 is considered normal for a pet Maltese who will not be bred. I think less than 15 is the number used for a breeding dog.

Gracie most likely has MVD. We have had many Maltese here on SM who have MVD and been spayed or neutered with no problem. With that said, there is no urgency to get her spayed before she comes into heat. The risk of cancer only rises to 7% if you get her spayed before her second heat. It jumps to 25% after her second heat so you'd want to make that decision before then.

Since you have a neutered male in the house, I would strongly consider getting Gracie spayed. Gus will react to Gracie being in heat even though he is neutered. A month is a long time to live with a panting, whining male who will still try to mate with her. Neutered males can even tie with females so you will have to keep them apart so neither one will be injured. Although Gracie can't get pregnant, false pregnancies are a possibility.


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## aksm4 (Nov 28, 2011)

Hello Tori ,

im so sorry about Gracies bat test , but just to give you some comfort Becky pre was 9 and post 129 much higher than Gracies not that im trying to say its ok but Becker number double Gracies and she is still playing , eating her canned l/d by force and acts normal , i am goint to do Protein C tomorrow for Becky my vet research everything and said yes we go for it ...she had never heard of this before and i gave her all the info she checked everything out and spoke to someone in the u.s.a because im in Canada and we are doing it tomorrow )))) i do not know if i should be happy or sad , the test is costing me 50 dollars and the shipping is where im afraid from Canada to \united States is my expense also .....from the courrier my vet uses she will get me clinic price , we need to know if its mvd or shunt because treatment not the same .....i believe the intern told her mvd dogs do better with vegetables diet ....we shall see but keep me posted , plese try not to worry ......


love 


Anna oxxoxo


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## gopotsgo (May 21, 2009)

Grace'sMom said:


> What is scintigraphy?
> 
> I'll meet with them sometime next week to discuss things.
> 
> ...


Tori, it sounds to me like your vet isn't an expert in the problems you have. That is OK, vet med is like human med, you cannot be an expert in everything. However, you need more help now. Gracie is at an age that a liver shunt will become apparent, she is acting like a liver shunt dog, not eating. However, her numbers aren't as bad as liver shunt dog usually are. But I always say, look at the patient, test numbers can only take you so far. We have mentioned to you before, an ultrasound is NOT the best way to catch a shunt, scintigraphy is. You simply cannot exclude a shunt based on an ultrasound. Please be very careful about the diet you have her on, the "prescription diet" is IMO, crap. At least you have her on Milk Thistle. My Stormy had very similar test numbers with the exception she did not act like a liver shunt dog, she had a good appetite. Her numbers self corrected after the diet I had her on. She also was noted to bleed easily. My very astute vet diagnosed Von Willibrand's disease, VERY rare in Maltese. We did have her spayed. We went through one heat cycle with her, she went into heat at 6 months! It was horrible, I never want to go through that or wanted Stormy to go through that again. Given her VWD she needed special transfusions to have her spay. Thank God we knew about her VWD or she could have bled out during surgery. If you are wondering about costs, in my area, a scintigraphy will cost about $500. Stormy's spay was over $1200. Yup, an expensive pup, but worth every penny and more. Good luck.


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## Grace'sMom (Feb 22, 2012)

Grace does not have a shunt. My gut tells me it is not a shunt.

This whole thing has been so nerve racking for me and I need to just remember to listen to my gut. I know my Gracie best 

We know she has liver damage.

When she was 14 weeks she was mistakenly injected with the Intranasal Bordetella vaccine (nose drops) into her leg.

She went from a healthy puppy to being a very sick puppy. We knew after that vaccine that her liver was compromised because of the mistake.

But, we were doing a "wait and see, hope and check" approach. Hoping that her liver would heal itself.

Seeing as it hasn't, we can assume it is a more permanent condition.

I will talk to the vets. I will ask for a referral. They may already be finding one for me, I don't know.

Even with a specialist - it won't change that her liver was damaged by that vaccine. :angry:

Grace's main treatment will be diet and supplements - supporting her liver and kidneys, helping her detox, and lowering inflammation. I am not a fan of medication unless absolutely necessary. Especially for a dog with liver problems. Why tax her kidneys even more?

I'm a believer that nature has powerful healing medicines, and I will do my own research if necessary. I will work with our holistic vet.

I also know that even though her levels may not be as high as some others here are: Grace is showing symptoms that her liver is not functioning properly. So I have to view her results as high for her. I don't know how high they are for toy poodles, but being a mix, it's hard to say genetically where she will fall.

Then again - this is not genetic. It was a vaccine injury.

I thank all of you for your help and your concern.... I always appreciate it, and I know you care 

Gracie says thank you, too.

Her spay is off for now....

Tori


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## zoostation (Jul 20, 2012)

If it were my dog I would wait on spaying a while, including permanently if necessary. She sounds like she's a delicate girl in a very fragile state right now to me. Just my layman's opinion.


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## Ladysmom (Oct 19, 2004)

Grace'sMom said:


> When she was 14 weeks she was mistakenly injected with the Intranasal Bordetella vaccine (nose drops) into her leg.
> 
> She went from a healthy puppy to being a very sick puppy. We knew after that vaccine that her liver was compromised because of the mistake.
> 
> ...


Tori, I am a little confused. You said in an earlier thread that Grace had a vaccine reaction. The intranasal drops being injected into a leg was just an anecdotal story your vet told you about a vaccine error they had made on another dog in their practice.

"She showed me EVERYTHING. And I was honestly convinced that Grace didn't have a mistaken vaccine. But that it was a really bad vaccine reaction.

She did tell me that they have had a vaccine mistake in the past - years ago - a new tech put a needle on the nose drops. But that it was quickly discovered at the same appointment and the dog was treated.

So if a mistake did happen, she would tell me. But after looking at Grace's chart, she really feels that Grace just had a terrible reaction."

http://spoiledmaltese.com/forum/49-anything-goes/119755-update-grace-vet.html#post2028279

I think you are understandingly overwhelmed by all of this. I know you love Dr. Julie, but as a holistic vet she may not be able to diagnose Grace since it is such a complicated case. I really urge you to not worry about the spay right now and just focus on finding a specialist who can sort all this out.


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## Grace'sMom (Feb 22, 2012)

I know - when I had that meeting with the other vet office where the incident happened I did feel like it could have just been a vaccine reaction.

But I still wonder because I haven't heard back from them - called them and they said the partner vet will call me in a few weeks.

I never heard back about the stickers on her chart, and I still ... I don't know. 

this is overwhelming, yes.

But I still get the voice in the back of my head saying it was what I thought - it was the wrong vaccine. When it first happened and she first got sick - that is what I knew it was. I was in the room. I saw the injection given.

Every time Grace has a symptom flare that nags at me.

So even though at the time of that meeting I was fairly appeased - I'm not in the long run. I still question it and am doubtful. I still go with my first gut reaction that it was a mistake... 

And she's paying for it with liver damage.

But what's done is done.


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## Ladysmom (Oct 19, 2004)

I know you are convinced Grace has liver damage from the vaccine, but try to be open minded. You said in that same post that Grace had trouble gaining weight as a puppy, even lost weight sometimes. That is not normal for a puppy and can be a symptom of liver shunt.

Even though you say that Grace's breeder did genetic testing, there is no genetic marker yet for liver shunts. I really urge you to consult a specialist for further testing and rule out a shunt.


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## Grace'sMom (Feb 22, 2012)

Thanks.

I will see what they say today.

Grace only had trouble gaining weight after the vaccine at 14 weeks.

She was healthy before that.

In my gut and my heart I know it is not a shunt. That doesn't mean I won't look into it more if her vets feel it should be. At this point her tests and symptoms add up to liver damage.

Like I said - back in June I was comfortable accepting this as a vaccine reaction. But it constantly nags at me that it wasn't, and that I just gave up because confrontation is not my strong point.

But I'm not getting into that again.

Thank you all for caring about Grace. I will take everything into consideration.

blessings,
Tori


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## brendaman (Mar 7, 2006)

Tori,

Last month, we had scheduled a spaying for Kayla. A few weeks before the scheduled spaying, I had the vet do a BAT on her. Her results were 65.3 pre-prandial and 37.7 post. I didn't know what to make of the results. My vet was not experienced in this and suggested the ultrasound and for us to see a specialist/internist. We discussed doing a Protein C test. I sent an email to Dr. Center, but never received a response. I did see some posts on SM from Jackie/JMM and MaryH that such tests may indicate MVD. My choice was to do nothing or continue the testing. Kayla was not exhibiting any symptoms of a dog with "liver issues". Yes, she could be MVD. But the bottom line is that I really wanted the BAT as a baseline, so Kayla's results are there as a baseline. I will ask for a retest at some point, especially if she starts to exhibit symptoms. If her BAT results were over 100, then I would be going to a specialist, and insisting on the Protein C. 

We did put a hold on the spaying as at the time, Kayla weighed a little over 3 pounds. I also needed time to digest all the info and do more research. Last week, we had a full blood panel done on Kayla and the results came out normal (a blood test, of course, isn't as thorough as a BAT in determining "liver issues"). Kayla weighed 3 lbs. 13 oz., a few ounces short of 4 lbs. We therefore decided to have Kayla spayed as she was already over 7 months old. Even though Kayla still did/does not exhibit symptoms of a dog with MVD or "liver issues," our vet treated her spaying as if she had "liver issues," e.g. used a specific type of anesthetic.

Kayla was spayed 5 days ago, and she's back to her bouncy self. (She was actually her bouncy self the day after surgery, but we didn't allow her to bounce around and rupture her stitches.) I've attached some pics of her -- please excuse the graphic pics with the stitches if you're squeemish. 

I understand the panic, worry and frustration you are feeling. Ultimately, you need to make the decision you are most comfortable with after receiving the necessary info. It does help to talk to a vet specialist/internist who has experience treating dogs with liver issues. You may never know whether the vaccine is what caused Grace's liver damage. It may be best now to treat the symptoms. Dogs can be spayed even those with liver damage. But again, it's best to consult with a veterinary specialist who has experience with small dogs with liver issues.


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