# Grace may have a liver shunt :(



## Grace'sMom (Feb 22, 2012)

We had an appointment for blood work this morning. Just to get it out of the way and make sure Grace's spay was good to go.

But her liver levels are REALLY HIGH.

I wasn't expecting that. Was expecting Dr. Julie to come out and give us the okay to go home and we'd be back Monday for the spay.

But she came back looking really somber and said they called the specialist and he would be in this afternoon to do an ultrasound. That Grace needed it done ASAP because of her blood work.

She said it is one of two things:

1. Grace has a liver shunt

2. The vaccine mistake really damaged Grace's liver 

I don't know which to hope for.

I need a crash course in liver shunts..... really really dumbed down for me (not sure how else to say it).

I know what a shunt is - it means there is a big (or little) vein that her blood is being sent through instead of going through her liver and getting cleaned.

What I don't know:

1. How serious is this?

2. How easy is it to fix?

3. How worried do I need to be going into the appointment this afternoon? I'm kind of freaking because of how somber Dr. Julie was  

4. How soon would Grace need surgery to repair this?


If it isn't shunt..... 

I just don't know. I'm almost hoping it is a shunt. I don't know how repairing her liver would go if it was damaged by that vaccine. If it is that my mother is all ready to go raise ____ (insert your word) with the other vet.... Me - I just want my Grace to be okay 


I'm really sad and scared right now. She looked so ...not her usual self and then they rushed the specialist out for today. That makes me worried. But that is good right? They are taking this seriously and want answers sooner rather than later. The old vet probably would have still spayed her :angry:

But a shunt would account for Grace's vaccine reactions..... and possibly her extremely picky eating? Not drinking much? And her reflux? Would that happen with a shunt?



This sucks.

Tori


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## MoonDog (Jun 6, 2011)

Oh Tori, I'm so sorry to hear this. I don't have any answers for you. I'm sure someone will chime in any second though. I just want you to know I will be praying hard for little Grace. I've already started.


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## edelweiss (Apr 23, 2010)

So sorry to hear this news & I am flying out tomorrow & not much time---not packed even. It is already past 9:00 PM here. 
I had a dog w/liver shunt who was operated. Long story, but he lived to be rather old. He had surgery but started seizing shortly thereafter. Many issues but as I said, long life. So much can be done, even w/liver shunt.
Did you have BAT already? That is VI.
How old is Gracie?
There is also stuff to be done w/high ALT's. I got Kitzi's down after he had too much anesthesia, meds, in a row. It took about a month w/special diet & Sam-E. His BAT was normal & even better than normal.
Hope coming your way!!!!!!!!!!!


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## Furbabies mom (Jul 25, 2011)

Oh Tori, I'm so sorry about Grace. I have no knowledge about a liver shunt or damaged liver. I'm praying that there is some other explanation for this that's easily fixable! Prayers for Gracie!!!


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## Ladysmom (Oct 19, 2004)

Oh, dear. I am so sorry.

Here is a crash course in liver shunts from U of Tenn, one of the experts in the field.

Portosystemic Shunts FAQ

And yes, trouble with vaccines and picky eating are symptoms of a shunt, but a BAT will tell you more.


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## harrysmom (Sep 28, 2007)

Tori,

Harry has a liver shunt that he acquired because his liver is not formed normally. His levels on blood tests are sky high and Despite that he is doing well. All of the things you mentioned, picky eater, etc.. Do not apply to Harry. I was fortunate enough to be able to take Harry to Cornell and have him treated by Dr. Center there. If your baby is diagnosed with a shunt, I would encourage you to have your vet contact Dr. Center. Please don't have any invasive procedures done. A liver biopsy on a dog with a liver issue might not be a good idea. I was told that a liver biopsy would have probably killed Harry. Dogs can live with liver shunts.... Harry is proof of that.

I know that it's very hard, but please take it one step at a time. Let us know what the doctor says.

Sending hugs....
Debbie


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## Grace'sMom (Feb 22, 2012)

What is BAT and VI?

Sorry.... It was a lot to take in at the vet's. So... I don't know if I have that?

Grace has been on special homeopathic treatments for her liver and kidneys and to flush toxins since we started seeing Dr. Julie 2 months ago.

So I think that is why she was shocked at the levels because she is already being supported and treated for things.... I can't imagine the levels if she wasn't on those already.

I'm opting to have an ultrasound done. Because I won't to know for certain if this is or is not a shunt.

Depending on what comes back from that - we will do other tests. Dr. Julie mentioned a blood test they do to test for liver shunts, but said if it came back looking like it was one they would do the ultrasound. 

She urged me to do the ultrasound. So I have a feeling she is thinking that is what this is based on Grace's history but can't say because she doesn't know for sure?

I will read the link.

Thank you!

Prayers are greatly appreciated. I'm so frazzled right now


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## Grace'sMom (Feb 22, 2012)

Thanks Debbie.

We are just doing an ultrasound today.

I forgot... Grace is almost 6 months.

Her kidney levels were slightly high as well. But her liver was the highest.

I won't do any treatment until I read up and educate myself. But I do need to know.

Thank you all

Tori


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## Kaiser (May 10, 2012)

I'm so sorry to hear about your little girl. I don't know much about liver shunts too but your Grace will be in my prayers. I know you'll do the best you can to get her healthy.


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## wkomorow (Aug 26, 2011)

Grace'sMom said:


> Thanks Debbie.
> 
> We are just doing an ultrasound today.
> 
> ...


I am so very sorry. Basically as food is digested, the nutrients pass through the blood stream. Part of the journey is through the liver, where toxins are absorbed and rendered into safe materials. A liver shunt is a blood flow that bypasses the liver. The blood toxins are carried to other organs (such as the kidneys) causing issues. Diet can reduce the effects of a liver shunt and it is possible under circumstances to have surgery which redirects the blood through the liver. Here is an explanation:

Portosystemic Shunts FAQ


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## Snowbody (Jan 3, 2009)

Tori - I'm so sorry about this news. An ultrasound isn't invasive so probably fine to do.I agree with Debbie - Dr. Center is probably the best vet in the country regarding Liver Shunt and vets often consult with her. I just am not that familiar with liver shunt other than what I've read here. Here were two SM stickies on Liver shunts and Bile Acid Tests: http://spoiledmaltese.com/forum/52-maltese-health-behavior/78171-bile-acid-test.html and
http://spoiledmaltese.com/forum/52-...106856-liver-shunt-bile-acid-test-thread.html
Prayers to you and Gracie.


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## Grace'sMom (Feb 22, 2012)

Thank you all. At vet now ... Grace is in back getting her ultrasound done. Will update ASAP


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## Snowbody (Jan 3, 2009)

rayer:rayer:


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## lmillette (Apr 23, 2012)

Prayers to you and Grace!! Sweet little angel!! Keep us posted.


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## Ladysmom (Oct 19, 2004)

Grace'sMom said:


> Thank you all. At vet now ... Grace is in back getting her ultrasound done. Will update ASAP


I was going to tell you that the next step would be a bile acids test (BAT), not an ultrasound. According to Dr. Center and Dr. Tobias, ultrasounds aren't that reliable for detecting shunts in a small dog like a Maltese, only between 65-80% accurate. So no matter what, Grace will still need a BAT.


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## brendaman (Mar 7, 2006)

Oh Tori! I'm so sorry, but I know that you and Tori will have the strength to take what comes your way. And we are here for you!


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## Grace'sMom (Feb 22, 2012)

They didn't find a shunt. Her liver isn't enlarged.

Vet and specialist say it is most likley damage from the vaccine 

Said to work w Dr Julie on supports. Then "hurry and wait" ...meaning detest often and hope it gets better. If not the will do a byopsy.

Sigh. Not a shunted...good! 

But now we wait and hope.


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## Grace'sMom (Feb 22, 2012)

Gah....just read that post. Ok. If levels don't improve next Check we will do BAT..... good to know.


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## Ladysmom (Oct 19, 2004)

Grace'sMom said:


> Gah....just read that post. Ok. If levels don't improve next Check we will do BAT..... good to know.


Please get a BAT. Here is the current protocol from Dr. Center:

http://www.ytca.org/health_biletestproced.doc-1.pdf


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## brendaman (Mar 7, 2006)

Ladysmom said:


> I was going to tell you that the next step would be a bile acids test (BAT), not an ultrasound. According to Dr. Center and Dr. Tobias, ultrasounds aren't that reliable for detecting shunts in a small dog like a Maltese, only between 65-80% accurate. So no matter what, Grace will still need a BAT.


Good point, Marj. I just assumed that they did the BAT already when Tori mentioned that Grace's "liver levels are REALLY HIGH" but then they could have done another type of liver testing (e.g. biliruben test).

 So happy that they've eliminated liver shunt.


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## Summergirl73 (Sep 18, 2011)

Lifting up a prayer for you all Tori. Bless your heart, you must be a bundle of nerves right now . I wish I could help, just know I'm here and sending healing thoughts.


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## Grace'sMom (Feb 22, 2012)

They did not do a BAT.

I will ask about doing it.

The specialist who they brought in is one of the oldest specialists in the area. He is highly qualified and one be one of the few "experienced" vets that could diagnose a shunt via ultrasound.

He also uses the latest ultrasound machine.... real high tech. I don't know much about it...but I did read his information online and talked to him.

Grace's liver is normal size - not enlarged, and not too small (one or the other in dogs with shunts). He did not see a shunt, either.

Her other labs are normal. It is only her liver and kidney levels that are off.

He recommends supportive therapies and close monitoring - frequent liver and kidney panels - to keep track of her levels.

If it goes higher, he recommends a biopsy. Which I know someone posted that a biopsy is dangerous in dogs with shuts. So I will revisit options if it comes to that.

The specialist and the other vet who was with us (Dr. Julie was with another patient) said based on Grace's file and history - This is liver and kidney damage from the vaccine.

They believe me 100% that Grace was mistakenly given the INTRANASAL as an IM injection.

Liver damage and kidney damage are both side effects from such an accident.

We will start the liver and kidney supports, adjust her diet, and hope that the levels start going down.

Until then the spay is off. Dr. Julie said she'd recommend waiting until she is 1 year

Right now I don't know what to do. May open another post since this will go off topic.

Thank you all for the prayers. Glad it isn't a shunt.... but the news is still not great.


Tori


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## lmillette (Apr 23, 2012)

Grace'sMom said:


> They did not do a BAT.
> 
> I will ask about doing it.
> 
> ...


Tori, 

You and Grace are in my thoughts and prayers. I wish I had more information or more comforting words for you at this very stressful time. 

I may have missed a previous thread as I am still new here, but what happened with the vaccine? If you don't or can't talk about those details right now, I completely understand!! 

Keep us posted on precious Grace. 

~Lindsay


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## Grace'sMom (Feb 22, 2012)

Lindsay -

Here is the other post:

http://spoiledmaltese.com/forum/59-...19446-vent-about-graces-vaccine-accident.html


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## Snowbody (Jan 3, 2009)

Tori - I'm so relieved it's not a shunt. I couldn't stop thinking about you and Grace and just prayed it wasn't that. Sounds like you're in good hands. I think I would still recommend the BAT test. All you do is fast Grace overnight, take her in for a blood draw. They then keep her there for a couple of hours and feed her and take another draw. It's quite non-invasive except the blood draw and that way you'll have a level to compare later on, that's quite accurate. We had Tyler's BAT done, just so that we would have a baseline for later in case there were ever any issues, then we would know if it always existed or was new. I remember your thread about the mistaken vaccine. It's infuriating and sad that this could cause liver and kidney issues. And to think they never apologized! I think the old vet should pay for all this. Wonder if a lawyer would give you some guidance or if you have any recourse.


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## aksm4 (Nov 28, 2011)

Sweet Tori im so sorry reading this you have been through so much these days  just letting you know i will be praying for Gracie , please keep us posted oxoxoxoxoxxoxoxooxoxox


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## hoaloha (Jan 27, 2012)

Tori-- I'm just catching up and I'll be praying and hoping that Grace's condition is something that will get better over time. I lost a maltipoo puppy around 8 months old to an unknown liver condition that led to fulminant liver failure and I wouldn't wish ANY other to have to go through that. He was from a BYB before I knew anything about how to find a reputable breeder. How high were her liver enzymes (AST/ALT?) You have our support and I hope that that you can truly clarify what happened with the other vet. There is a nuclear scan that can be done as well if shunt is still in question as well as the bile acid test. **HUGS to you and Gracie and Gus** keep us posted...


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## educ8m (May 19, 2010)

Tori, about two and a half years ago, Cisco's liver and kidney numbers were sky high. I was sure it was the end for him. Luckily I had just changed to a holistic vet and she put him on all natural supplements that completely healed his liver and kidneys. If you can find a vet that carries Standard Process I would RUN to him/her. Cisco is on Standard Process Renal Support, Standard Process Hepatic Support, and Standard Process Whole Body Support. Standard Process Veterinary Formulas - Small Animal
I had two medical experts tell me that they believe Standard Process has kept Cisco alive for the past two years. Best thing I ever did was find a holistic vet. Holistic vets practice traditional medicine, but are trained in holistic practices, too.


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## Ladysmom (Oct 19, 2004)

Snowbody said:


> Tori - I'm so relieved it's not a shunt. I couldn't stop thinking about you and Grace and just prayed it wasn't that. Sounds like you're in good hands. I think I would still recommend the BAT test. All you do is fast Grace overnight, take her in for a blood draw. They then keep her there for a couple of hours and feed her and take another draw. It's quite non-invasive except the blood draw and that way you'll have a level to compare later on, that's quite accurate.


Just an FYI - Dr. Center has not recommended a fast before the BAT for years.

See #2 of her most protocol:

_2. It is NOT necessary to fast a dog 12-hours before collecting the pre-meal or pre-prandial sample._

http://www.ytca.org/health_biletestproced.doc-1.pdf


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## Grace'sMom (Feb 22, 2012)

Deb,

Dr. Julie is a Holistic Vet  You all encouraged me to find one when Grace first got sick from the vaccine mistake 

She started her on the Standard Process Hepatic Support today. She mentioned others, but does like to start her pups on them one at a time. So when we see her next she will add another as long as Grace has done well.

She's also on Thuja (spelling?) - which will help her body detox. I think that has helped her big time. Without it I'm sure she would have been much sicker 

She's on Traumeel

A good probiotic and multivitamin from Dr. Julie.

So we are getting there....one thing at a time  I'm hopeful that she will recover.

Dr. Julie and her colleagues are renewing my faith in vets. They all are very well educated, open minded, and caring. I don't meet any resistance like I did with the other vet.

I will get the actual numbers - I have thme but am in bed resting right now.

thanks all!

Tori


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## educ8m (May 19, 2010)

Oh, Tori, so glad to hear that Dr. Julie is a holistic vet. :chili:Super, super excited to hear that she is using the Standard Process and Thuja (don't know how to spell it either. My vet uses it with all vaccines to help detox.) Cisco takes Traumeel sometimes also. Give hugs and kisses to sweet Grace.


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## zooeysmom (Aug 1, 2011)

Oh, I'm so hoping Grace will be okay! I will keep her in my prayers.


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## mysugarbears (Aug 13, 2007)

I'm so sorry to hear about Grace, if it's caused because of the vaccine that was administered incorrectly i hope that the vets will pay. I will keep Grace in my prayers.


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## Piccolina (Dec 25, 2009)

Sharing my concern for Gracie as I too, dread the upcoming months when I will have to do the BAT for Valentina. 
The worst nightmare of a new mommy. 
Will send good thoughts for Grace.:heart:


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## Grace'sMom (Feb 22, 2012)

Thank you all 

You are wonderful and so supportive! Couldn't do this without totally losing it without you!

Grace has been refluxing all night from the stress of all the tests  But she thanks you for the prayers  She's snuggling right now.


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## Charlie'sMom (May 12, 2012)

Oh Tori, I just finished reading BOTH posts....this is terrible!
I'm so very sorry that this happened to you and your precious baby girl :sorry:.

As far as I know, the liver actually has the best regenerative ability of all organs. Even though it's not a Pair organ, people and animals can even live with only a piece of liver left after the accidents, etc...
With a proper diet and a lifestyle it will eventually heal.

I don't blame you for being furious! I would be, too.....your former vet is lucky it wasn't me....I would file a claim and contacted my lawyer immediately. And I would let her know, that this is not over. You know, some doctors do what they want - with human patients as well as all others.
Modern medicine is a miracle, but it can be a curse, too.

The fact that she falsified (or could) the records doesn't mean you do not have any options.
I know it isn't about the money, but on the other hand why should Gracie and her whole family pay - emotionally and financially - when it was somebody else, who messed up.
$2000 is nothing compared to the baby doggie, who already has a messed up liver thanks to the routine mistake....that cannot be undone by any money, but the vet should do right by Gracie.
Sorry if I sound harsh, but unless the victims don't speak up, the doctors and vet will continue doing these horrible mistakes and cover their behinds (pardon my French)...
I think you and your baby girl are fully entitled for covering the expenses.

Unfortunately you are not the first one with a problem like this. My neighbor has 4 little fluffs and we talk almost every day.
Last year I took Charlie to get his vaccines and he got this HORRIBLE allergic reaction. 
20 mins after the vaccine has been administered we left a vet's clinic and we were just leaving the parking lot, when he started banging his little head on the window.....I was so horrified I almost crashed the car. When I checked his face, his eyes and lips were red and swollen and he was shaking badly. I ran back to the vet's office like a maniac....
I had to spend another 5 hours over there, because he needed a shot and they observed him till the closing hours.

I told this story to my neighbor the very same evening and she said she does ONLY the necessary 3 vaccines and nothing more, because when they got their Shih-Tzu, they of course did all vaccines as told and he developed a tumor at the vaccination site...at 5 months of age!!!!!!!

Now tell me guys, if this sounds normal. After reading Tori's posts I immediately thought of little Fluffy next door. He is fine, needed 2 surgeries and some other treatments, but he recovered just fine. 
My point is, that we don't really know, what they really put into our babies. it's the same like with people - we all are a testing dummies at some point. There's no other way to do it...just to test it on actual patients.
Plus I've read somewhere, that those doses they do are all the same more or less.....I would easily believe this, because Charlie was fine with his first vaccine and he got so sick the next year...I suspect, they administered a larger amount than he was supposed to get....I'm quite sure of it. 
He could have died that day. Thank goodness it wasn't late and they were still open, so I didn't have to look for 24 emergency here in Chicago.

Sorry for a long post, but I deeply feel for you and your girl, Tori. I'm quite new here, but I already feel like this is my second family.
I will keep you both in my prayers. 
I'm sure Gracie will overcome this whole thing with your help and enormous LOVE and it will make you even closer than ever. Bonds like these can never be broken.

Hugs and kisses for both of you,

Katie & Charlie.


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## aprilb (Jul 9, 2010)

My Lily had an anaphylactic reaction to her distemper vaccine and almost died. Soon after her vaccine reaction, she developed allergies and IBD. No more shots for her!


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## Grace'sMom (Feb 22, 2012)

Katie, thank you for the thoughts.

I will see what my mom says when she gets home - she travels with work - as she is more willing to do something about this.

I would love to do something about it - but with my own illness I have litter energy left for fighting other battles. My energy is going toward helping Grace. Maybe my mom will handle the other vet.

Grace (and Gus) will no longer get any vaccines other than the 3 year rabies. This is the only vaccine Dr. Julie gives, and that is only because it is a law.

So no more vaccines for Grace, and we will probably be waiting on her rabies until her liver levels go down some...will have to ask Dr. julie.

Okay. Grace is insisting she lay right on my neck and that I hold her chewy. Clingy much? Has been like this since yesterday....all the pokes. So I can't type well LOL

Thank you all again!

Tori


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## MaryH (Mar 7, 2006)

Hi Tori, I'm happy to hear that no shunt was detected on Grace's ultrasound. My questions after reading your initial post in this thread was how high is really high liver values? And what liver values ... ALT/AST? It has been my experience that vets unfamiliar with liver issues in small dogs, i.e., Yorkies, Maltese, etc., panic when they see liver enzyme results and/or bile acid results out of the normal range. We can't and shouldn't immediately blame the vets. They cannot possibly know every issue about every breed of dog so they go by what the textbook says. My advice to anyone whose dog has higher than normal liver enzymes is (a) don't panic; and (b) get a bile acid test done. Liver enzymes can be elevated for any number of reasons, not just a liver shunt. The bile acid test measures liver function and that's what we all really need to know. And it's been estimated by the experts that we could have upwards of 65% of all Maltese with higher than normal bile acid results. Does that mean a death sentence? Generally, no! Does is mean a sickly dog? Generally, no! Does it even mean special diet and/or liver support supplements? Generally, no! I would be happy to speak with you privately and share what I know and what my experience is with liver issues. Feel free to PM me if you'd like to talk.


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## Grace'sMom (Feb 22, 2012)

Hi Mary,

I think I left my lab copy at the vet...there were a lot of papers shuffling yesterday because I was submitting everything to insurance.

Dr. Julie sounds really knowledgeable. I know her partner who watched the ultrasound works with a lot of liver and kidney patients, and the specialist who came in - well that is what he does.

They know her breed, which is why they wanted to check for a shunt. I know the levels were high enough that the specialist wanted to do the ultrasound that day.

When one wasn't found they went back to the vaccine. And the specialist said he would recommend she start support MEDICATION immediately.

Right now we aren't restesing or doing more tests. Dr. Julie looked back over her file and Grace did have blood work done prior to her vaccines. I had them done at 11 weeks - maybe too early for most people but with Gussy's health issues when we got Grace I wanted to be sure she was HEALTHY. So she had great levels at 11 weeks and was healthy until that vaccine. So Dr. Julie says her liver is compromised at the moment. It needs to heal. It will be slow.

The vaccine mistake that occurred causes liver damage. Sometimes liver failure resulting in death (usually in dogs with a lower immune system - like Gus). And sometimes the liver damage is not seen until a month or two after the accident happens. Which is why blood work right after the incident wouldn't be helpful for much.

I'm rambling a bit 

I will PM you Mary, thank you.

Tori


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## Charlie'sMom (May 12, 2012)

aprilb said:


> My Lily had an anaphylactic reaction to her distemper vaccine and almost died. Soon after her vaccine reaction, she developed allergies and IBD. No more shots for her!


April, My Charlie had his reaction to a distemper as well...:angry:.
Are you going to do it the next year?


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