# Symptoms of Liver Shunt



## SweetMalteseAngels (Oct 16, 2011)

Hello everyone,

I was reading one of the articles that an SM member posted on one of the threads and after reading the article, I am concerned because Milo seems to have many of the symptoms listed in the article. Here is the link of the article I am talking about: http://ezinearticles.com/?Liver-Shu...-3.5-Years-And-How-You-Can-Spot-It!&id=800718

Below is what the article said were the symptoms of liver shunt:

1. Poor Doer: A puppy/dog that is always getting sick. Because liver shunts cause toxicity in the blood because the dog is not having its blood filtered by the liver. This causes various illnesses to occur often.

Milo hasn't really been sick except once when he threw up on and off for like 24hours when he was a young pup. He hasn't had any problem since.

2. UTIs: A puppy/dog that has frequent urinary tract infections or looks like it is having a urinary tract infection due to having many accidents all over the house, isn't able to be housebroken or urinating small amounts.

He hasn't had any problem with this.

3. BAD ODOR: A puppy/dog that has bad mouth odor and/or bad urine odor. Often, the urine is also a darker color yellow instead of the "barely" yellow of normal healthy urine. (Note: Puppy and young dogs should have good breath. Bad breath is a RED FLAG that something isn't right)

He doesnt have terrible breath but his breath is definitely is stinky compared to Mimi. I think he may have retained baby teeth that he needs to get removed? 

As for His urine, it is yellow. I am not sure what is considered dark but Milo's pee is definitely not "barely" yellow.

4. Head Pressing: Dogs with liver shunts don't filter their blood which results in ammonia build up in the blood. Ammonia toxicity causes their heads to feel funny - so they rub their heads a lot.

Milo tends to rub his head against the wire puppy pen at times and he also rubs his head on the floor from time to time. I assumed that perhaps he has hair in his eyes and he is trying to get it out but maybe perhaps he is feeling "head pressing"?

5. CRYSTALS IN URINE: This is from the excess ammonia in their system. Any dog with crystals in the urine should have a bile acid test.

I am not sure what crystals in urine looks but what I do see is glitter like thing on the newspaper once the urine dries. It looks like glitter was sprinkled over the newspaper. Is this the crystal that they are referring to? (FYI, my dogs uses Ugodog with newspaper underneath it.) I am not sure if it's from Milo's pee or Mimi's pee since they both uses the same Ugodog.

6. Complete Blood Count (CBC): This test is easily given in the vet's office. Liver shunt dogs often have a lower than normal BUN and Creatin count.

I haven't done any bloodwork done on Milo so I don't know the answer to this at this point.

7. Depression: Liver shunt dogs are not very active or they may be active for very short periods of time. They are known as "quiet" puppies or "quiet" dogs. A "quiet" puppy usually isn't very normal and all "quiet" puppies should have a bile acid test to make sure they are okay.

Milo has a very gentle and quiet personality. He isn't very active. He is active for short spurts and usually want to be up on the couch with me while Mimi is all over the place, curious about everything, gets into everything, etc. If I don't pick him up on the couch, he will play with Mimi for short period of time and would walk over to a corner and put his head down on the floor in down position and just watch Mimi.

8. Low Weight: Puppies with liver shunts look normal with a milk belly, etc. As they grow into dogs it is obvious they are too skinny. Their ribs show, their bones are prominent and they don't develop muscle mass. Not all liver shunt dogs have low weight though, but many do. They tend to have low weight because their liver cannot absorb and process nutrients to bring these liver shunt dogs to their normal weight.

Milo is very small. He eats much better than Mimi but he is skinnier and lighter than Mimi. You can feel his bones with thin layer of skin on his back and ribs. You can also feel bones on Mimi too but she has thicker layer of skin than Milo. I am not sure if the difference is because she is a girl and has more fat than Milo?

9. Small: Dogs with liver shunts often do not grow as much as their siblings. They have smaller than normal livers and sometimes smaller than normal features. Wendy never developed the strong leg muscles that all greyhound breeds exhibit.

Milo was the smallest of his litter and he currently weighs 3.4lbs at 14 months.

10. Anorexia: Many liver shunt puppies/dogs do not eat normally. They eat very little dog food. They may chow down on a newly introduced canned food or people food - but they invariably resort back to not eating very much. Eating food makes them not feel well because of the higher toxicity they have after a meal - so they tend to shun food.

In general, both Mimi and Milo doesn't eat much but Milo eats more than Mimi. Currently, milo eats about 1/4-1/2 cup of Acana Pacifica a day. 

As you can see Milo meets many of the symptoms above but he doesn't have problems with throwing up or diarrhea. Should I be concerned? What do you guys think?


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## Ladysmom (Oct 19, 2004)

Make sure both Mimi and Milo have a bile acids test. That will put your mind at ease.


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## SweetMalteseAngels (Oct 16, 2011)

I plan to get the BAT test for them because I am concerned especially for Milo. Do you know i the Crystals in the urine is visible to the naked eye? Does it sound like what I described?



Ladysmom said:


> Make sure both Mimi and Milo have a bile acids test. That will put your mind at ease.


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## CrystalAndZoe (Jul 11, 2006)

First of all, like Marj suggested, I think ALL puppies should have a CBC and BAT. You may find out one or both of your babies are asymptomatic MVD which the MAJORITY of all Maltese are. And there is nothing to worry about or do differently if that is the case. But it's good to have as a base line in case later on there is an illness. If you know they already have a higher than normal bile acid, it will aid you and the vet with diagnosing. And like Marj said, it will help to put your mind at ease.

Secondly, that post is a great post on what is typically associated with a liver shunt dog. However I happen to know of 2 Maltese that show absolutely none of those symptoms. And yes, I'm talking PSVD (shunt) rather than MVD.

So every dog and every case is different. But I understand your worry. I'm the ultimate worrier. Jett is a very calm, laid back, low energy dog. I'm constantly worried I'm missing something. But every year we do a CBC and a urinalysis and his #'s are perfect. It's just his personality.


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## Ladysmom (Oct 19, 2004)

SweetMalteseAngels said:


> I plan to get the BAT test for them because I am concerned especially for Milo. Do you know i the Crystals in the urine is visible to the naked eye? Does it sound like what I described?


A vet would see crystals in a urine sample.

Don't make yourself crazy worrying. Just get the BAT done.


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## jmm (Nov 23, 2004)

3. BAD ODOR: A puppy/dog that has bad mouth odor and/or bad urine odor. Often, the urine is also a darker color yellow instead of the "barely" yellow of normal healthy urine. (Note: Puppy and young dogs should have good breath. Bad breath is a RED FLAG that something isn't right)

He doesnt have terrible breath but his breath is definitely is stinky compared to Mimi. I think he may have retained baby teeth that he needs to get removed? 

*If he has retained teeth they need to be removed because they are a cause for chronic infection and dental disease. *

As for His urine, it is yellow. I am not sure what is considered dark but Milo's pee is definitely not "barely" yellow.

*By dark they mean an orangish/brownish color. Yellow or light yellow is normal*

4. Head Pressing: Dogs with liver shunts don't filter their blood which results in ammonia build up in the blood. Ammonia toxicity causes their heads to feel funny - so they rub their heads a lot.

Milo tends to rub his head against the wire puppy pen at times and he also rubs his head on the floor from time to time. I assumed that perhaps he has hair in his eyes and he is trying to get it out but maybe perhaps he is feeling "head pressing"?

*It is normal for dogs to rub their heads, especially with a top knot. By head pressing it means the dog sits in a corner or against you and holds constant pressure on their head. *

5. CRYSTALS IN URINE: This is from the excess ammonia in their system. Any dog with crystals in the urine should have a bile acid test.

I am not sure what crystals in urine looks but what I do see is glitter like thing on the newspaper once the urine dries. It looks like glitter was sprinkled over the newspaper. Is this the crystal that they are referring to? (FYI, my dogs uses Ugodog with newspaper underneath it.) I am not sure if it's from Milo's pee or Mimi's pee since they both uses the same Ugodog.

*Crystals in urine are microscopic. Your vet can check a fresh urine sample to evaluate for crystals. *

7. Depression: Liver shunt dogs are not very active or they may be active for very short periods of time. They are known as "quiet" puppies or "quiet" dogs. A "quiet" puppy usually isn't very normal and all "quiet" puppies should have a bile acid test to make sure they are okay.

Milo has a very gentle and quiet personality. He isn't very active. He is active for short spurts and usually want to be up on the couch with me while Mimi is all over the place, curious about everything, gets into everything, etc. If I don't pick him up on the couch, he will play with Mimi for short period of time and would walk over to a corner and put his head down on the floor in down position and just watch Mimi.

*Many dogs with liver issues are described as "dull"....they don't catch on to things like normal dogs, they take a long time to train. This is very subjective. *

8. Low Weight: Puppies with liver shunts look normal with a milk belly, etc. As they grow into dogs it is obvious they are too skinny. Their ribs show, their bones are prominent and they don't develop muscle mass. Not all liver shunt dogs have low weight though, but many do. They tend to have low weight because their liver cannot absorb and process nutrients to bring these liver shunt dogs to their normal weight.

Milo is very small. He eats much better than Mimi but he is skinnier and lighter than Mimi. You can feel his bones with thin layer of skin on his back and ribs. You can also feel bones on Mimi too but she has thicker layer of skin than Milo. I am not sure if the difference is because she is a girl and has more fat than Milo?

*A dog of a healthy weight has a light coating of fat over the ribs and spine. When wet no bones should be prominent.*

10. Anorexia: Many liver shunt puppies/dogs do not eat normally. They eat very little dog food. They may chow down on a newly introduced canned food or people food - but they invariably resort back to not eating very much. Eating food makes them not feel well because of the higher toxicity they have after a meal - so they tend to shun food.

In general, both Mimi and Milo doesn't eat much but Milo eats more than Mimi. Currently, milo eats about 1/4-1/2 cup of Acana Pacifica a day. 

*That is a normal amount. My 6 1/2 lb'er only gets 1/2 cup a day. *

As you can see Milo meets many of the symptoms above but he doesn't have problems with throwing up or diarrhea. Should I be concerned? What do you guys think?[/QUOTE]

*EVERY Maltese should have a bile acid assay as a young dog to rule out liver shunt and MVD. Early treatment and/or surgery can be the different between life and death. Every single puppy should be tested. *


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## harrysmom (Sep 28, 2007)

I have a dog, Harry, with a liver issue and he doesn't have any of those symptoms. He loves to eat, he's very active and playful, and imo he's very smart. We realized that Harry was sick when he suddenly started retaining fluid in his abdomen.

I agree with Jackie and the others that a bile acid test is necessary. We found Harry's problem at 6 months and started treating him immediately and I think that early detection made all of the difference.


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## LJSquishy (Feb 27, 2008)

It actually sounds like Milo does not have many (or any) of the signs of a liver shunt. I had a Maltese that had one and it was heartbreaking to go through. Head pressing is not just rubbing their head. As Jackie said, they push their head against the wall and leave it there. No one should ever have to witness that, it is absolutely one of the worst things I've ever seen before. That, and the confusion. When Benson was near the end, we were in the middle of a kitchen remodel and had the base cabinet doors off. He climbed into a cabinet and curled up. He was so confused and very sick. Just heartbreaking.

You can have them tested, but I'm telling you not to worry.


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## harrysmom (Sep 28, 2007)

harrysmom said:


> I have a dog, Harry, with a liver issue and he doesn't have any of those symptoms. He loves to eat, he's very active and playful, and imo he's very smart. We realized that Harry was sick when he suddenly started retaining fluid in his abdomen.
> 
> I agree with Jackie and the others that a bile acid test is necessary. We found Harry's problem at 6 months and started treating him immediately and I think that early detection made all of the difference.


When I re-read this, I think it sounds like I think something might be wrong with Milo and that's not what I meant at all :huh:. I was just saying that a bile acid test is a good idea for all dogs just to make sure and to get a base line in case of future issues.


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## jmm (Nov 23, 2004)

My Roo recently had changes to his liver on an ultrasound. The first thing brought up was a shunt. I was able to tell the vet that Roo had a normal screening bile acid assay as a puppy and did not have a congenital shunt. They were quickly able to address a different liver issue. Had I not screened Roo, he would have undergone potentially invasive and expensive testing for a problem he didn't have. EVERY Maltese puppy should be screened to ensure problems are treated and issues prevented in the future.


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## edelweiss (Apr 23, 2010)

I totally agree that Milo & Mimi should have had the BAT/or should do it *now*. I don't understand why this important test isn't done by everyone here. We talk about it all the time, encourage it, etc. It is a safety measure that ensures valuable knowledge should it ever be needed in regard to the liver. You may have to ask your vet to do it, if they haven't already suggested it. It is something I would insist on!


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