# Liver shunt just diagnosed



## schmeez (Sep 21, 2006)

My vet suspects, after some preliminary testing, that my little Leo, who just turned 2 years old in July, has a liver shunt or possibly some sort of liver disease. His Albumin is low, his blood proteins are low, and his cholestrol is low. They took fluid, blood, and urine samples, we are doing a bile acid test tomorrow and an ultrasound with an internal medicine specialist as quickly as we can get in.

My wife and I were out of the country for 10 days and we left him and his brother (not by blood), Copper age 7, with friends who had watched them several times before. When we returned we noticed that his belly was distended and he seemed to have lost muscle mass. We brought him in Wednesday and x-rays showed that his abdomen is filled with fluid, so much so that no organ detail was visible.

With all of this the vet is pessimistic and does not believe that there is a good result possible. He has implied that we are talking about weeks or months if it is a liver disorder (there is some possibility that there may be an intestinal issue instead, but that is much less likely and just as bad).

From everything I have read, I cannot determine for myself what the odds are. 
We love him so much and are financially able to do whatever is necessary. We could manage it medically (antibiotics, low protein diet, Lactulose - all of this has already begun) but he would live to at best four years old, but maybe not even to the end of this year. It seems as though surgery will either grant a normal life quality and span or will cause death through hepatic hypertension, robbing him (and us) of what few very precious months or years we have left - I cannot accept weeks. The likelihood of hepatic hypertension is apparently higher for him because of his age. The liver has had so much longer to atrpophy then most cases that when the shunt is ligated the liver may be wholly incapable of handling the blood flow.

The worst part is that now, looking back, after reading everything that I have read in the last 24 hours, it seems perfectly clear to me that he has had symptoms since the first week we had him, particualy excessive drinking and urination (we had him checked out several times for this (no bile acid test I only now realize) but it just sort of went away on its own after a month and we didn't think another thing of it until now). It was just a funny story to tell friends about him (he peed 17 times a day, no really, we had kept a log of it to show the vet - ha ha) but now it just makes me cry.

I have read several threads on this subject initiated by someone like me and they just seem to end without a stated resolution. From that I can only fear the worst. Please, if you have been through this, happy or sad, I just need to know what to expect.

We only want to choose the course that leaves him with best quality of life for the longest period of time.


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## k/c mom (Oct 9, 2004)

Oh, bless your heart. I am so very sorry to hear what you are going through. I'm just curious if you don't mind my asking..... were his blood tests normal before neutering or for his yearly physicals?

My heart goes out to you and your family... I think all of us here know what it is like to deeply love a Maltese.


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## paris (Apr 8, 2005)

I have no knowledge to offer...just wanted to let you know that you and your little fluff butt will be in my prayers.


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## KimKarr (Feb 4, 2006)

I'm so, so sorry to hear this news about your Leo. Members here on SM have experienced so many diseases and illnesses with their cherished Maltese, so I'm sure that someone will be able to give you some guidance or help you to know what may be in store as Leo fights the good fight. You may always comes here to share what you are going through and be assured of compassionate, caring support.








to you, your family, Cooper and your beloved Leo.


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## msmagnolia (Sep 8, 2004)

Welcome to SM. I'm sorry that you are joining us at such a trying time for you and your family. There are people here who have had experience with liver shunt problems. Unfortunately Maltese seem to have some predisposition to the problem. I hope someone can help you with encouragement and information. 

I recently lost a maltese to a brain disease. I would recommend that, depending on your diagnosis, you seek additional information from a specialist. Perhaps there are some treatments or management issues that your vet may be unaware of. Be as proactive as possible in order to get to the root of the problem. I wish you the very best in your quest......


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## schmeez (Sep 21, 2006)

> Oh, bless your heart. I am so very sorry to hear what you are going through. I'm just curious if you don't mind my asking..... were his blood tests normal before neutering or for his yearly physicals?
> 
> My heart goes out to you and your family... I think all of us here know what it is like to deeply love a Maltese.[/B]



Thank you for your good wishes. The vet gave us the option of having the pre-op blood screening and we said yes. So as far as I know the test came back fine.


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## Cosy (Feb 9, 2006)

I have a little yorkie with a Liver Shunt. Your vet or a specialist will need to perform
more extensive tests including sonogram, fasting blood tests, etc. There are different
types of shunts. Some can be repaired through surgery, some do well with lifetime
medication. Some cannot be surgically repaired. There is a myriad of information
on the net about this. Just search "Liver shunt in dogs". You can also PM me and
I will share any info I can to help.


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## MissMelanie (Feb 13, 2006)

I hope the best for Leo's health. I am very sorry for this.

Melanie


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## coda (Jan 21, 2006)

My name is Becky and my Coda is 13 months old and is a survivor of liver shut surgery. Outside of my husband, he has my heart as with everone on this forum. While I have sneeked around for almost a year, I have never introduced myself...shame on me. I will formally do so at another time.


Coda was diagnosed with a liver shut at 6-7 months when he had his neuter pre-op blood work performed. Outside of ocassional vomiting for no reason and a little on the thin side, Coda did not display any of the more serious symptons. He immediately went on the special diet, lactose. After the fasting, the sonogram, I scheduled Coda for the Anaroid constrictor surgery at Georgia Vetenary Specialst here in Atlanta. His shut was external(portosystemic) which is what I pray for since the surgery has a high success rate. The constrictor today is the procedure of choice for this diagnosis because it slowly closes shunt to allow liver to adjust to the new blood flow.

I am so sorry for your pain and worry.. Even though Coda did not have serious symptoms as Leo does, I was very upset and scared when we began the process. But, as Cosy says, there is a lot of information on the subject on the internet. Please see a specialist for all of your testing. General vets do not always have the knowedge or the equipment and specialist will want to perform the same tests all over again. 

Websites that were the most helpful for me was the University of Tenn Vet College(www.vet.utk.edu/clinical/sacs/shunt) and MO(before change of ownership) (www.malteseonly.com/shunt.html) and www.vetsurgerycentral.com/pss.htm 

Many prayers and positive energy being sent your way for Leo and your familu


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## Scoobydoo (May 26, 2005)

I am so sorry you and your family and little Leo are going through this difficult time. I don't have any information but just wanted to let you know my thoughts and prayers are here for you all


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## schmeez (Sep 21, 2006)

> My name is Becky and my Coda is 13 months old and is a survivor of liver shut surgery. Outside of my husband, he has my heart as with everone on this forum. While I have sneeked around for almost a year, I have never introduced myself...shame on me. I will formally do so at another time.
> 
> 
> Coda was diagnosed with a liver shut at 6-7 months when he had his neuter pre-op blood work performed. Outside of ocassional vomiting for no reason and a little on the thin side, Coda did not display any of the more serious symptons. He immediately went on the special diet, lactose. After the fasting, the sonogram, I scheduled Coda for the Anaroid constrictor surgery at Georgia Vetenary Specialst here in Atlanta. His shut was external(portosystemic) which is what I pray for since the surgery has a high success rate. The constrictor today is the procedure of choice for this diagnosis because it slowly closes shunt to allow liver to adjust to the new blood flow.
> ...



Thank you and I thank everyone who has replied and will reply. I had previously found two of the sites you provided but not the vetsurgerycentral.com which is extremely helpful.
I am glad that all went well for you and I hope for the same.
I will talk to the vet about a specialist tomorrow. I am close enough to both Cornell and U Tennesee, both places that have surgical specialist extremely familiar with these issues.


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## Lexie & Lucie's Gammie (Jul 4, 2006)

A few months ago - my Maltese was either stung by a bee or bitten by a spider - the research I did according to her symptoms sent me into a frenzy. The vet was not sure of anything, the blood test indicated liver disease, then pancreas problems, the internet research indicated cancer and the vet stated there was no way an insect could have affected her this way, that it was probably something preexisting. I took her off all the antibiotics and other meds prescribed by the vet, (because after 2 months she was still very listless and not herself) and switched her to an all natural food diet, very low protein (liver doesn’t digest protein well) and also added to her daily routine "Only Natural Pet Liv-Herb Herbal Formula" which is an herbal supplement designed to aid liver disorders, with antioxidant properties to help it protect the liver. It is formulated to aid in liver regeneration after toxic exposure. Milke Thistle is known as an excellent herb for the liver and for its ability to regenerate liver cells and stimulate the flow of bile. It was a miracle. I went through the entire bottle – about 4 – 5 weeks and she is completely healed! After I ran out of the liver detox, I started her on Only Natural Pet Echinacea Herbal Formula, to support her immune system. But I must say she is so back to her old self, that I seldom give it to her – if she felt any better, I would have to put her on tranquilizers. I am just sharing what worked for my Maltese, I am not sure it would work for you, but a natural alternative can not hurt. I am so ecstatic that Lexie is back to normal, I was so distraught at the thought of loosing her to cancer or liver disease – I thought my family would commit me! I just keep saying – amazing! And thank you God! I will keep you and your baby in my prayers – thank God for our babies, they do bring us such joy.


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## Maidto2Maltese (Oct 19, 2004)

So sorry you have this worry with your little Leo. I've posted a link that will explain blood work ( the tests and what they mean.) I can't help but wonder if there some irritable bowel disease/colitis? I have to go back and re-read your initial post.
I want to also say you are doing the right thing by learning as much as you can.
Though my little Missy had a different problem ( dx with bladder cancer)..I was devestated.. and she had diabetes and heart issue besides. I was first shocked and terrified.. then I was determined I was going to "fight"..learn everything I could.. pick the brains of the experts..etc.
The "normal" dx for her type cancer was 90-180 days!!! ... a "good" prognosis was 260 days..something like that.. Well she beat the odds and when she passed.. it was NOT from the cancer and it was at 1 year 9 months after dx and STILL not having any problems from the cancer. 
I tell you this.. because though ,yes, when faced with a serious problem.. you can't put your head in the sand.. you have to be realistic and recognize the possibilities. However.. these statistics are not carved in stone. My Missy proved that!! I researched as your are.. I also had several pow-wows with the vet discussing the pros and cons of various options. ..I knew I needed to make informed decisions.. not just emotional ones. That meant learning the good with the bad. Then I PRAYED! that I would make the best decision for Missy's well being. 
I pray you are lead to the right decisions for Leo..but know that no matter what they are and no matter what the result.. they are made with love and those are always "right"!

Fot the link below.. know that each lab has it's own set of values for the "normal-range" you would see that range on your blood panel results.

http://www.petplace.com/dogs/understanding...gs-2/page1.aspx


wanted to add.. wonder if digestive enzymes would help at all? and have seen many pets at our diabetes board who have liver disease have great improvement with Milk thistle and Sam-E ( both for liver support.) Many Holistic vets recommend these for liver problems. Now I realize that a shunt is different..or additional problem to "just" liver impairment..but something you might look into .


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## Jacki (Jul 13, 2006)

I'm so sorry that poor little Leo has been given this diagnosis.







My thoughts & prayers are with your family right now! You will find this group to be very supportive in hard times; it's good that you are here.


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## jmm (Nov 23, 2004)

Depending on the type of liver disease, it is not necessarily a death sentence. However, the abdominal effusion is not a good symptom to have. While shunts and MVD are common in Maltese, other types of liver disease are also possibilities. Your vet's plan of action sounds right on, especially with the referral for further diagnostics with a specialist. 

Shunt in Maltese: Many Maltese live quite a long while on medical management. If your dog has MVD or occlusive vascular disease in the liver as well as a shunt, surgery may not be recommended due to the likelihood of acquired shunting. Each case is different, but even if your dog is not a candidate for the ameroid constrictor, it does not necessarily mean you can't have quality of life for a time (depending on the severity). 

Most dogs with shunts and/or MVD are not diagnosed as puppies. They are more often diagnosed as young adults. 

Good luck! Once you have more information, I'm sure there will be further guidance for supportive care. 

I'm on liver dog #3 and only 1 of mine had any severe illness.


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

I found SM researching liver problems--you have come to the right place. When Tanner was 7 months old, I took him in to be neutered and found his ALT to be in the 300 range. I went to a specialist for an ultrasound & they did not see a shunt. Tanner has been on low protein food, right now he's eating canned Innova Senior, and he gets Milk Thistle & Denosyl daily. Over the last year and a half, I have had his ALT done quarterly and it has gone from a high of 800 to a low of 329. A month ago, I decided to have a biopsy done and no liver shunt was found. Both the surgeon and the internist are puzzled as to the problem, they say the liver problem is secondary to something else but don't seem to know what the something else is. Tanner's ALT is the only thing that has been abnormal. I did have bile acids done and that was high (44/42 or something like that) but not excessively high. Tanner is 2 now. His activity level is fine, he eats fine, poops fine, acts fine. I tell you this because a liver diagnosis is not necessarily bad, it is manageable. There is a wealth of information on this site & it has helped me tremendously. I wish you the best.


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## schmeez (Sep 21, 2006)

The update.

We had the bile acid test today and the urinalyis and abdominal fluid test came back. The urinalysis had no proteins, which means that it is the liver and not the intestines. Everything else was normal except the urine color was "turbid" rather than clear.

The abdominal fluid test showed no infection ruling that out. It is the liver.

I now have a copy of the blood test from Wednesday.
Total protein is 4.0 (normal range 5.0-7.4)
Creatinine is 0.5 (NR 0.5-1.6)
Albumin is 1.9 (NR 2.7-4.4)
AST (SGOT) 94 (NR 15-66)
Cholesterol 56 (NR 92-324)
Calcium 8.2 (NR 8.9-11.4)
Magnesium 1.4 (NR 1.5-2.5)


Everything else is well within the norms including White Blood Cells, BUN, Bilirubin and ALT.

We now have him on Denosyl, neomycin, lactrulose, Flagyl/Metronidazole and Hill's l/d spread out over the day as much as possible.

The bile acid test results will come in tomorrow.

At this point the vet still says that Leo has a few months at best.


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## KimKarr (Feb 4, 2006)

Still holding you all close in thought and praying for comfort for Leo. We'll keep looking for updates and are always hear to listen.


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## Bonnie's Mommie (Mar 2, 2006)

Oh I'm so sorry to hear this. Leo knows how loved he is, and will always know that. I love him, too.


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## momtoboo (Jan 30, 2006)

I'm so sorry about Leo.







I looked at his pic in your gallery,he's a beautiful little boy with such a sweet face.Wish I could help.


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## flossysmom (Aug 4, 2006)

So sorry to hear this about Leo. I will keep you all in my prayers


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## schmeez (Sep 21, 2006)

The bile acid test came back. The number was very high - 332.5, with under 20 being normal and 100 indicating liver disease. His pre-meal, post 15 hour fast number is 50.1 with under 10 as normal. 

The vets says one month, if we are lucky. The ultrasound on Thursday (if we even do it now) will tell us the precise nature of the disease, but even if it had been operable in the past, the liver is too far gone to handle the blood flow after ligation.

They removed from his belly 480 ml of fluid, which weighed just over one pound. So at least now he is more comfortable and can go up and down the stairs again.

A steroid has been added to the 4 other drugs to try to reduce the accumulation of the more fluid, the quickness with which it returns will tell us how little time we have left.

We asked how it would happen and the answer was hard to hear. It is a wasting away. If he doesn't want to eat, if he doesn't seem to be enjoying life anymore (oh the cruelty of that, he enjoyed life more than any dog I have ever had), we will know it is time. Seizures are possible, but he does not think it is likely, because there have been no brain effects evident to this point. We are supposed to check the whites of his eyes to see if they turn yellowy, that is the jaundice.

There is one thing that I have learned from this and it is a lesson that I would love for everyone to know. The bile acid test cost $80. If I had known that such a test existed, one year ago, two years ago, I can't bear the thought. Get one when you get your puppy. Maybe get one every year. The earlier this is caught the better chance you have to prevent everything you just read.


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## msmagnolia (Sep 8, 2004)

I am so very sorry. As I posted earlier, I too know the agony of having a sick, young puppy. You do everything you can to fight, but with the fight comes acceptance. With acceptance you will know when the time comes and believe me there will be some relief then.....relief for your sick baby and relief for you, too. 

My heart goes out to you. You are not alone at this time. Come here for support - we can help you face whatever is ahead. 

In friendship,
Susan


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## MickeysMom (Jun 16, 2006)

I just wanted to say how very sorry I am. Liver disease is too common in small dogs. My boss (a vet) lost her mini schnauzer early this year at 6 years old to a liver shunt. Molly lived much longer than expected. 
I also want to thank you for posting so much helpful information, even though it must be very hard for you. You will most likely help save someone's little pooch.
God bless


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## momtoboo (Jan 30, 2006)

[attachment=13302:attachment] How very sad this is.


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## Bijousmom (May 29, 2005)

I am so sorry for your family and Leo. I feel so helpless other than to give you my thoughts and prayers during this difficult time.







Julia


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## schmeez (Sep 21, 2006)

It has been 4 days since he was drained and the fluid is not visibly back, which is great. He is eating very well and he loves the l/d food, which surprised both vets. Apparently the low protein, low fat diet is not usually appreciated. 

The lactulose was doing its job too well, so we had to take him off of it. His belly is still bruised from the swelling and draining

The ultrasound is tomorrow. Though we don't expect that there is anything that can be done we will still want to have it just in case. Hope against hope. 

He is still himself, except with less energy to spare. He sleeps a lot more than he used to, but he still brings me the squeeky toy to throw and the rope to play tug of war with. He still aggravates Copper, he comes running up an into him to get Copper to play. He runs to the end of his leash to meet new people on the sidewalk, he jumps up and down at the feet of the neighbor he loves.

It is hard to accept that he isn't going to make, since the change in him is so small. I keep praying that he got into something toxic which is working its way out of his system and he will then be fine. 

We should have the ultrasound results immediately tomorrow and I will let you know.


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## Maidto2Maltese (Oct 19, 2004)

I will be praying that Leo will prove them all wrong about dx!! I always believe on hanging on to "hope" as much as you can!


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## Ladysmom (Oct 19, 2004)

I am so sorry you are going through this with your precious Leo. Thank you so much for sharing Leo's story and encouraging potential puppy parents to get the bile acids test done before they buy. Perhaps you can spare others the heartbreak you are going through, a legacy for Leo.

My thoughts and prayers are with you.


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## k/c mom (Oct 9, 2004)

My heart goes out to you. I hope and pray for the best.


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## sheila2182 (Nov 28, 2004)

I agree with Terry, and keep us posted.Our thoughts & prayers are with you


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## msmagnolia (Sep 8, 2004)

Thanks for posting this update. I will also hope onto hope that somehow somethiing can be done or that thinks aren't as bleak as once thought.


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## thelittlepet (Apr 18, 2006)

God bless you and Leo. My thoughts are with you. 
Aimee


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## I found nemo (Feb 23, 2006)

My thoughts are with you..

Andrea~


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## schmeez (Sep 21, 2006)

There is nothing that can be done.

The internal medicine specialist gave him the ultrasound today and his liver has normal architecture but is very small. She believes that he has 20% or less of liver function as that is when the protein loss, of the type he is experiencing, kicks in.

In her opinion this is not a shunt, she couldn't see one and the bile acid test results don't indicate that it is. When it is a shunt apparently the pre-meal number is usually over 100 and up to 200 with the post meal over 200 or 300. His pre-meal was 50.

Her diagnosis is some form of heptatitis or fibrosis (scarring). There is nothing that we could have done to cure it no matter when we found out. We could have added time to his life span by use of the medications; the enzyme, the supplements, etc, but in the end we were always going to find ourselves here. Unless we didn't have him, which is not a choice I would go back and change.

The amount of time he has left will depend on how quickly the fluid returns, which we are watching closely.

He has some fluid back according to the ultrasound, but it is difficult to determine the amount.

I have to get back to work, so I will have to finish this later.


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## Furbaby's Mommie (Jul 10, 2004)

Poor Leo, I'm so sorry. Just take real good care of him and give him all your love.


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## Holliberry (Feb 5, 2005)

I am so awfully sad to read about Leo. I went through a similar situation waiting and trying everything possible, with my much older maltese. I remember it all too well when I read stories such as yours It breaks my heart, and at any age, but certainly to see this in such a baby is extremely hard. Thinking of you guys.


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## k/c mom (Oct 9, 2004)

Oh, I am so very sorry to hear this.









If you don't mind my asking, did the vet indicate what would cause something like this or is it congenital?


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## paris (Apr 8, 2005)

You, your family, and Leo are in my prayers.


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## sheila2182 (Nov 28, 2004)

So sorry to hear this. Prayers to youy all.


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## schmeez (Sep 21, 2006)

> Oh, I am so very sorry to hear this.
> 
> 
> 
> ...



The theory, and that is all is, is that the liver sufferred some in utero trauma. Either the mother had a virus or his brother kicked at the wrong time and caused damage. But the truth is, they really don't know the initial cause.


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## Maidto2Maltese (Oct 19, 2004)

Oh I'm so sad to read this. I can only suggest from experience.. yes be vigilent ( as I know you are) for the sake of comfort.. but then try as best you can.. to ENJOY "today" and all the 'todays' you can.. focus on them, treasure them... and try to not look at "tomorrow".. 
I pray you have lots and lots of 'Todays" ahead.


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## Bonnie's Mommie (Mar 2, 2006)

> Oh I'm so sad to read this. I can only suggest from experience.. yes be vigilent ( as I know you are) for the sake of comfort.. but then try as best you can.. to ENJOY "today" and all the 'todays' you can.. focus on them, treasure them... and try to not look at "tomorrow"..
> I pray you have lots and lots of 'Todays" ahead.[/B]


I couldn't have said it better. So very sorry to read your update.


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## coda (Jan 21, 2006)

> > index.php?act=findpost&pid=262560
> 
> 
> 
> ...


Neither can I...My heart is breaking for you.


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## KimKarr (Feb 4, 2006)

My heart goes out to you all. Feel our love and support.


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## msmagnolia (Sep 8, 2004)

I am so sorry to hear of this latest news. At least you have done all that you could possibly do to see if Leo could be helped by other medical intervention. Poor little guy! My heart hurts for you...........


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## schmeez (Sep 21, 2006)

Thank you all for your thoughts and prayers, my wife and I, and Leo appreciate it.

The internal medicine specialist called today to discuss adjusting his meds.

The steriod and denosyl will stay the same. The flagyl is going to be reduced to 0.2 ml twice per day because she believes that the lower dose will do just as well for him and prior amount of 0.5 ml twice per day was too much and could cause neurologic effects on its own. 

The neomycin has been discontinued for now because it has the same benefits as Flagyl and is therefore not doing anything. We are supposed to hold it in reserve, so that if we begin to see neurologic signs , such as staring off at nothing after eating, or bumping into things, we can use it then. It works best when things get bad, she said. 

If/when those things happen we are also supposed to start him back on the lactulose, because the speed with which he eliminates will be more important for good neurology than the runniness will be bad for him.

Lastly the marin supplement that he is on since yesterday has a concentrated form of the active ingredient in milk thistle and he is supposed to stay on that long term.

I noticed yesterday that when he goes down a filght of stairs he only uses one back foot. He tucks up his back left leg as he hops down. This is so funny and I don't know why I never saw it before. I know that he has always gone up the stairs in a tripod fashion, but not down. When going up he alternates steps with his front two and pushes off with the back two together. He does the same thing going down with the front legs, but looks three legged. I am going to have to get video of it.

I have tried to take the words of advice I heard here and live with him only today. My wife has said it too. Live like he lives, there is no tomorrow to worry about, there is no yesterday to compare with, it is just today. He doesn't lament his condition, he is just happy to be with us. I am just happy to be with him.


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## k/c mom (Oct 9, 2004)

> I have tried to take the words of advice I heard here and live with him only today. My wife has said it too. Live like he lives, there is no tomorrow to worry about, there is no yesterday to compare with, it is just today. He doesn't lament his condition, he is just happy to be with us. I am just happy to be with him.[/B]


Oh, that is so beautifully expressed.


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## schmeez (Sep 21, 2006)

When I originally started this thread, one of the things I said was that the others on this topic just seem to end without any resolution. I know why that is now and it will not be the case here.

Leo survived with his condition until this morning at 4:30 a.m. when we had to say goodbye. 

Since the last post things went very well, his condition improved we put him on a strict schedule for his medications. There were some dicey moments early on but it stabilized and reached a certain level of normalcy that unless you knew him before you would have had no idea that he was sick. We didn't tell people, we didn't want to talk about it, I would not order more than one month worth of the medications at a time. I feared every day of jinxing the miraculous good luck that we were having. As a result I also dared not post anything about it. Fate has a way of smacking people down when they get comfortable.

That he lived as long as he did was not a miracle, it was the result of his spirit, love of life and will to squeeze as much out this existence as he could. He was happy, playful, spunky, tenacious, loving, energetic and perfect until the end. It was as if he knew that he had to get it all in fast.

In the end it was an issue that he was originally not supposed to live long enough to face. Dogs with liver disease forms urate stones in the bladder. Over time these stones, unless they are passed, get big enough that they can block the urethra. That happened on the evening of December 17. He tried to go potty but could not get anything to come out. He strained for over a minute with no success. We knew this was obviously wrong. We took him to the emergency vet where he spent the night with a catheter allowing him to go.

The following day we spoke to the surgeon who gave us two options: they could work the stone back up into the bladder and we could hope that it did not reoccur with to great a frequency or they could perform surgery to empty the stones from the bladder and open a new urethra where his testicle once were. This would allow him a larger hole so when the stones redeveloped as they certainly would they were more likely to pass.

Because of his liver condition we opted to avoid surgery if at all possible because of the anesthesia. They worked the stone back into the bladder on Tuesday and he came home that night. For the next 24 hours everything was fine, he was able to go unobstructed 5-6 times, but then on the evening of the 19th he was blocked up again.

We brought him in, opted for the surgery, which could not occur until Friday because they needed to give him a course of treatment to increase his chances, plasma, clotting factor tests, etc. 

The surgery began around noon on December 21 and as completed by 2. While they were in there they looked at the liver, took a biopsy for later use in his on going treatment. The surgeon was hoping to find, once in there, that there was a single large shunt which might be correctable. We were actually faced with the possibility that he might be cured outright. Cruel hope that was. She instead found that there were 50-60 acquired shunts and no surgical fix was possible. She did remove the stones and create the new urethra. 

The surgeon was happy with the results and several hours after surgery Leo was behaving as expected. We were elated. We were almost through the woods, it was the anesthesia that we feared once he came out of it we were golden.

Over the evening we called every hour or so to make sure as was well and it continued to be. That is until the doctor called at 2:30 a.m. this morning to tell us that his blood pressure was very low and she was concerned that he would not make it. We rushed over to see him and make choices. We spent the next 90 minutes while they took him off the pain killers which were making the blood pressure lower, giving him dopamine and praying.

His blood pressure did not improve and the pain became worse, it was time. He had fought as long as he could, he had given everything he had to living and we could ask no more.

And that is how it ends.


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## k/c mom (Oct 9, 2004)

Oh, my heart is breaking for you. I am so very, very sorry that you lost your precious Leo. I went back and read your previous posts and it seems like you had him a lot longer than the vet was estimating and that he felt pretty well during that time. I'm really glad that you had over a year longer with him but no matter how long, it is never enough when we love them so much. 

Thank you for taking the time, in your grief, to update us. My sincere condolences to you and your wife. :grouphug: 

[attachment=31416:bridge_w..._wording.jpg]


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## Ladysmom (Oct 19, 2004)

I am in tears as I read your post. I am so very sorry that you lost your Leo. :grouphug:


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## Toby's Mom (May 7, 2004)

Oh no! I am so very sorry for your loss. My heart aches for you. :grouphug:


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## kathym (Aug 5, 2006)

:smcry: I am so sorry for your loss :grouphug:


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## ClaBec Maltese (Feb 19, 2007)

I am so sorry for you loss of Dear Leo. Please know that you are in my thoughts and prayers during this time. 

rayer: :grouphug: :grouphug: :grouphug: rayer:


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## harrysmom (Sep 28, 2007)

I am so sorry for your loss!!! :grouphug: :grouphug:


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## dogloverx3 (Apr 14, 2006)

:grouphug: I am very sorry for your loss . Sarah


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## chichi (Apr 12, 2007)

I am so sorry for the loss of your precious Leo, He knew how loved he was by you and he will be waiting for you at the Bridge . :grouphug: Jill


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## Bonnie's Mommie (Mar 2, 2006)

I'm so sorry for the loss of your darling Leo. He really lived a good life, knowing how loved he was by you and your wife. Bless you for caring for him so completely.


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## MaryH (Mar 7, 2006)

I just sent the following to Cornell University Vet School: "Please accept this donation to Dr. Sharon Center's Liver Shunt Research Project in memory of Leo, a little Maltese who each day brought happiness to those who knew and loved him."

My thoughts and prayers are with you.

MaryH


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## schmeez (Sep 21, 2006)

I quit writing one sentence too soon.

That is not how it ends. He will be with us the rest of our lives and each day that he gave us was a gift. He was originally not supposed to make it out of October 06, then they said 4-6 months at best. He went 15 months and a day and made every day count.

I cannot image how much worse this would be if it had snuck up on us. In a perverse way this was his old age, we did not know when or how but we always knew it was around the corner and we got to say goodbye for 3-15 times longer than anyone thought we would.

At the one year port-diagnosis mark I sat at the computer and almost gave an update then. It would have been a joyous celebration and maybe I should have done it. But I know that if I had I would have been blaming myself for the rest of my life for tempting fate. It turns out she needed no temptation from me she had her own plans.

Thank you for your wishes. For me this is a cathartic exercise and the fulfillment of the promise that I made over a year ago, to finish this.


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## precious paws (Jun 7, 2006)

I'm so sorry for your loss. :smcry: :grouphug:


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## luvmyfurbaby (Feb 11, 2007)

I am so sorry for your loss.....I don't know if it's because I just lost my Dad but I am sitting here crying like a baby. Hugs to you and your family. I'm glad you had the extra year. :grouphug: :grouphug: :grouphug: :grouphug: :grouphug: :grouphug:


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

I am so so sorry for your loss. Leo was blessed to have you for his parents because he was loved so very much.


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## Tina (Aug 6, 2006)

I am so sorry for your loss of Leo. You were part of that "fate". You with your perseverance kept Leo going with a lot of love and care</span>. :grouphug:


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## CloudClan (Jan 31, 2007)

Bless you and your family!

I admire you so much for all the beautiful words you have shared about your precious Leo. It is hard to express in words what beautiful spirits our little dogs have, but as I read your words I felt that I was given a window into Leo's lovely little soul. You have paid him a beautiful tribute here. :bysmilie:


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## binniebee (Sep 27, 2007)

I so hope all goes well for you and your pup. I can hardly imagine what you are going through.

*hugs*
Cyndi


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## msmagnolia (Sep 8, 2004)

> Bless you and your family!
> 
> I admire you so much for all the beautiful words you have shared about your precious Leo. It is hard to express in words what beautiful spirits our little dogs have, but as I read your words I felt that I was given a window into Leo's lovely little soul. You have paid him a beautiful tribute here. :bysmilie:[/B]


Very well said. 

You write so expressively and I feel your pain AND your joy at having had little Leo in your life. I lost a sweet little malt before her 2nd birthday to a cruel brain disease which she endured for nearly 6 months. Every time that I posted something hopeful about her, she took a big step back. I understand your reluctance to tempt fate......

My heart goes out to you and your family.


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## Andrea&Luci (Jul 30, 2006)

:bysmilie: :bysmilie: I am so terribly sorry for your loss...Thank you for that beautiful tribute to your strong little man... You were his strength and helped him fight this.. I am so sorry that it all had to end so suddenly like this. I pray for your strength and again I am so sorry for your loss... RIP beautiful Leo.. :grouphug: :grouphug: :grouphug:


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## sophie (Jul 9, 2006)

I am so sorry for the loss of your baby Leo. You were wonderful parents to love and care for him so much. I pray that you can find some peace as time goes on. Thank you for sharing Leo with us. :grouphug:


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## Gemma (Jan 19, 2006)

:smcry: :smcry: :smcry: I'm so sorry. that made me cry even though I didn't know about Leo last year. I just read everything today :smcry: :grouphug: :grouphug: :grouphug:


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## Maria71 (Sep 25, 2005)

:smcry: I am so very sorry for your loss of Leo :smcry: :grouphug:


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## kodie (Aug 24, 2004)

I am so sorry for your loss... your family is in my prayers... rayer: :grouphug:


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## Carol Ann (Dec 5, 2004)

My deepest condolences on the loss of your precious Leo. Thank you for sharing him with us, and thank you for your beautifully expressed thoughts. Your words always brought me to tears - the hopeful ones, the grateful ones, the anguished ones, the sorrowful ones, the loving ones. Leo's was so very lucky to have had parents as special as he was. You were blessed with a joyful, sweet and loving pup who will always hold a place in your hearts. May he rest in peace, and may you find comfort and solace.


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## lillady (Jan 25, 2007)

I am deeply sorry for your loss :smcry: :smcry: :smcry: :smcry: May the memories of Leo bring a smile to your face in your time of sorrow :grouphug:


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## MissMelanie (Feb 13, 2006)

My deepest condolences go to you and your wife.

Often I had been wondering about Leo's health and I am so sorry to hear his end came so very soon, yet I am thankful you and your wife did have the time with him that you feel was prolonged. 

I also want to thank you for doing all you could for Leo.
Melanie


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## schmeez (Sep 21, 2006)

I don't really have any substance to add, but I do want to thank every one here.

It is surprising to me how much it helps to talk about this in this way. I am typically an extemely private person, but sharing Leo, the good of him and the bad in him, has eased the pain. I dont know if that is because his memory has been spread, which he deserves or if it is the wonderful kindness that each of you has expressed throughout, or the most likely answer - both. 

Thank you.


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## Furbaby's Mommie (Jul 10, 2004)

> My deepest condolences on the loss of your precious Leo. Thank you for sharing him with us, and thank you for your beautifully expressed thoughts. Your words always brought me to tears - the hopeful ones, the grateful ones, the anguished ones, the sorrowful ones, the loving ones. Leo's was so very lucky to have had parents as special as he was. You were blessed with a joyful, sweet and loving pup who will always hold a place in your hearts. May he rest in peace, and may you find comfort and solace.[/B]


Carol Ann said so beautifully how I also feel. This especially hits home for me since my beautiful little 6 mo. old Shoni has just had the bile acid and Protein C tests come back pointing toward shunt. So far he has no symptoms but I understand that is often the case until later on. We are going to repeat everything then probably do a scintigraphy to look for a shunt. We would hope to do the surgery if it looks operable. I am praying this is all a horrible mistake and Shoni will be as perfect as he looks to be, but I know in my heart that is probably not the case. It is breaking my heart and I am begging God to not let this happen to my darling baby.
I send you my love and prayers and thank you for sharing this heart rendering experience with us. :grouphug: :grouphug:


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## revakb2 (Sep 8, 2006)

Thank you for sharing your story.


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## Scoobydoo (May 26, 2005)

I am so very sorry for your loss of sweet little Leo :smcry: 
What a courageous little boy he was to fight as hard as he did.
May you always feel the warmth of his spirit in your hearts :grouphug: 
Rest in Peace little Leo :grouphug:


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## babygirlmom (Jul 3, 2007)

I am so sorry about the loss of your little Leo. My prayers go out for you and your family. I know how hard it is to lose a pet & family member. You were so generous to let us get a glimpse inside this remarkable fellows little life & what a wonderful parent you were to him. I know he is looking down from the Rainbow Bridge thanking you for the wonderful & loving care you gave him.


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## ShilohsMom (Jun 25, 2007)

I was not here last year and just read the entire thread. You have a way with words and what you have shared is heart wrenching and yet a beautiful example of the love between a malt and their people. What a wonderful tribute to your beloved Leo. Thank you for loving him the way every pet deserves to be loved. I know it is no comfort but it sounds like their was alot of quality in the time with Leo if not enough quantity. Thank you for taking the time to finish this, in spite of the pain. My best wishes to you and your family.


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## mooshe (Dec 12, 2007)

> I quit writing one sentence too soon.
> 
> That is not how it ends. He will be with us the rest of our lives and each day that he gave us was a gift.[/B]


I just picked up this thread and want to send my deepest thoughts and heart-wishes to you.

Yesterday was the year anniversary of the death of our beloved Samantha, who went through a very similar experience as Leo - ups and downs - elation at what could be interpreted as 'good' news and despair at what wasn't - the conflict of desperate hope and hard reality - and a year of missing part of our hearts. But we have exquisite memories and feel gifted to have had her for as long as we did. You are not alone in your mourning - and it only diminishes, never leaves.

Blessings to you.


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