# Vet said baby is dying-we need your help a.s.a.p.!!



## LOVE_BABY (May 5, 2015)

VET TOLD ME BAABY IS DYING --HE ACTUALLY SAID DYING! His horrifying blood test results are attached. I don't want to believe it. Baby suddenly became very sick now going 2 weeks ago.Here are his liver/blood test results results. Dr. Thinks he has shunts inside of his liver and that his liver is abnormally small. His eyes are goopy and look unhealthy, all he does is sleep, no playing anymore, he doesn't want to get up in the a.m.'s. by some miracle he is still eating but that is all. We have had him to emergency room=where they did zero there. We had him to a new vet on the day our usualy vet was in surgery, she put us on Metro, told us her in house blood test which she gave Baby couldn't be read because baby's levels were so high & sent us home with no diagnosis. Then we went to our regular vet and first he said food poisoning from the Stella & Chewys freeze dried, then he said no not food poisoning but leptospirosis, but then he had an ultra sound done and they couldn't see any shunts so now he thinks it is liver shunting inside the liver and doesn't think it is lepto anymore. They he did a bile acid test and told us those results indicated a liver shunts. Baby had a lepto test at vet we had seen that day when our regular vet wasn't available & it was negative for lepto. I have since learned on my own by googling that lepto can hide for 10 days or more before being detected when tested for lepto. Now I am wondering about lepto again & we need a new test just to rule that out. 

it has been 2 weeks since Baby has taken a downward spiral. We need to figure out what to do next. Our vet told us he thought it best to medically support baby with diet & meds & not do surgery or further testing because it's very risky. But the way Baby is acting I feel we might loose him if we don't do something more right away. I've heard a CT scan is the thing to get so that we will actually know what we are dealing with and the full extent of it. However the referral hospital with the specialists that our vet reffered us to has some very bad & scary reviews. *I have read that Dr. Center at Cornell is the 'Guru' to see about liver crisis. We are in NJ and she is several hours away NY so we can go there which I am investigating now. I hope she still treats dogs now because the post where I heard about her was from Walter and is from 2015 and he took Lucky to Dr. Center. Does anyone have any more info that can help us? We are desperate and don't want Baby to die please help, please I'm begging*:crying:. *--thank you*


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## pippersmom (May 21, 2012)

OMG Sandy. I can't be of any help other than to send prayers that you find out what is wrong and can get it treated. Someone here will probably have some good advice on what to do next. Please keep us updated.


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## sherry (Jan 4, 2013)

Sandy, this is really scary news! Yes, Dr. Center is who you need to see. I would make arrangements as soon as possible. Walter sees her every year and will have more info for you.


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## maddysmom (Mar 8, 2012)

I'm so sorry!
Did they do a protein c test to dx shunts?
A lot of tick borne diseases can cause high liver values, as well as gastro disease.
Suki just had a very high liver counts 5x her norm but after 2 weeks of metronidazole, her liver was back to normal, which means it was her GI disease.
I would not call Baby dying. That's jumping the gun. A good internist or liver specialist will know much more than your vet, IMHO.
We are here for you, Sandy. Please, before you make yourself sick, find a good doc to dx.
Sending hugs to you.

Edit: Also...would like to add his ggtp levels are normal, which would be high in liver disease.
Edit again: dogs fed raw have higher liver values in general


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## LOVE_BABY (May 5, 2015)

Thank you for your prayers. Cornell has an answering service answering on Sunday today is Sunday. The person who answered told me to call on Monday or to come in as an emergency. Ithica NY is 4 hours a way and we want to know for sure that Dr. Center will be there and will be able to see us before we go dragging Baby while he is so sick so far away without a definite appointment. I don't even know if she could be on vacation for all I know. This is so scary it looks like I will have to wait until tomorrow morning to call Cornell about an appointment. I hope and pray I can reach Dr.Center and that she will be able to see us a.s.a.p. Every morning I am so afraid I will find him passed away inside of his crate I am so afraid to look. We tried having Baby sleep in our bed with us but I think we kept him awake and he didn't get rest, he isn't used to sleeping in our bed {we had been afraid we would roll over on him when he was a puppy so we never started that habbit}. I thought if he slept with us now that he is sick it might keep his spirits higher & he might feel some comfort from us & feel our love which we hope would be healing to the spirit and maybe affect his body as well, but when he slept with us I don't think he got the rest he needs. So I have been letting him sleep in his crate again so he can get rest. When I put him in his crate at night to sleep {which is the only time he is ever in his crate} it seems like in the mornings he is worse after being alone. We need to speak with Dr. Center badly too much time has already gone buy which was wasted. Baby is only 6..... he is the love of our lives... I keep hoping to wake up from this nightmare.


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## LOVE_BABY (May 5, 2015)

maddysmom said:


> I'm so sorry!
> Did they do a protein c test to dx shunts?
> A lot of tick borne diseases can cause high liver values, as well as gastro disease.
> Suki just had a very high liver counts 5x her norm but after 2 weeks of metronidazole, her liver was back to normal, which means it was her GI disease.
> ...


Thank you Joanne, no Baby has not had a protein C test. Our vet didn't mention it. I have also heard 'portography' and 'CT scan' and 'dye test' are good things to do. What we need is an expert as you said. We feel like Baby is slipping away despite having been to 3 different vets in the past week. Dr. Center sounds now to be our only hope. I can't seem to fine specialists in our close immediate area who can help us. I have read the reviews about some of these places such s Red Bank Veterinary Hospital and the negative reviews for there are so scary. Red Bank Veterinary Hospital is where our regular vet recommended us to go to speak to a specialist only after I asked him for 2 days straight to please tell us where else to go. The neg. reviews for Red Bank made me want to run. 

Again thank you, and also everyone else for your help and prayers. Please don't be offended if I can't respond at this time individually directly to everyone's individual post, but rest assured I will be regularly checking in and reading every single one of them and I appreciate them more than you can know. I am spending most of my time researching this problem and tending to Baby meanwhile dong the necessary daily chores to get us through our days. Joanne he was also on Metro for 10 days and hasn't improved. He is currently on Lactulas, Ursidiol, and soon will be on Denamarin as soon as it comes in.


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## sherry (Jan 4, 2013)

What were the BAT numbers? My Riley and Sissy have MVD. Riey's was a big scare back when his test came back and I had him scheduled for surgery. Then the protein C test came back and was 90% MVD and only 10% chance of shunt. I cancelled the surgery and he has done well with diet and meds for years. His BAT numbers still come back high but he is healthy. Sissy's numbers are not bad compared to Riley's. Besides Baby's liver enzymes being high everything else looks normal. Try to calm down and make an app't with Dr. Center's office tomorrow. The meds he is getting are normal for liver problems.


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## wkomorow (Aug 26, 2011)

First do not panic. Luck has been medically managed for 7 years. He want through something similar and came through it. The standard medication for liver support is metro , lactulose and denimarin. Denamarin supports the liver and lactulose neutralizes the ammonia. You need a c protein test. That will distinguish between a shunt and MVD. 

In terms of diet, Luck is on Royal Canine Hepatic - which does not have meat in it. He is also on a no meat but high dairy product with lots of veggies. He has done amazing on it.

However, looking at his results, it does not look very shunt like. His albumin is normal. In shunt dogs, they can not process proteins as well and typically the albumin it low. His Alt and Asp are off the charts, Lucks are normal. If I were to hazard to guess, it looks more like something is damaging his liver rather than shunting. GI issue, tick infection, ate something Baby shouldn't.

I think you have 2 courses of action. The first is to stabilize. I would avoid a raw diet for now and focus more on veggies and dairy, it will put less stress on the liver. Metro, lactoluse have an immediate effect on shut symptoms. The second is to make an appointment with Cornell even if Dr Center is not available. The internal medicine department is very knowledgeable. The residents have a lot of experience with shutting. I would also insist that the chief on duty also see Baby. At this point I think Baby needs a board certified internist whether that is Center or not. You can PM me with any questions.


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## wkomorow (Aug 26, 2011)

I should have said, Luck's problems which took a week to diagnose was tick related, it was that which uncovered his liver shut. He was sick for several weeks and lost a lot of weight. BTW, many Maltese have undersized livers because of MVD.


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## thesummergirl (Oct 1, 2018)

You have received such wonderful wisdom on this thread so far, so I just wanted you to know that we will be praying for your family and Baby. We lost our Lady Bella to a liver shunt a couple of years ago, and if you search the threads, you will see the whole story. What I will add is that I would give anything to be able to go back and try to medically and diet manage her Shunt, rather than surgical intervention, since surgical intervention took her life. Every dog is different. No two situations are the same. What is right for one, may not be right for the next. Pray deeply and consider all of your options. Only you guys can know what is best for sweet Baby. We are all here for you. Dr. Karen Tobias at UT is also a specialist in Shunts btw, so you may want to research her. Our Vets were able to do a phone consult with her, but unfortunately it was post-op (rather than pre-treatment), and Bella's body was not able to heal from the surgical intervention.


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## wkomorow (Aug 26, 2011)

I should have defined chief on duty - a professor at Cornell that supervises the residents that day. All are board certified specialists.


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## Snowbody (Jan 3, 2009)

Sandy - I'm so sorry. If it's liver related, Cornell is the place to be. But if they're not sure what's going on, and it sure sounds that way from what you wrote and you can't get to Cornell I would strongly recommend Animal Medical Center in NYC. They're very good in diagnosis and treatment. They really saved Ava's life over a year ago when vet after vet in NJ whom Pat went to (A Team) didn't do anything to help and they figured out what would help. She saw Dr Palma. Since that time others I know have gone to them for cancer and neurology and they are very knowledgeable in their fields. Just far and away the best vets. So think about that as well esp if it's not the liver and is something else. And they are open 24/7.


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## wkomorow (Aug 26, 2011)

AMC has a number of internists. It may be a great first choice. We stabalized Luck before we sought a second opinion at Cornell.


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## harrysmom (Sep 28, 2007)

I agree with Walter's post. Harry lived for over 10 years after his diagnosis, medically managed. I was told that surgery would have killed him.

He was also on Royal Canin Hepatic (canned and dry) which worked for him. We also went to Cornell and would recommend it highly. Lactulose and Metronidazole were wonder drugs for Harry for many years. Stop feeding raw.... animal proteins are hard for liver dogs to digest. Rice and tofu with cheese sprinkled on top is what Harry lived on (and loved) for many years. 

If I can help in anyway.. let me know.
Praying for Baby.

Debbie


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## edelweiss (Apr 23, 2010)

Just curious Debbie about how you prepared tofu for Harry?


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## harrysmom (Sep 28, 2007)

edelweiss said:


> Just curious Debbie about how you prepared tofu for Harry?


I just gave it to him raw right out of the package and broke it up/mashed it with a fork.


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## edelweiss (Apr 23, 2010)

Wow, considering it is a soy product I am surprised it did not do anything to his tummy.


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## michellerobison (Dec 17, 2009)

Checking in on updates:wub::wub::wub:


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## maggieh (Dec 16, 2007)

Walter and Debbie have given you some great advice. Getting medical attention from an expert is first priority. Many little ones have done well after a shunt diagnosis - the first thing is to stabilize. Let us know how today goes!


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## LOVE_BABY (May 5, 2015)

Checking in very quickly-I am off to our vet again today to get a second lepto test just to rule out lepto, I will also ask for another tick disease test. The Lactolos is giving Baby the liquid squirts so I have to tell them that today, his stool is not 'soft' as they said they would like it to be, its just liquid.We will be needing for our vet to 'refer' us to Cornell I called Cornell today & they told me that. Dr. Center doesn't see patients upon request anymore, they told me there is no garantee we could see her. I'm glad to hear the Internal Medicine department there is a good choice even if it doesn't include Dr.Center, I've made note of speaking to the Cheif on duty. I am going to look into AMC since it is the number one choice of Walter. We are in NJ and willing to drive several hours to get somewhere else such as Cornell, My husband doesn't like going into Manhattan but we will if the best care is there. C protien test I will ask if we can have one today, I'm not sure if it is a quick thing or a special appointment will have to be made for Baby to stay there and have it. I am surprised to hear from Walter that after looking at Baby's test results that they might show that it might not be a shunt but MVD or Tick related I can't wait to get to the bottom of this and find out from a specialist what is really going on for sure. All the votes on a veggie-dairy diet are good to find out about {we may have a challenge with the dairy because I suspect Baby is lactose intolerant, before he was sick whenever I gave cheese or yogurt he had diarrhea}. There is more great advice that I didn't comment here about because I need to run to the vet now, but I wrote it all down & thank you so much for it. I'm so sorry summergirl for your loss, I'm so sad to hear that happened thank you so much for the warning.Thank you Walter, Debbie, harrysmom, and everyone else whom I haven't mentioned. I have to run now but will try to check back in later after the vet , or as soon as I know anything, have done anything, gone anywhere new for another diagnosis, or if anything changes. Blessings to you ALL.


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## sherry (Jan 4, 2013)

The C protein test is a blood draw that is sent to Cornell. It will take a few days for results.


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## wkomorow (Aug 26, 2011)

Checking on Baby. Cornell has a satellite hospital in Stamford CT if that is easier to get to. In the long term having a borad certified internist look at Baby will save money and will be easier on him, because they are more likely to have expertise to point you in the right direction. I think a trip to Cornell could be helpful once stabalized. They can also provide dietary assistance. You can check to see when Center is on duty and schedule for that day.


Hope Baby is doing better.


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## m_n_m84 (Jun 13, 2012)

Praying for Baby and mama. Hope they can get this poor thing back in the right direction! Keep us posted


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## Dixie's Mama (Mar 19, 2008)

I’m keeping Baby and you in my prayers. You have received wonderful advice. Praying for help for Baby.


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## Snowbody (Jan 3, 2009)

Checking back....


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## Happinesstogo (Oct 17, 2015)

So sorry!!!! Do pray that the vet discovers what is needed to help your sweet Baby. 

Have no advice, only prayers, but you have them.

Lainie


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## thesummergirl (Oct 1, 2018)

How's Baby feeling today? Any news or results back yet? Keeping you guys in our thoughts.


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## pippersmom (May 21, 2012)

Praying we hear good news soon. My heart is breaking for what you're going through.


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## sherry (Jan 4, 2013)

Looking for update...


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## edelweiss (Apr 23, 2010)

We are all here on the bench. . . . waiting, hoping, praying for you & Baby!

:grouphug::Waiting::Waiting:


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## Maglily (Feb 3, 2009)

Just seeing this and hoping Baby is doing better.


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## Aviannah's Mom (Apr 28, 2017)

I am just seeing this as well! I am so glad you have gotten some great advice and so sad and heartbroken at the same time! My thoughts and prayers are with you.


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## michellerobison (Dec 17, 2009)

Checking in on you and Baby,,


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## Snuggle's Mom (Jan 3, 2008)

Just getting back on here since yesterday and hope that things are looking up for Baby.


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## edelweiss (Apr 23, 2010)

Prayers continue!


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## LOVE_BABY (May 5, 2015)

Thank you everyone for prayers, concern & precious wonderful advice. This has been exhausting I'm sorry it took so long I didn't mean to leave you hanging wondering, I haven't had free minute to myself I was to the vet so many times last week with Baby for testing, and alone by myself to pick up meds, etc. that I lost count. We are currently waiting for the results of the Protien C test, and have had the bile acid test {BAT}, a second blood test, Ultra sound, & a 2nd lepto test which was negative. Here is a copy of Baby's_* 2nd*_ blood test results after having been on the Metro, Lactulos, Ursodiol, & denamarin for a few days. And plus his other test results.

Three out of four of the high liver enzymes have come down, 3 are now normal and the ALT is still high at 292 --but the ALT is down from 2,500.00 what it had been previosly so a significant improvement. Baby seems to be feeling quite a bit better and acting more like himself.... but he sleeps ....A LOT. I also notice a bit of foam on his lower lip from time to time, and his eyes are so goopy & dry. The vet tole me to put 'Genteal Tears' in them 3 times a day & I clean them twice a day, they were never like this until now that this is going on with his heatlh. I have also included photos of his bile acid test and ultra sound results. 

I did not want to bring Baby to the specialist until I had done the research, and at this point now all fingers seem to be pointing me to Animal Medical Center in NYC, and then after that perhaps down the road to Cornell in Ithica to see Dr. Center if I can find out when she will be on duty {hopefully they will be willing to divulge that info to me}. So many people from here at S.M. feccomend AMC and also two of my own relatives have been to AMC and recommended AMC at this point that I feel God is leading us to go there. 

My next step is to make an appointment and go which I will be making one first thing tomorrow. My father tells me that from where I live which is so close to Manhattan, it should only take us 20 minutes to drive into the city through Lincoln Tunnel to the East side where AMC is. I'm wondering if Dr. Center ever works in AMC or is she strictly in Ithaca at Cornell? I've also made not of the name 'Dr. Palma' at AMC whom Susan {Snowbody} mentioned. I'll keep you all posted as soon as we've seen someone and know more. 

I am trying to keep Baby's spirits up as well as our own. I've opened all of the blinds & curtains to let as much sun in as possible. I don't want Baby depressed and sleeping in a corner now that the meds are having a positive effect, the spring sunlight is helping us feel more positve as well. I have been putting Baby into his stroller and walking around the block so he can get some sun and fresh air. And Baby has now officially moved permanantly into our bed for sleeping at night from now on. We tried it again having him sleeping with us and we've all finally gotten used to it & Baby is getting the sleep he needs. Having him there with us is doing us ALL some good. I love feeling his little body snuggled up to my chest. Sometimes he sleeps against my husbands back.

I asked my vet if the blood tests now show vast improvement, is Baby considered to be 'stable now?' and my vet said "no". So I am so confused as to what exactly is considered to be a 'stable'? 

Our current daily Med's routine:
8:00 am Denamarin tablet
9:00 am Lactulos & Ursodiol, & breakfast {all Baby does is sleep for hours after being given these two meds & seems depressed}
4:30 pm Lactulos {Baby seems to start feeling his best in the evenings}
11:00 pm lactulos

I am terrified the surgeon when we go will recommend surgery. I'll keep everone posted as we find out more after the specialist.
Thank you thank you thank you all!


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## wkomorow (Aug 26, 2011)

Sandy, I looked at the results, and they appear normal. I can not read a sonogram, but everything else is normal except the bile acids which are often high in maltese. The protein c will strongly indicate a shunt if there is one. Normally in shunts there is an increase of bilirubin in the urine.

Hopefully Baby will start to feel better soon. AMC is a great place and an internist will be able to guide you. I still think something else is going on. Denimarin takes weeks or months to have any affect.

Good luck you are a great mommie


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## sherry (Jan 4, 2013)

Sandi, I'm with Walter. I could only wish Rileys bloodwork looked that good. And Rileys BAT is more like 140 pre and 350 post. I will say that vets who are unfamiliar with the these tests in maltese tend to flip out and stress the parents. I know this because I have ben there. I think all will be OK if you give the meds a chance. And I also think the protein C test will come back saying no stint and only MVD. I have controlled Riley's MVD for years. Please just try to not get stressed out.


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## mss (Mar 1, 2006)

I was trying to read what the printed ultrasound report said, especially about the liver and gall bladder, but it's too blurry. Does it say anything helpful?


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## maggieh (Dec 16, 2007)

I agree with Walter. I think you’ll see Baby feel better as the meds do their thing! Baby’s tummy might also be a bit upset from the meds which might be causing the foamy lips. 

Regular vets often freak out when they see elevated liver enzymes. The ALT isn’t that high so a month or two on the Denamarin should make a huge difference.


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## LOVE_BABY (May 5, 2015)

*Sorry I couldn't reply to everyone on this thread individually but will try if I can!*



wkomorow said:


> Sandy, I looked at the results, and they appear normal. I can not read a sonogram, but everything else is normal except the bile acids which are often high in maltese. The protein c will strongly indicate a shunt if there is one. Normally in shunts there is an increase of bilirubin in the urine.
> 
> Hopefully Baby will start to feel better soon. AMC is a great place and an internist will be able to guide you. I still think something else is going on. Denimarin takes weeks or months to have any affect.
> 
> Good luck you are a great mommie


Walter thank you for sharing your wisdom & experience to help my precious Baby, we should be getting our 'Protien C test' results back in a couple more days. I'm anxiously awaiting them and to hopefully get more insight into what the problem is. I'm really wondering now because more than one person has commented that it might be something 'other' than shunts going on with Baby, and as you mentioned 'biliruben' is usually high in the urine of dogs with shunts and Baby's urine bilirubin appears to be in the normal range. Could it be possibly reading normal because the med's are masking his true bilirubin reading? I will have a lot of questions for the specialist. 



sherry said:


> Sandi, I'm with Walter. I could only wish Rileys bloodwork looked that good. And Rileys BAT is more like 140 pre and 350 post. I will say that vets who are unfamiliar with the these tests in maltese tend to flip out and stress the parents. I know this because I have ben there. I think all will be OK if you give the meds a chance. And I also think the protein C test will come back saying no stint and only MVD. I have controlled Riley's MVD for years. Please just try to not get stressed out.


Thank you Sherry, The BAT test we took was taken only after Baby had been on Metronidozol for a few days. Are Riley's BAT results 140 pre and 350 post while taking med's or while not on meds? Interesting you are one of several people who suggest it might not be shunts at all & something else. Protien C test results when we get them in a few days will hopefully indicate what it is. MVD is Mitral Valve disease am I correct? I've read about it here on SM a bit and also googled. I think I need to read more about it. It is a floppy heart vaulve that doesn't close completely or opens in the wrong direction correct? Baby had an ultra sound & they said his heart looked normal except for an overly long beat of one of his ventricals is how I understood it. My vet didn't even mention it so I thought it wasn't anything to worry about. I wonder now if that could indicated MVD?



mss said:


> I was trying to read what the printed ultrasound report said, especially about the liver and gall bladder, but it's too blurry. Does it say anything helpful?


Thanks mss,
I will try to get a clearer photo then post it on this thread of the ultrasound regarding the liver and gallbladder. The vets printer was running out of toner. I will read it again myself & try to understand it.



maggieh said:


> I agree with Walter. I think you’ll see Baby feel better as the meds do their thing! Baby’s tummy might also be a bit upset from the meds which might be causing the foamy lips.
> 
> Regular vets often freak out when they see elevated liver enzymes. The ALT isn’t that high so a month or two on the Denamarin should make a huge difference.


Thankyou Maggie, 
The meds creating the foam, yes makes sense. I started worrying blood sugar or organ failure and increasing my fear. When he has foam on his lower lip I offer him water and he drinks a lot, seams very thirsty when that foaming happens. The ALT reading on the 2nd blood test we took this week that I posted is much lower than it was a few days ago when we took the 1st blood test. it was super high in the 1st blood test I posted on the beginning of this thread. It started out being 2,414 and has gone down to 292 which is still reading as high but is much improved after taking the meds for a few days now. I will post test results side by side for comparison, plus I will post a blood test from last year from 2018 to show how much things have changed and gotten worse.


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## LOVE_BABY (May 5, 2015)

*Hear are the blood tests side by side for comparison, change from 2018 to now 3 tests*

Here are 3 blood tests side by side easier to compare.
one from April 2018 before there was any problems, the other taken March 22nd 2019 before meds with skyhigh ALT & other enzymes, and the third taken April 1st 2019 taken after being on meds for a few days with much lower but still high ALT & other enzymes down to normal after taking the meds for those few days. I also included the individual results again just incase the three together are too small to read. I've posted these all before but posted them here again so that you can see the super high ALT in the same post as the lower ALT after the meds {2 tests taken within about 1 week or a little more of each other}.


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## edelweiss (Apr 23, 2010)

Sandy, since you are in NJ I would highly recommend that you do an extensive tick panel. This caused both of my pups liver enzymes to spike when they had tick-borne diseases. New England is almost as bad as Greece w/ticks.


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## sherry (Jan 4, 2013)

Sandy, MVD is short for microvascular dysplasia. It is common in the maltese breed. And yes, those numbers I gave you for Riley are unfortunately his normal.


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## LOVE_BABY (May 5, 2015)

edelweiss said:


> Sandy, since you are in NJ I would highly recommend that you do an extensive tick panel. This caused both of my pups liver enzymes to spike when they had tick-borne diseases. New England is almost as bad as Greece w/ticks.



Good idea Sandi, thank you. Baby was tested for lyme, & heart worm and tested negative two weeks ago. When I asked my vet if Baby should be retested for tick born illness he said no. But now you have me wondering again. I'll ask him to do 'extensive tick panel'. Baby's health went from very great in 2018 with a super low ALT of 39 to what it is now ….so something major is going on I can't wait to get to the bottom of it. 

I am calling AMC in Manhattan as soon as I sign of of SM, I just wanted to check in here before I do, so that I will have as much info as possible from all of you kind & generous souls before I make an appointment. My husband will have to take off of work to come into the city with me because I don't want to go into the city alone with Baby along. Many moons ago I used to go to art school in Manhattan & take the subway alone all the time but that was a long time ago. Now that I have Baby I need an extra set of eyes and hands, and someone to watch our backs and who better than his father to do that. It's hubby's busy season at work so it will be difficult for him to take off but there is no other choice.


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## LOVE_BABY (May 5, 2015)

sherry said:


> Sandy, MVD is short for microvascular dysplasia. It is common in the maltese breed. And yes, those numbers I gave you for Riley are unfortunately his normal.



Riley, and all of the other sick fluffs are in my prayers! 
This being sick business is no fun at all:angry:.


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## Kathleen (Aug 4, 2011)

Sandy, I am so sorry for what you are going through. I am glad that you have been given such good advice here. It sure does sound like it could possibly be something else, since his ALT improved so quickly. Was there anything else he could have been exposed too - vaccine, tick and flea meds, anything else you can think of that might have caused a reaction?
I think it is great that you are going to investigate tick borne disease further.
In Chinese medicine, eyes are related to the liver, so it makes sense that his eyes would be goopy.
The integrative vet that I go to, Smith Ridge in South Salem NY is probably not too far from you. If you don’t have any luck finding answers, they are awesome at looking at the big picture and figuring things out from lab work. Just something to keep in mind as an option if you are interested.
I am so happy that his numbers are improving. I hope Baby continues to feel better and that you can get to the bottom of it. Sending lots of good thoughts and prayers. :grouphug:


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## LOVE_BABY (May 5, 2015)

*I'm sorry for this bieng a long post, contents important though.*



Kathleen said:


> Sandy, I am so sorry for what you are going through. I am glad that you have been given such good advice here. It sure does sound like it could possibly be something else, since his ALT improved so quickly. Was there anything else he could have been exposed too - vaccine, tick and flea meds, anything else you can think of that might have caused a reaction?
> I think it is great that you are going to investigate tick borne disease further.
> In Chinese medicine, eyes are related to the liver, so it makes sense that his eyes would be goopy.
> The integrative vet that I go to, Smith Ridge in South Salem NY is probably not too far from you. If you don’t have any luck finding answers, they are awesome at looking at the big picture and figuring things out from lab work. Just something to keep in mind as an option if you are interested.
> I am so happy that his numbers are improving. I hope Baby continues to feel better and that you can get to the bottom of it. Sending lots of good thoughts and prayers. :grouphug:


Thank you so much Kathleen,
I hope you and yours are doing well. Smith Ridge is an excellent suggestion which I had sort of ruled out previously because I had thought a 'specialist' had to be our next step now that you mention Smith Ridge I am going to rethink going there as a possible 1st option. Smith Ridge is within driving distance as I've mentioned to you a while back, & that I've read Dr. Marty's book I think highly of the place. I didn't know that about the liver being related to the health of the eyes-good to know!

As far as Baby being exposed to anything I can't imagine what? We watch him supervise him, especially when he is outdoors and I am always right next to him. We keep the inside of the house 'puppy proofed'. I've been racking my brain thinking what it could possibly be, what if the dog food had something bad in it? Wonder if it could be this overdose of vitamin D in dog food that is going on in the news? Although there hadn't been any recall on our particular brand. Wondering if it could be the 'Cranmate' cranberry supplement for dogs I was giving Baby to help prevent crystals in his urine or stones in his bladder or kidneys. I stopped giving Cranmate to him just in case that's what it was. We live on a corner lot in an active neighborhood our yard is fenced in, it is possible someone threw something toxic over our fence onto the grass too small to see or Baby stepped in it then licked his feet? 

Baby hasn't had vaccines for years --I titer for Parvo, Distemper & Rabies, & I haven't been vaccinating for Lepto or Lyme {Baby is allergic to lyme vaccine}. Baby tested negative for Lepto he's had two tests for it in two weeks, both were negative. The only other thing I can think of is that we have been forced to spend most of our time during the past two years downstairs in our family room which has an open flame burning in the furnace which is in the laundry room next to the family room. Contractors wouldn't finish our kitchen, our entire upstairs where the kitchen is was unusable for two years... I wonder if fumes from our furnace could be the cause? As a precaution I called PSEG 3 times over the winter to come and check to make sure it was safe, they used their meters to check, because sometimes it smells slightly like a car exhaust down there. I had them check it carbon monoxide & gas on 3 occasions this winter & each time they told me there is "no problem".

Only two days ago I had thought I was so certain about taking Baby to AMC in nyc as our next step, but I have been getting cold feet about going to talk to a specialist who also does surgery. I am so afraid that he/she might jump to recommending surgery when it could be unnecessary if they misdiagnose and something else is going on with Baby as you mentioned. Some surgeons are just 'surgery happy' and money hungry and recommend unnecessary procedures. This concern I have does not include or apply to Dr. Center of course who has a stellar reputation and who I trust. I'm only talking about if we were forced to see someone else other than Dr. Center since she is difficult to see nowadays. 

Smith Ridge might be a good idea for us to try as a last ditch effort before going to the more extreme measure of going to a surgical center. I have been thinking and thinking about this situation constantly every single day. It's hard to know which direction we should go in. I've read a lot of bad reviews of surgical centers in general, it seems like they all have reviews with horror stories of misdiagnosis, failed surgeries, improper care. Summergirls sad story of loosing her little one from surgery for a shunt has been haunting me. 

Since it seems at the moment as if Baby's numbers are within a somewhat safe range from the meds right now, that perhaps it wouldn't hurt for us to go and take him over to Smith Ridge first before resorting to going elsewhere. Thank you:thumbsup: for reminding me of Smith Ridge as a first step before we take any big leap to a surgical center. It certainly couldn't hurt to go there first! I will PM you, I have a question.

Thanks!
Sandra


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## maddysmom (Mar 8, 2012)

I'm sorry Sandra...I've been MIA taking care if my parents. I wanted to check in to see how Baby was. Any improvement?


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## Snowbody (Jan 3, 2009)

Sandy - I only have one warning about holistic medicine. At rescue we took in a puppy about 9 months ago. He had a very serious heart condition -- we've seen PDA etc but this was a lot worse. The owner went to a well known vet on Long Island who ran all the tests etc, said there was no surgery that could be done and gave her herbal meds. The dog's growth was stunted and he likely would have only lasted a few more months. He was 3 months old. We were contacted by the mom and she surrendered him to us. Our foster took him to AMC. They checked him out every which way, said they could do surgery in about 3 months and felt optimistic, threw out the herbal meds and put him on a beta blocker. His heart got stronger, he started growing, he had lots of energy and he had the surgery at 6 months. He is so strong and they think the surgery was a total success. He just hit his one year birthday a few weeks ago. His foster adopted him and he's just a normal dog now. So I get leary about serious medical issues and the holistic route in some cases. It's all individual but this is what we went through.


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## edelweiss (Apr 23, 2010)

Sandra, do we have any new info on Baby? I know you must be concerned and am praying for wisdom as you move forward.


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## LOVE_BABY (May 5, 2015)

maddysmom said:


> I'm sorry Sandra...I've been MIA taking care if my parents. I wanted to check in to see how Baby was. Any improvement?


Thanks for asking about Baby, & I hope your parents are doing well. Baby is pretty stable at the moment and his ALT level came down to 292, he is more sleepy than usual but is acting normal at times barking etc., he hasn't asked to play since this happened though. I am trying to decide where medically to have him seen. Thank you for your concern.




Snowbody said:


> Sandy - I only have one warning about holistic medicine. At rescue we took in a puppy about 9 months ago. He had a very serious heart condition -- we've seen PDA etc but this was a lot worse. The owner went to a well known vet on Long Island who ran all the tests etc, said there was no surgery that could be done and gave her herbal meds. The dog's growth was stunted and he likely would have only lasted a few more months. He was 3 months old. We were contacted by the mom and she surrendered him to us. Our foster took him to AMC. They checked him out every which way, said they could do surgery in about 3 months and felt optimistic, threw out the herbal meds and put him on a beta blocker. His heart got stronger, he started growing, he had lots of energy and he had the surgery at 6 months. He is so strong and they think the surgery was a total success. He just hit his one year birthday a few weeks ago. His foster adopted him and he's just a normal dog now. So I get leary about serious medical issues and the holistic route in some cases. It's all individual but this is what we went through.


That is a scary story. I'm thinking it couldn't hurt to go to both places, to the holistic vet just to see what he thinks is going on, and also to Cornell or AMC. I like how AMC treated the puppy in your story at it sounded very reassuring how they handled him and that it all ended well. I'm glad the puppy is thriving now! 



edelweiss said:


> Sandra, do we have any new info on Baby? I know you must be concerned and am praying for wisdom as you move forward.


I spoke with my regular vet on the phone yesterday. We talked about how there is the real possibility that it is actually not a shunt but something else going on. My Vet thinks it is a shunt because the evidence 'as he sees it', points to that diagnosis. He also agreed that this somehow might have been caused by a toxin or tick disease. When I asked him about it he agreed to do a more intensive tick screening for me if I want it. He already checked for Lyme, Anaplasmosis, and something else already, but said there are other tick diseases even though they aren't common in this area which I already knew. I am going to bring Baby back in so he can draw more blood for more extensive tick testing. 

Baby seems to be stable right now, now that his ALT came down a lot to 292. He is pretty happy although is tired and a little depressed in the a.m., buy the mid afternoon he perks up. Some people said the meds might be making him sleepy in the a.m. I got his Protien C test back today and I will be posting it in hopes that someone can let me know what it means. All that my vet said was that it was 'normal'. Thank you for praying for and asking about Baby, I need all the divine wisdom and enlightenment I can get regarding such important choices I am trying to make, thank you.


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## LOVE_BABY (May 5, 2015)

*Here is baby's protien c test results-can anyone dicipher it?*

HERE IS BABY'S PROTIEN C TEST RESULTS-CAN ANYONE DICIPHER IT?

These are Baby's Protein C Activity Assay Test Results, they emailed them to us today. Does anyone here know how to decipher it? I'm not quite sure I understand what it is saying. All my regular vet told me about it is that it is 'normal'. If anyone has experience with reading it I'd love to hear your opinion what you think possibly may or may not be possibly going on? 
Thank you very much in advance:heart:! P.S. I'm also wondering if you can tell if this test result indicates that Baby does not have a shunt or MVD? Is it possible he could have shunts even with these test results? This test was sent to Cornell who did the findings for it.


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## sherry (Jan 4, 2013)

Hi Sandi.Baby's Protein C test came back about the same as Riley's. These results say that Baby is only 10% chance of shunt and 90 % chance of MVD. MVD, Microvascular Dysplasia, is very easily managed with lactulose and denamarin. And lower protein diet.. I think it is time for you to take a deep breath and try to relax.


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## Maglily (Feb 3, 2009)

I'm glad about the Protein C test, I think Sherry's advice above and from others is good and helpful, (I 'm sorry I don't have any) but looks like you can relax now and not worry it's something worse. Thank goodness for that.


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## wkomorow (Aug 26, 2011)

Wow, that is a great result. Protein C under 70 strongly suggests congenital shunts. Baby is well above that number.


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## maddysmom (Mar 8, 2012)

Sandra...that's great news! Im so relieved for you. 
Regarding Baby's other results, I had to go back and find Lacie's protein c test (113%) and while looking, I found all her other blood work, which were very high liver enzymes, in fact everything was way off on her blood work. I guess my point is...could it be something with Baby's gallbladder or underlying gi disease, like I mentioned before. It was with Lacies but went undiagnosed for the longest time. 
Being that Baby's values all dropped after being on the antibiotic (which GI disease is responsive too) it makes me wonder. Or like mentioned, a tick borne disease.
What are your next steps to dx?


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## wkomorow (Aug 26, 2011)

I agree with Sherry. 80% of Maltese have some level of MVD, but really does not look like Baby has congenital PSVA (shunt). It is still possible that Baby got into something, but I would have expected him to be better by now. Tick disease is also a possibility. I have no experience with GI issues, but I imagine a flair up could cause liver values to increase; Lucky follows a vegetarian diet and has an iron digestion. He only had loose stools a couple of times in his life when he was fighting the tick borne disease that uncovered his liver issue and when he was on a pain medication after being neutered. I tend to favor spicy tofu dishes and he will literally steal hot peppers off my plate and return for more. (No I am not suggesting people feed their dogs hot peppers, it is just Luck loves them.) I would ease off the protein a bit. When you have a better sense of what is going on, you could do a consult (via phone) with a dietitian at Cornell or Tufts for a better home cooked diet.


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## edelweiss (Apr 23, 2010)

Great advice on this forum---great compassion too!


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## LOVE_BABY (May 5, 2015)

*Thank you all for looking at Baby's test & for your care and concern!*



sherry said:


> Hi Sandi.Baby's Protein C test came back about the same as Riley's. These results say that Baby is only 10% chance of shunt and 90 % chance of MVD. MVD, Microvascular Dysplasia, is very easily managed with lactulose and denamarin. And lower protein diet.. I think it is time for you to take a deep breath and try to relax.


It's so helpful to have the support and knowledge of you all, my vet didn't mention MVD, but he did say " I suspect Baby has a whole bunch of tiny shunts inside Baby's liver that would be like looking for a needle in a haystack to fix surgically which I don't recommend doing." Perhaps he could have been referring to 'MVD' but just didn't use the name of the disease. He didn't indicate to me at all that the Protein C test indicated MVD or anything else for that matter. He just said "his results are normal" and that was all. I was briefly happy about Baby's 'normal' range results until realizing that it doesn't mean Baby is out of the woods and doesn't have some type of problem still such as MVD, or some other thing. I'm trying to take a deep breath and relax, thank you for caring about me, but it is difficult though. My husband and couldn't fall asleep last night with this dilemma about what to do next, and what it could be heavy on our minds. I'm so glad for you that Riley is responding so well to treatment and that does give me a lot of hope for a good future for Baby too if he also has the MVD. Has Riley ever had any surgical testing done and had to be put under anesthesia, or has he had any surgery for this problem? I am wondering what is the long term prognosis for dogs with MVD? The things I've read said they can do well for about 5 years sometimes but it sometimes turns into Hepatic Encephalopathy {ammonia on the brain} which eventually antibiotics might no longer be able to treat.....Is this true? Or can MVD continue to be managed and controlled indefinitely by meds? Is it a given that it will eventually progress to a point where I can't be managed? The more I read the more scary this gets. I'm hoping you'll be able to tell me since you are dealing with MVD now. *I'm very sorry I'm having to bring up such scary topics for you to think about I don't mean to scare you.*



Maglily said:


> I'm glad about the Protein C test, I think Sherry's advice above and from others is good and helpful, (I 'm sorry I don't have any) but looks like you can relax now and not worry it's something worse. Thank goodness for that.


Thank you, yes I am so appreciative of the wonderful support and advice everyone is so generously sharing with us.



maddysmom said:


> Sandra...that's great news! Im so relieved for you.
> Regarding Baby's other results, I had to go back and find Lacie's protein c test (113%) and while looking, I found all her other blood work, which were very high liver enzymes, in fact everything was way off on her blood work. I guess my point is...could it be something with Baby's gallbladder or underlying gi disease, like I mentioned before. It was with Lacies but went undiagnosed for the longest time.
> Being that Baby's values all dropped after being on the antibiotic (which GI disease is responsive too) it makes me wonder. Or like mentioned, a tick borne disease.
> What are your next steps to dx?


Thank you so much for going to the trouble of looking up Lacie's test numbers & records to compare them with ours, I really appreciate that you did that! I think our next step is to go to AMC in NYC, and then Smith Ridge in NY. We may actually go to AMC first because it is a little closer and we can probably get a sooner appointment there much faster. We have an appointment at Smith Ridge but it is not for a while, the doctor there is in high demand and hard to see. I hadn't considered about GI disease or gall bladder issues mostly because my vet had never mentioned they could be on the radar as a possibility. And I seem to hear more talk in general about liver issues. At this point we really need a specialist to look at Baby do determine what has been going on. I just hope they won't be 'surgery happy & money hungry $$$' and that's because my biggest fear is the specialist suggesting dangerous testing and/or surgery just to make $$$ when it might be unnecessary or if there is a misdiagnoses. {I am trying to stop my worrying but I can't seem to stop...}



wkomorow said:


> I agree with Sherry. 80% of Maltese have some level of MVD, but really does not look like Baby has congenital PSVA (shunt). It is still possible that Baby got into something, but I would have expected him to be better by now. Tick disease is also a possibility. I have no experience with GI issues, but I imagine a flair up could cause liver values to increase; Lucky follows a vegetarian diet and has an iron digestion. He only had loose stools a couple of times in his life when he was fighting the tick borne disease that uncovered his liver issue and when he was on a pain medication after being neutered. I tend to favor spicy tofu dishes and he will literally steal hot peppers off my plate and return for more. (No I am not suggesting people feed their dogs hot peppers, it is just Luck loves them.) I would ease off the protein a bit. When you have a better sense of what is going on, you could do a consult (via phone) with a dietitian at Cornell or Tufts for a better home cooked diet.


I hadn't heard about the high statistics of most Malts having some amount of MVD! So now I have many new possibilities to consider: MVD, Toxins, Tick Disease, GI issues, Gall bladder issues. Now we have to talk to someone who can figure it out for sure. If the specialist we will see says we need a CT Contrast Scan and a biopsy {where multiple samples are taken from different areas of the liver} that will be a scary day indeed. I read that the only way to determine if this is MVD for 100% Sure is to take biopsy's from all over the liver. According to my regular vet in his opinion it would be super dangerous for Baby to go under the anesthesia with his liver being compromised and so small, which would be required in order to do the two procedure's and not worth the risk of going under. I'm not sure if I mentioned before in any posts etc. that Baby's liver was found to be very undersized during the Ultra sound he had recently. I am wondering if we go to AMC will they allow us to make our own choice about weather to have surgery? I am afraid they might try to force us into having it. 

I giggled out loud when I read that Luck loves hot stuff! So unusual for a dog. Capsaicin in hot peppers is supposed to be good for circulation & other healthy things. Amazing that he willingly eats that and that it sits well with him. Baby has a thing for 'Burt's Bee's Original Lip Balm' {its minty} every time I put it on myself he tries to lick my mouth its really funny. I don't let him lick it of course, but something about it drives him crazy. He seems to like the scent after I brush my teeth as well I guess he is a mint fan. However the actual herbal mint growing outside in the garden he could care less about--go figure?



edelweiss said:


> Great advice on this forum---great compassion too!


Yes :heart:thank you all for your "great compassion" how Sandi put it so well. I'm hoping someday I will get to meet some of you. I would love to meet you ALL, but I know that's probably not possible since we are all scattered over the US and also the world. Maybe God willing Baby will be well enough to get to that party down the shore one of these years coming up. I'm hoping so because if Baby was well enough to do that it would mean he was doing well. We would love to go to meet some of the faces behind the wonderful words:heart:.


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## maddysmom (Mar 8, 2012)

Found this on my search
The pretenders

A number of diseases may be confused with hepatic disease because of clinical signs or clinicopathological abnormalities. Increased liver enzymes, ALT, and ALP may occur in pancreatitis, diabetes mellitus, and hyperthyroidism. Moderately increased bilirubin can occur in a variety of non-hepatic diseases as well as in conditions such as prolonged anorexia, catabolic states, and infection. Mild increases in ALT may be observed in animals with cardiac pathology. Substantial increases in ALP with moderate increases in ALT will occur in most dogs with hyperadrenocorticism


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## LOVE_BABY (May 5, 2015)

maddysmom said:


> Found this on my search
> The pretenders
> 
> A number of diseases may be confused with hepatic disease because of clinical signs or clinicopathological abnormalities. Increased liver enzymes, ALT, and ALP may occur in pancreatitis, diabetes mellitus, and hyperthyroidism. Moderately increased bilirubin can occur in a variety of non-hepatic diseases as well as in conditions such as prolonged anorexia, catabolic states, and infection. Mild increases in ALT may be observed in animals with cardiac pathology. Substantial increases in ALP with moderate increases in ALT will occur in most dogs with hyperadrenocorticism


Wow! Thank you honorary 'Doctor' Joanne! Very informative. I think Baby's bilirubin was normal on his blood test. I worry about pancreatitis & diabetes because the Lactulose he is on is pure sugar and I wonder what it could be doing to his blood sugar especially if he could have a problem such as diabetes. I also shudder to think what it will do to his teeth over time. To put him under anesthesia is risky and we all know what sugar does to teeth. To put things into perspective, right now 'teeth' are the least of our worries. Again, this info you just gave us screams --get him to the specialist --stat!
P.S. in his recent Ultra sound they said all of Baby's other organs looked normal & healthy, except for his liver which is very undersized. The vet had said he heart looked good. But I guess maybe they can't tell everything that could be going on with the other organs with only just the ultra sound.


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## maddysmom (Mar 8, 2012)

LOVE_BABY said:


> Wow! Thank you honorary 'Doctor' Joanne! Very informative. I think Baby's bilirubin was normal on his blood test. I worry about pancreatitis & diabetes because the Lactulose he is on is pure sugar and I wonder what it could be doing to his blood sugar especially if he could have a problem such as diabetes. I also shudder to think what it will do to his teeth over time. To put him under anesthesia is risky and we all know what sugar does to teeth. To put things into perspective, right now 'teeth' are the least of our worries. Again, this info you just gave us screams --get him to the specialist --stat!


I was thinking diabetes or cushings with the high Alt. Did they check him for either?


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## LOVE_BABY (May 5, 2015)

maddysmom said:


> I was thinking diabetes or cushings with the high Alt. Did they check him for either?


No they didn't check him for diabetes or Cushings, but his ALT did come down to 292 {down from 2,484} when he was last checked about a week ago after being on the meds {Metronidazol, lactulose, Ursodiol} for several days. Now he is also on Denamarin which I began giving to him last Monday. 292 is still high but no where near what it was.


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## maddysmom (Mar 8, 2012)

LOVE_BABY said:


> No they didn't check him for diabetes or Cushings, but his ALT did come down to 292 {down from 2,484} when he was last checked about a week ago after being on the meds {Metronidazol, lactulose, Ursodiol} for several days. Now he is also on Denamarin which I began giving to him last Monday. 292 is still high but no where near what it was.


I’d be curious if he had done another course of Metronidazole, if that ALT came down more, which could point towards gallbladder or some other GI disease. Suki’s ALT just spiked really high, as well as her other liver enzymes, not as high as Baby’s, but close to that, a few months ago and I was freaking out, but like I said earlier in the thread, they dropped back down to almost normal, which meant she had an overgrowth of bacteria in her gut. If she didn’t respond at all, it was most likely liver related.

If you can try and pinpoint, the vets won’t run additional test. It’s when you walk in blind, like I was with Lacie that they tend to do a lot of unnecessary test.
You now know it’s not a shunt, thankfully, so I would think the focus would be tick, GI related, diabetes, maybe even endocrine related.

The best news is Baby is not dying. Why in the world would your vet insinuate something like that without thorough testing is beyond me, yikes.


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## maddysmom (Mar 8, 2012)

LOVE_BABY said:


> P.S. in his recent Ultra sound they said all of Baby's other organs looked normal & healthy, except for his liver which is very undersized. The vet had said he heart looked good. But I guess maybe they can't tell everything that could be going on with the other organs with only just the ultra sound.


Ultra sounds are only a good resource, depending on who is doing and reading the results.
Ex: Lacies’s ultrasound sound showed nothing, perfectly normal, no inflammation in liver, gallbladder or pancreas, yet she was very sick. The following day, her Spec CPL test came back with very, very high numbers of pancreatitis, she was hospitalized for 5 days.

So unless the ultrasound was done at a specialty hospital and not at your regular vet...I wouldn’t bank on those results, imo.


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## LOVE_BABY (May 5, 2015)

maddysmom said:


> I’d be curious if he had done another course of Metronidazole, if that ALT came down more, which could point towards gallbladder or some other GI disease. Suki’s ALT just spiked really high, as well as her other liver enzymes, not as high as Baby’s, but close to that, a few months ago and I was freaking out, but like I said earlier in the thread, they dropped back down to almost normal, which meant she had an overgrowth of bacteria in her gut. If she didn’t respond at all, it was most likely liver related.
> 
> If you can try and pinpoint, the vets won’t run additional test. It’s when you walk in blind, like I was with Lacie that they tend to do a lot of unnecessary test.
> You now know it’s not a shunt, thankfully, so I would think the focus would be tick, GI related, diabetes, maybe even endocrine related.
> ...


Thank you --I agree 'YIKES' about what he said. I haven't had the nerve to ask 'why' he said that to me. I was afraid of what the answer would be if I asked.... I was afraid he would explain why, then it would be true. Instead I chose to tell myself that you all here at SM have been through some of this with your fur babies, and would be honest & direct with me and have a heart while doing it, and that my vet might not actually know everything. One thing that made me doubt him is when he jumped from malady to malady proclaiming it was the raw food I was feeding {my vet HATES raw & would love to blame that}, then changing it to that it was Leptospirosis, then doing a test that proved that wasn't the case at all, then saying it was a shunt. After three diagnosis in one week with no proof for any of them I told myself my vet might not really know if Baby is d____. I don't even want to say or type the word again. Baby is still here with us obviously. 

I may still ask him 'why' he said that when I am not feeling quite so fragile as I was last week. If the specialist says he is not d____, then I will for sure ask my regular vet why he told me Baby was. My vet has been mad at me for years for feeding raw, and for being a pro-active informed pet parent, he doesn't like to be questioned at all and gets angry if you do. I wonder if he could have taken some sick pleasure in telling me Baby was d____? I sure hope not, that would mean I have a really bad man as a vet. In our area of NJ good vets are few and far between, I personally don't know of any others. Which is why I was thinking of getting a second opionon about this at Smith Ridge in NY. I was in tears sobbing before he told me Baby was d____, when he said that it was like a knife into my heart. I drove home from there 40 min. away with tears streaming down my face the entire ride and felt as if I didn't want to be here anymore if Baby couldn't be. It was a very dark day and a very dark comment.... I felt much better after reading what people here had to say and like I still had some hope. A thousand times thankyou to everyone here.


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## maddysmom (Mar 8, 2012)

LOVE_BABY said:


> Thank you --I agree 'YIKES' about what he said. I haven't had the nerve to ask 'why' he said that to me. I was afraid of what the answer would be if I asked.... I was afraid he would explain why, then it would be true. Instead I chose to tell myself that you all here at SM have been through some of this with your fur babies, and would be honest & direct with me and have a heart while doing it, and that my vet might not actually know everything. One thing that made me doubt him is when he jumped from malady to malady proclaiming it was the raw food I was feeding {my vet HATES raw & would love to blame that}, then changing it to that it was Leptospirosis, then doing a test that proved that wasn't the case at all, then saying it was a shunt. After three diagnosis in one week with no proof for any of them I told myself my vet might not really know if Baby is d____. I don't even want to say or type the word again. Baby is still here with us obviously.
> 
> I may still ask him 'why' he said that when I am not feeling quite so fragile as I was last week. If the specialist says he is not d____, then I will for sure ask my regular vet why he told me Baby was. My vet has been mad at me for years for feeding raw, and for being a pro-active informed pet parent, he doesn't like to be questioned at all and gets angry if you do. I wonder if he could have taken some sick pleasure in telling me Baby was d____? I sure hope not, that would mean I have a really bad man as a vet. In our area of NJ good vets are few and far between, I personally don't know of any others. Which is why I was thinking of getting a second opionon about this at Smith Ridge in NY. I was in tears sobbing before he told me Baby was d____, when he said that it was like a knife into my heart. I drove home from there 40 min. away with tears streaming down my face the entire ride and felt as if I didn't want to be here anymore if Baby couldn't be. It was a very dark day and a very dark comment.... I felt much better after reading what people here had to say and like I still had some hope. A thousand times thankyou to everyone here.


Your vet sounds like my regular vet, unfortunately.
Just remember “A master of all, is a master of none.” That’s why there are specialist. :thumbsup:
If Smith Ridge is an option...that would be terrific! Kathleen has had the best experiences there. Do they have vets who specialize or would you still need to be referred to a speciality hospital?


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## wkomorow (Aug 26, 2011)

I would not do a liver sampling. I did not consider cushings - I don't have experience with it. T4 was normal, so I would think the thyroid is not involves with baby's issue. I do think this is a fishing expedition for the vet; a good specialist might see something immediately.


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## Snuggle's Mom (Jan 3, 2008)

Not sure where you live in NJ, but as a former resident, there are some really great Vets that I would only be happy to recommend to you.


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## Snowbody (Jan 3, 2009)

Good news with the Protein C. I totally agree with Sherry and Walter. Used to be that vets would put dogs through every sort of invasive procedures, US's and biopsies and really the Protein C test is a better indicator than all of them.



Remember you cannot be forced into anything by any vet. It's your pet/child and the decision lies with you. The internist that I met at AMC for Pat's Ava was so learned and did such a great job explaining everything...not like we're idiots, not like they know all and we knew nothing but totally listened to our concerns, what we observed and what we thought and then very professionally explained it all in layman's terms. (when I say we, I mean a few of us SM moms were there with Pat.) It was all one of the best experiences I've seen with a vet or specialist. They didn't push anything and in Ava's case they did need to do surgery to circumvent her trachea because it was so inflamed that she couldn't get food down, threw up, was losing weight alarmingly. There really was no other way to help her...about 4 or 5 specialists and vets in NJ tried other things that just made her sicker. They left the choice up to Pat. I asked him "Would you do it if this dog was yours?" He said, "Definitely." That totally sealed the deal.


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## maddysmom (Mar 8, 2012)

Found this link that might be handy. IMO, its really accurate on the group of test done regarding liver, immune, GI, infection.
https://www.2ndchance.info/dxme-testOrganization.htm


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## Matilda's mommy (Jun 1, 2005)

I just want you to know that I have been praying for Baby and for you. I will continue 
Hugs to you


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## LOVE_BABY (May 5, 2015)

*As it stands now, we will be going to both AMC & the Holistic Vet*



wkomorow said:


> I would not do a liver sampling. I did not consider cushings - I don't have experience with it. T4 was normal, so I would think the thyroid is not involves with baby's issue. I do think this is a fishing expedition for the vet; a good specialist might see something immediately.


Yes, liver sampling/biopsy is not something I am eager to have done. Thanks for letting me know what you think about the T4 being normal that might indicate it might not involve his thyroid, I didn't know you could tell that by looking at T4. We are also going to make an appointment with a specialist at AMC I finally decided we see both, holistic and conventional specialists. Unfortunately the waiting list for both to be seen is one month..... Baby seems to be doing OK on the meds I hope he continues that way until he can be seen. Baby lights up when I offer to take him out in his stroller, he is loving rolling around in the spring air and 'sniffing all the sniffs' lol. Our vet said not to walk Baby so at least he can still enjoy being outside in his stroller.



Snuggle's Mom said:


> Not sure where you live in NJ, but as a former resident, there are some really great Vets that I would only be happy to recommend to you.


Yes Snuggles Mom,
I would absolutely love the names of some great vets in NJ if you could recommend them to me! Thank you! I have been searching endlessly and reading reviews for years now to no avail for anyone in NJ. *Could you please PM {personal message} the names to me? *



Snowbody said:


> Good news with the Protein C. I totally agree with Sherry and Walter. Used to be that vets would put dogs through every sort of invasive procedures, US's and biopsies and really the Protein C test is a better indicator than all of them.
> 
> I'm glad we did the Protein C test, especially since a lot of people such as your self seem to think it is so telling about what is going on, I can't wait for a specialist to read our when we finally see one--there is a one month wait. Every one is saying it is 'good news' about Baby's Protein C results, but I'm still scared because I've read up as much as I can about MVD, and it seems scarier than a portosystemic shunt which is the kind outside of the liver {I think I have the terminology right anyway}. The ones outside the liver which seem to have a high success rate when treated surgically, 85% or some figure like that. MVD on the other hand to my knowledge is chronic and can't usually be surgically treated because there are so many tiny micro shunts in a usually undersized liver, but instead to my knowledge can only 'medically' managed most of the time. I've still not been able to find out much at all about the 'long term' prognosis for a dog with MVD if it turns out that is what Baby has. What I have read about the long term is scary.
> 
> ...


That is so nice that you and others were able to support Pat & Ava throughout that difficult experience & journey. *Would you please PM me the name of the Doctor that treated Ava at AMC? If you remember it that is.* Right now I am trying to choose an Internal Medicine doctor at AMC. Obviously I want to chose the best, most qualified person as possible for my fur child. If you have the name that would be great! My current vet uses 'scare tactics' when dealing with me, I'm a bit jaded due to that experience. That's why I have my guard up when it comes to being pressured into anything, it's what I've become used to dealing with on a regular basis. I hope my experience going forward with new doctors will be markedly different. 



maddysmom said:


> Found this link that might be handy. IMO, its really accurate on the group of test done regarding liver, immune, GI, infection.
> https://www.2ndchance.info/dxme-testOrganization.htm


Thank you! Coincidentally I came across that same doctors website and was reading up about MVD there recently! He is very knowledgeable with his articles on 2ndchance. His article about MVD explained about it better than anything else I had read before that, very much in layman's terms . I haven't had a chance to read your link yet but will try to get to that one tonight. Appreciate it!




Matilda's mommy said:


> I just want you to know that I have been praying for Baby and for you. I will continue
> Hugs to you


Thank you so much! PRAYERS are what we need _most_. My husband and I are praying that this is nothing serious, and that Baby will be completely healed from whatever it turns out is going on with him, we pray for a complete and total healing and that he won't even need any meds at all in the future--this is our prayer God willing!! :innocent:rayer:


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## LOVE_BABY (May 5, 2015)

Snowbody said:


> Good news with the Protein C. I totally agree with Sherry and Walter. Used to be that vets would put dogs through every sort of invasive procedures, US's and biopsies and really the Protein C test is a better indicator than all of them.
> 
> 
> 
> Remember you cannot be forced into anything by any vet. It's your pet/child and the decision lies with you. The internist that I met at AMC for Pat's Ava was so learned and did such a great job explaining everything...not like we're idiots, not like they know all and we knew nothing but totally listened to our concerns, what we observed and what we thought and then very professionally explained it all in layman's terms. (when I say we, I mean a few of us SM moms were there with Pat.) It was all one of the best experiences I've seen with a vet or specialist. They didn't push anything and in Ava's case they did need to do surgery to circumvent her trachea because it was so inflamed that she couldn't get food down, threw up, was losing weight alarmingly. There really was no other way to help her...about 4 or 5 specialists and vets in NJ tried other things that just made her sicker. They left the choice up to Pat. I asked him "Would you do it if this dog was yours?" He said, "Definitely." That totally sealed the deal.


*IN MY REPLY RESPONSE TO YOUR POST ABOVE, I ACCIDENTALLY INSERTED THE PART WRITTEN BELOW OF 'MY OWN' REPLY TO YOU INTO YOUR QUOTE THAT I "QUOTED" ---OOPS! THIS PART BELOW IS MY QUOTE, MY WORDS AND IS SOMETHING I HAD SAID, NOT YOUR QUOTE OBVIOUSLY --VERY SORRY ABOUT THAT! I HAD ACCIDENTALLY CHOPPED MY OWN REPLY BACK TO YOU INOT TWO PARTS, INCLUDING HALF OF MY OWN REPLY INTO YOUR QUOTE AND TOO LATE TO EDIT IT OUT-- OOPS! *

*I'm glad we did the Protein C test, especially since a lot of people such as your self seem to think it is so telling about what is going on, I can't wait for a specialist to read our when we finally see one--there is a one month wait. Every one is saying it is 'good news' about Baby's Protein C results, but I'm still scared because I've read up as much as I can about MVD, and it seems scarier than a portosystemic shunt which is the kind outside of the liver {I think I have the terminology right anyway}. The ones outside the liver which seem to have a high success rate when treated surgically, 85% or some figure like that. MVD on the other hand to my knowledge is chronic and can't usually be surgically treated because there are so many tiny micro shunts in a usually undersized liver, but instead to my knowledge can only 'medically' managed most of the time. I've still not been able to find out much at all about the 'long term' prognosis for a dog with MVD if it turns out that is what Baby has. What I have read about the long term is scary.*


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## edelweiss (Apr 23, 2010)

Sandy, I would respectfully disagree w/you about the MVD & PSshunt---I think a shunt is much worse & MVD is very easily medically managed. I don't really understand why you think that? My Kirby had PSshunt & was operated (sucessfully) but forever thereafter he had seizures---pretty bad ones. I would gladly have taken MVD given the opportunity! MVD is extremely common in maltese & is well known among vets---so treatment is fairly easily managed.


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## LOVE_BABY (May 5, 2015)

edelweiss said:


> Sandy, I would respectfully disagree w/you about the MVD & PSshunt---I think a shunt is much worse & MVD is very easily medically managed. I don't really understand why you think that? My Kirby had PSshunt & was operated (sucessfully) but forever thereafter he had seizures---pretty bad ones. I would gladly have taken MVD given the opportunity! MVD is extremely common in maltese & is well known among vets---so treatment is fairly easily managed.


Either way I think both diseases suck, and It's unfortunate that Kirby was left with seizures as a result of surgery. My comment was primarily not my opinion, but was about my feelings of being "scared" and of what "to my knowledge" I've read about both types of shunts. When I say "to my knowledge" that means I don't know for sure. I am only just learning about these conditions I'm going by things I've read and things I'm told. I don't know for sure what is and isn't correct. I've read things that seemed to say the same things over and over such as the screenshot example of the article I've attached to this post. This was one of the articles that I've read that seemed to say {to my understanding of the article} that a PS shunt was more treatable surgically and MVD not so much, unless I'm misreading something in this article or it's misinformation? I'm just getting used to the medical terminology and the names and characteristics of each type of disease. I was also going by what my own vet told me. He seemed to think that if present, in the case of tiny multiple micro shunts 'inside' the liver, they aren't worth operating on because they were too risky for the patient and too hard to find. My vet said it would be "like looking for many tiny needles in a haystack". We have an appointment to see a specialist at AMC in May, so soon he will be able to finally separate the fact from fiction of all that I've read and heard and tell us what is the truth of the matter regarding Baby's specific health.


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## Matilda's mommy (Jun 1, 2005)

How's little Baby doing, I need to know more specifics on how to pray, I am praying for you as well. Hopefully you will find peace in your decision. I believe Baby will come through this.


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## maggieh (Dec 16, 2007)

Sandy, while MVD sounds scary, I know many dogs who are doing quite well with a good diet, holistic supplements, and integrative veterinary care. Traditional vets don't know a lot about it so having a good care team that includes holistic care is important.


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## sherry (Jan 4, 2013)

Sandy, as Maggie just stated MVD is easily managed. And very common. While Riley's BAT numbers are high, Sissy's were much less and she never had symptoms like Riley did. But he is doing just fine on lactulose, Animal Protein liver detox and a lower protein food. He was diagnosed over 5 years ago.


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## edelweiss (Apr 23, 2010)

Sandy, I did not mean to confuse you. I think sometimes reading articles on the web (which I also do) is misleading & I simply wanted to speak from my own personal experience. I hope you find, as Maggie said, the right team to work w/you, give you guidance, etc. We are just here to encourage you & give you hope. I did not mean to fail in that---it was meant to encourage you. 
I know what Baby means to you---we love these little ones so much. Take heart, my friend, you will be guided & you will then be able to guide others who come behind you.
Hugs.


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## Jeep's Mommy (Apr 7, 2019)

Why don’t you have your vet do the testing for heart worms, Erlichia and Lyme disease. That way you can R/O those, and you won’t have to wonder anymore.


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## LOVE_BABY (May 5, 2015)

Mare said:


> Why don’t you have your vet do the testing for heart worms, Erlichia and Lyme disease. That way you can R/O those, and you won’t have to wonder anymore.


Thanks Mare,
We did have him tested for all of those you mentioned and he is negative for all of them. Soon we will also be having him tested some of the less prevalent tick diseases in our area. A more extensive tick panel which Sandi among others had encouraged us to do which is a great idea.

We have an appointment in May at AMC in NYC with a specialist. We hope to get a lot more answers from the Doctor who went to school, instead of dear old Mr. Google lol!


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## edelweiss (Apr 23, 2010)

Sandy, ask specifically for the Babisia TBD result along w/the others! My dogs had it w/Erlichiosis.


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## LOVE_BABY (May 5, 2015)

edelweiss said:


> Sandy, I did not mean to confuse you. I think sometimes reading articles on the web (which I also do) is misleading & I simply wanted to speak from my own personal experience. I hope you find, as Maggie said, the right team to work w/you, give you guidance, etc. We are just here to encourage you & give you hope. I did not mean to fail in that---it was meant to encourage you.
> I know what Baby means to you---we love these little ones so much. Take heart, my friend, you will be guided & you will then be able to guide others who come behind you.
> Hugs.


Sandi,

Thank you for your support and hope! Don't worry I was confused long before I read your post :w00t:! I was just concerned that I might have unintentionally insulted you by my wondering if MVD was less treatable by surgery, and therefore a little more scary to me than PS shunt which from what I'd read & heard are more easily operable. I was trying to clarify that I didn't intend to diminish in any way the serious nature of the PS shunt your pup had. I just wanted to explain that these were my feelings of fear, and were what I had heard and read and were not necessary something I 'knew' for sure. Sometimes words we read and words we say can be 'subjective' to the eyes and ears of a hearer/reader and it is difficult to know for sure the intended tone and intended meaning of what people say to each other especially online. An unfortunate hazard of posting our thoughts in any forums. I might have misunderstood and jumped to conclusions. I apologize if that was the case. Most of the time I think we say what we mean, and mean what we say and are understood by others but there are those rare occasions when something gets lost in translation. SM is a great place and we are all rooting for each other, that's really what makes it so special. The last thing I ever intend to do is offend, my enthusiasm & passion can sometimes get lost in translation and be misconstrued/misinterpreted despite my best efforts to avoid that from happening. If we could hear each other speak these words instead of reading them we would probably all hear them in an entirely different way! When we can see a face & hear the voice it helps a bit, and there is less room for misinterpretation, but it still can happen even then. No one can be in someone else's head except God lol!

Thank you and God bless you friend!
Sandy


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## maddysmom (Mar 8, 2012)

How is Baby doing?


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## The A Team (Dec 1, 2005)

Sorry I haven't been around in a while, I wanted to stop in to see how Baby is doing. I haven't read all of the comments, but I did see that you will be going to AMC in May! I hope and pray the doctor there can do something for Baby. 

Ava was saved by Dr. Palma, but I'm sure all of the doctors there are just as good. I actually couldn't believe how he figured out what was wrong in such a short time while I had spent $$$$$$ at two other hospitals! 

It's been some time now, has he improved at all?


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## LOVE_BABY (May 5, 2015)

maddysmom said:


> How is Baby doing?


Hi Joanne,
Thank you for asking:biggrin:! Baby is acting much better now & seems to be feeling much better thank God. I'm guessing either the meds are doing their job, or he has improved on his own. Since we still don't know exactly what the cause was/is, or why his liver is small it is hard to say for sure why he improved. I'm just so thankful that he has improved and seems more like himself now. He no longer hides his head in the corner of the couch facing away from us and sleeps all day. He still naps a lot but it seems to be more normal napping. He faces in our direction when on the couch, and he is in a more comfortable pose rather than the fetal position. I read somewhere that normally healthy dogs can sleep to 17 hours a day so it is difficult to know what exactly is normal since he's had this health crisis. He is eating normally and has gotten 'sort of' used to taking the 3 different meds. I am worried what the 'Lactulos' he is on which is sugar, is going to do to his teeth and his blood sugar over time. The likely hood of decay & diabetes are something I will ask the specialist about. 
Thank you,
Sandy 



The A Team said:


> Sorry I haven't been around in a while, I wanted to stop in to see how Baby is doing. I haven't read all of the comments, but I did see that you will be going to AMC in May! I hope and pray the doctor there can do something for Baby.
> 
> Ava was saved by Dr. Palma, but I'm sure all of the doctors there are just as good. I actually couldn't believe how he figured out what was wrong in such a short time while I had spent $$$$$$ at two other hospitals!
> 
> It's been some time now, has he improved at all?


Hi Pat,
I'm so happy for you and Ava that Dr. Palma helped you so much & saved sweet Ava :thumbsup:! I remember reading about your story here on SM a while back. I'm glad he figured out Ava's problem in a short time, I hope the other Doctor we have an appointment with at AMC will do the same thing for Baby. I know what you mean about spending lots of $$$$$$ elsewhere and getting no definite answers, we have done the same. Baby is doing much better than he was, perhaps it's the meds or he just improved naturally. I can't wait to hear what the Doctor at AMC has to say in May. The reason I picked the other Doctor & not Dr. Palma is because the other doctor has a 'special interest' {according to his bio}in Hepatology & gastroenterology. Hepatology as you probably already know is the study of the liver, pancreas, gall bladder etc. It was the interest in the Hepatology and the fact that he received his veterinary training at Cornell, and probably studied under the great Dr. Sharon Center the dog liver expert which really caught my eye. This doctor was also available sooner. Of course I'm second guessing my decision now, I hope I didn't make a mistake not going to Dr. Palma. But if I have to I can always go to Dr. Palma next time instead if need be. 
Thank you,
Sandy


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## maddysmom (Mar 8, 2012)

Sandy...u might want to have his b12 level checked. They sleep a lot when it’s low and very common in the breed. Out of my 3, Suki doesn’t retain her levels, which she is now on supplement for life. She sleeps all day when in the normal-low range vs. my other two who will sleep only a few hours during the day. I, like you didn’t know what the norm was until I noticed that she slept sooo much more than my other two. 
It’s a simple blood test, fasted before.


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## The A Team (Dec 1, 2005)

LOVE_BABY said:


> Hi Pat,
> I'm so happy for you and Ava that Dr. Palma helped you so much & saved sweet Ava :thumbsup:! I remember reading about your story here on SM a while back. I'm glad he figured out Ava's problem in a short time, I hope the other Doctor we have an appointment with at AMC will do the same thing for Baby. I know what you mean about spending lots of $$$$$$ elsewhere and getting no definite answers, we have done the same. Baby is doing much better than he was, perhaps it's the meds or he just improved naturally. I can't wait to hear what the Doctor at AMC has to say in May. The reason I picked the other Doctor & not Dr. Palma is because the other doctor has a 'special interest' {according to his bio}in Hepatology & gastroenterology. Hepatology as you probably already know is the study of the liver, pancreas, gall bladder etc. It was the interest in the Hepatology and the fact that he received his veterinary training at Cornell, and probably studied under the great Dr. Sharon Center the dog liver expert which really caught my eye. This doctor was also available sooner. Of course I'm second guessing my decision now, I hope I didn't make a mistake not going to Dr. Palma. But if I have to I can always go to Dr. Palma next time instead if need be.
> Thank you,
> Sandy


Sandy, it sounds like you picked the absolute right doctor to see!! I'm sure you will get the answers you need....just hope they are good answers :huh:, the kind you want to hear...:thumbsup:
Is anyone going with you? When you're worried and a bit stressed, it's always good to have an extra pair of ears (or two) to hear what the doc has to say. One of my friends even recorded Dr. Palma when I picked her up to bring her home...just so I could listen to it again. 

So glad to hear he's doing better now! :chili:


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## Snowbody (Jan 3, 2009)

The A Team said:


> Sandy, it sounds like you picked the absolute right doctor to see!! I'm sure you will get the answers you need....just hope they are good answers :huh:, the kind you want to hear...:thumbsup:
> Is anyone going with you? When you're worried and a bit stressed, it's always good to have an extra pair of ears (or two) to hear what the doc has to say. One of my friends even recorded Dr. Palma when I picked her up to bring her home...just so I could listen to it again.
> 
> So glad to hear he's doing better now! :chili:


 Pat - I already offered to meet her. Her husband is going along but if they need me I can easily meet them. I'm so impressed with every visit there. I took my foster because I stepped on her foot...twice.She was limping the next morning too. My vet's office sent me there (that's another story - they should have seen me.) They were fast to triage here, a short wait for the ER doc, said he was taking her for exrays but talked to the ortho doc first who checked her and said what he saw in one foot was the same in the other and no pain points and said no exray needed. Other ER hospitals would have run up the bill on me. They didn't!  

Hoping all goes well for Baby and glad he's doing better.


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## Abella's Mommy (Mar 31, 2019)

I don't have any experience in this area.....All I can add is that I am praying the drs will have wisdom in knowing which tests to run and quickly finding the answers you are looking for.


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## LOVE_BABY (May 5, 2015)

Snowbody said:


> Pat - I already offered to meet her. Her husband is going along but if they need me I can easily meet them. I'm so impressed with every visit there. I took my foster because I stepped on her foot...twice.She was limping the next morning too. My vet's office sent me there (that's another story - they should have seen me.) They were fast to triage here, a short wait for the ER doc, said he was taking her for exrays but talked to the ortho doc first who checked her and said what he saw in one foot was the same in the other and no pain points and said no exray needed. Other ER hospitals would have run up the bill on me. They didn't!
> 
> Hoping all goes well for Baby and glad he's doing better.


Thank you Sue, 
Baby does seem more like himself {and might I add thankfully Baby DOES NOT look to us as if he is "DYING".... because as you already know our regular vet had said Baby was dying...} and our appointment at AMC is drawing nearer every day! Nice that they didn't try to run up the Xray bill for you there if it was an unnessesary step. I like the sound of that. Also thank you again for your very kind offer to meet us there! I just didn't want to inconvenience you to do that but I do appreciate your kind offer. Of course you are welcome to be there too if you'd like, we'd love to have you there. And Hubby will be with me. I don't have a smart phone at the moment so will have to figure out a way to record what the doctor says if he lets me do so. Perhaps with my lap top or my camera.
Thanks,
Sandy



Abella's Mommy said:


> I don't have any experience in this area.....All I can add is that I am praying the drs will have wisdom in knowing which tests to run and quickly finding the answers you are looking for.


Thank you Abella's Mommy,
Your prayers are what we need right now! Answers about how serious Baby's condition really is, is what we are looking forward to finally get. After our regular vet told us "Baby is dying", we need to find out what the truth really is. Baby sure seems like he wants to live to me. I think having him sleep in our bed from now on has really helped to boost up his spirits! He was crate potty trained from a small puppy and as a result he enjoyed sleeping in his comfy, decked out, padded like a palace crate only at night during the day he would roam anywhere in the house. However when he got sick recently, he no longer wanted to be alone in his crate at night and began to cry. So right away we put him in our bed with us. After sleeping along with us, {where he will always be a night from now on} and the meds our regular vet prescribed and he has improved a great deal. We just need to get to the bottom of what his state of health for certain really is, and what to do about it!
Thank you for your prayers!
Sandy


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## The A Team (Dec 1, 2005)

Snowbody said:


> Pat - I already offered to meet her. Her husband is going along but if they need me I can easily meet them. I'm so impressed with every visit there. I took my foster because I stepped on her foot...twice.She was limping the next morning too. My vet's office sent me there (that's another story - they should have seen me.) They were fast to triage here, a short wait for the ER doc, said he was taking her for exrays but talked to the ortho doc first who checked her and said what he saw in one foot was the same in the other and no pain points and said no exray needed. Other ER hospitals would have run up the bill on me. They didn't!
> 
> Hoping all goes well for Baby and glad he's doing better.


Sue, you are lucky to live close to such a great hospital!!!


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## Jeep's Mommy (Apr 7, 2019)

*Baby*

I’m glad to hear that Baby is doing much better. I know how painful it is to see them sick and not being able to find an answer. When are you going to see the new vet?


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## LOVE_BABY (May 5, 2015)

Mare said:


> I’m glad to hear that Baby is doing much better. I know how painful it is to see them sick and not being able to find an answer. When are you going to see the new vet?



Thanks Mare, 
We're going into NYC the end of May a few weeks from now. I can't wait to get some answers then, but my Hubby is not looking forward to driving into the city. We usually always take a bus in and leave the car home, but we can't do that this time with Baby with us. My hubby gets very nervous with all of those one way streets and crazy drivers, especially the taxi drivers:OMG!:!


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## Happinesstogo (Oct 17, 2015)

I've been away and am only now catching up on posts. Do pray all goes well with Baby. You certainly are doing all you can for him. 

Gentle hugs,
Lainie and Whispy


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## LOVE_BABY (May 5, 2015)

Happinesstogo said:


> I've been away and am only now catching up on posts. Do pray all goes well with Baby. You certainly are doing all you can for him.
> 
> Gentle hugs,
> Lainie and Whispy


Thank you so much Lanie & Whispy!--a cute & original name by the way!


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## pippersmom (May 21, 2012)

I'm so happy to hear that Baby is doing better and I hope you get answers when you take him to the city.


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## Snuggle's Mom (Jan 3, 2008)

I certainly can understand why your Husband would be nervous having to drive into NYC since the traffic there is pretty horrendous. I used to work in NYC a very long time ago and it certainly has gotten a lot worse over the years especially if a person is not used to traveling in there.


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## Snowbody (Jan 3, 2009)

Good luck news week at AMC. I'm getting in a new foster on Tuesday and taking her to be checked at our vet on Wed. Looking up the time I saw that Baby's appt is that day...have it in my schedule. So happy she's feeling better but I hope they can at least give you guidance for the future to avoid the scares.


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## LOVE_BABY (May 5, 2015)

*Baby will be seeing the specialist in NY on Wednesday*



Snowbody said:


> Good luck news week at AMC. I'm getting in a new foster on Tuesday and taking her to be checked at our vet on Wed. Looking up the time I saw that Baby's appt is that day...have it in my schedule. So happy she's feeling better but I hope they can at least give you guidance for the future to avoid the scares.


Hi Susan,

So exciting for you to be getting your new foster tomorrow! I hope he/she will adjust quickly & easily to the new temporary home. Baby is still feeling better, and his new blood test results that I just received today from our regular vet are in the 'normal' range now that Baby has been on the meds for several weeks. I also had another BAT test done for Baby today & we will also get those results sent over to the specialty vet in NY for Wednesday so he can read them all. I'm so happy Baby's results are reading in the normal range now, but my husband and I can't help but wonder what would happen without these 3 meds being given which Baby takes every day. Today my regular vet warned me again that the specialist's 'job' is to do a lot of invasive testing & to give us answers. And that in the process of getting the 'answers' that we want that it might not be worth the 'riskiness' of having the tests done, and possibly having anesthesia and all. If faced with the option for testing we will have to do some serious soul searching before making any decisions this whole thing is so scary. Thank you so much for thinking of Baby, we appreciate it so very much:biggrin:!

Sandy


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## wkomorow (Aug 26, 2011)

I think your vet is trying to scare you. Typically it would be blood tests and an ultrasound. The specialty vet will look at the protein c and know a shunt is unlikely.


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## Snuggle's Mom (Jan 3, 2008)

Personally speaking, I agree with Walter. When I first read your post Sandy, I had my doubts about why your Vet would even suggest what he/she did. To me is sounded as though he was not in favor of you going to see a Specialist with Baby and was trying to steer you away from taking Baby's issues further to see what really was going on. I will be anxious (along with many others) to hear what you will have to report back here on SM.


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## Matilda's mommy (Jun 1, 2005)

I have been praying for Baby, I agree with Walter, it sounds like your vet is scaring you. I am anxious to hear more about what you find out. 
Hugs to you and your hubby, please remember you are loved and we are praying for little Baby


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## maggieh (Dec 16, 2007)

I agree with Walter. Your "regular" vet sounds like he's not happy being second-guessed, and also being wrong. Good luck with the specialist - they won't do anything that isn't in Baby's best interest!


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## Snowbody (Jan 3, 2009)

Good luck tomorrow! I'm in agreement with all. Your vet may be trying to cover up his own tracks in finally getting Baby on the right track. He might worry that they might say she could have been helped earlier. Go with an open mind and remember you make the decisions. Eager to see how it goes. 

And thanks for the foster good wishes. She's a little doll. We had horrible traffic getting home with her and she was as good as can be. Fitting in well. Eating, drinking, using the wee wee pads and eager to show she can sit, roll over, beg, shake. Many things about her make me call her Tyler's female counterpart! Spoiled may be one of them. :wub:


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## edelweiss (Apr 23, 2010)

Thinking of you today!
Also, Sue---spoiled is good! All the best for her!


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## Snowbody (Jan 3, 2009)

:Waiting::Waiting:


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## maddysmom (Mar 8, 2012)

Sandy, I'm hoping today went well. Anxious to hear how it went. I will wait for your update and hopefully you have good news to share.


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## LOVE_BABY (May 5, 2015)

*I'm sorry it took so long to update you, my computer was down*

*THANKYOU EVERYONE* :wub: !
FIRST BEFORE I REPLY TO EVERYONE BELOW--LET ME SAY I'M VERY SORRY IT TOOK ME SO LONG TO REPORT ABOUT OUR VISIT TO SPECIALIST! MY COMPUTER WAS DOWN FOR A WHILE I FINALLY HAVE IT WORKING AGAIN! THANK YOU ALL FOR YOUR SUPPORT AND CONCERN!:wub:
NOW THAT WE DO HAVE A WONDERFUL SPECIALIST TO GO TO AT AMC, IF ANYONE HERE CAN RECCOMEND A FANTASTIC REGULAR VET IN NJ PLEASE LET ME KNOW! WE ARE LOOKING FOR A LONG OVERDUE CHANGE...OUR REGULAR VET IS ... NOT SO GREAT....

*Now for 'the update'*
Our visit to AMC in NYC went great! Our doctor was wonderful, he was so knowledgeable, personable, patient, kind & interactive. It is a teaching hospital so a newly minted vet saw us first to ask preliminary questions before we finally got to speak to the specialist. In short *we loved him!{the specialist}:w00t:* He spent over half an hour speaking with us and let me record our conversation {I neglected to turn on the recording in the beginning, & then remembered to turn on the recorder. AMC recommends recording your conversation with your doctor.} We got up at 3:00 am & went into the city at 5:00 am and waited 5 hours in our car for our appointment time, we packed a lunch. We wanted to make sure we weren't late because we never had been there before and lanes were closed in the Lincoln tunnel so we wanted to avoid rush hour. It was cool outside so everyone was comfortable, however Baby refused to relieve himself on pavement or concrete. He didn't go potty again until we got back to grass again in NJ around 3:00 PM. I can't believe he held it for 10 hours! He wouldn't go potty in the designated area in the hospital either. 

Now to the meat of the matter... the specialist said Baby definitely had some sort of trauma to his liver in March, he said he can speculate but can't tell us the exact cause. He said it could possibly be gastrointestinal which might have caused the liver trauma, from being exposed to a toxin of some sort from unknown source. the Specialist told us he believes Baby has congenital MVD that he was born with. He doesn't know yet if Baby could be among the small 5% of Malts with MVD who will go on to develop additional liver disease on to of the MVD of hepatic encephalitis & Acquired shunts later down the road. He told us that many Malts with MVD can go on to lead normal lives and are often asymptomatic during their lives. The specialist also said he doesn't care about the bile acid tests at all. He told us that Malts with MVD often live healthy lives even with a somewhat abnormal bile acid test result.

He told us he does not believe Baby has hepatic encephalitis at all and does not need any medications at this time. He recommended we take him off ALL THE MEDS! YAY! Which really surprised us but we are thrilled to take him off of them! He said "stop the Lactulose, Denamarin, and Ursodiol completely". He said if we'd like we could still keep Baby on Denamarin if we feel uncomfortable with taking him off of everything, but said we don't even need to give him the Denamarin. We told him we're happy to take him off meds. He told us call him and let him know immediately if when off meds Baby does get worse within the next month. If that happens then we might need to go back to AMC and do CT scan &/or biopsy. The specialist said at this time in his professional opinion he thinks Baby has MVD common among Malts which he said many can live a normal life with asymptomatic. But told us he can't say that for 100% sure and told us that time will tell. He doesn't think invasive testing is needed at this time and we should wait & see how Baby does. He asked us to redo Baby's liver blood test in one month and send it to him in a month. He will read it and let us know if it is healthy or if we need to take further action on Baby's behalf at that time then do more testing. 

So my husband and I are guardedly happy :biggrin: and hopeful that Baby might actually go on to live a normal life despite having this MVD problem as long as it remains MVD and doesn't turn into Hepatic Encephalitis and/or Multiple Acquired shunts later on. 

Regarding diet and exercise, vaccines & heartworm meds: the specialist told us quote" I have no problem with Baby eating Stella & Chewy's raw food, and that Baby can return to his normal freeze dried raw diet, with no restrictions regarding diet." He told us we can feed him whatever diet we want to {which is great news for us because _Baby turns down every other type of food_ there is besides the raw, including homemade...}. He also told us there are no restrictions on Baby's exercise or on taking car trips with us. He said he can have vaccines and take heart worm preventative. We are exempt for this year from rabies so perhaps we'll get the rabies vaccine next year Baby is due for. Now that we don't have to give Baby lactulose any more, we don't have to worry about him having messy loose stools getting him dirty anymore either which would have put a damper on us bringing Baby visiting to places with us. So we are VERY, VERY HAPPY:w00t:! We know we are in great hands at AMC! *We are praying:innocent: :heart:Baby:heart: remains healthy with out meds for the rest of his life, and hope it is a long life*. However if anything happens we know where to go and know Baby will get the best care. We are even thinking of having Baby's teeth cleaned at AMC if they will be willing do it there, because of their top notch anesthesiologists & experts on call incase something bad did happen during the cleaning while on the table. 

I hope I covered everything, but if I think of anything I missed I'll post it on this thread. *Thank you all again for your support and for sharing your knowledge of Malts and help suggesting diagnosis, treatment protocols and placed to go for treatment for what is going on with him! You guys are great!:wub: * *God Bless you all* rayer:!
*Now I will answer your individual posts below:*



wkomorow said:


> I think your vet is trying to scare you. Typically it would be blood tests and an ultrasound. The specialty vet will look at the protein c and know a shunt is unlikely.


Walter, yes my vet seems to take some kind of pleasure in scaring my husband and I and to make us worry and fear. For example when he told me Baby was dying when Baby first became sick several weeks ago, he told me that almost with a happy sneer on his face like he was laughing about it. Neither he, his assistant or his receptionist comforted me AT ALL when I couldn't control my crying after he said that. It is an unusually COLD hearted veterinary practice. I have been looking for another vet for quite some time. I tried a new one but that didn't work out because their testing was of low quality done in-house. There is only one assistant guy who works there who is very warm hearted and he loves baby, he is always smiling the only day I didn't see him smile was on the day I was crying he had sadness in his eyes But he is not the vet treating Baby year to year, so it is not enough.






Snuggle's Mom said:


> Personally speaking, I agree with Walter. When I first read your post Sandy, I had my doubts about why your Vet would even suggest what he/she did. To me is sounded as though he was not in favor of you going to see a Specialist with Baby and was trying to steer you away from taking Baby's issues further to see what really was going on. I will be anxious (along with many others) to hear what you will have to report back here on SM.


Yes, I belive my vet is first and foremost MONEY HUNGRY and is most concerned with the bottom line. He over charges for everything, his practice is more expensive than any others in our area and I believe money might be his god. I'm wondering, possibly could this be one of the reasons for him to try to stear me away from taking Baby to a specialist? I don't think he wants me paying anyone else but him for Baby's care. He is also very controlling and wants to be right about everything 100% of the time, he hates when I ask questions or suggest other options. 



Matilda's mommy said:


> I have been praying for Baby, I agree with Walter, it sounds like your vet is scaring you. I am anxious to hear more about what you find out.
> Hugs to you and your hubby, please remember you are loved and we are praying for little Baby


Thank you for your prayers, concern, love and support it means so much to us! I will give Baby a hug for you!



maggieh said:


> I agree with Walter. Your "regular" vet sounds like he's not happy being second-guessed, and also being wrong. Good luck with the specialist - they won't do anything that isn't in Baby's best interest!


 You are spot on with your impression of our regular vet. If I question him at all he gets VERY NASTY. He prefers me to be ignorant, take his word for every single thing and not ask ANY questions. He has expressed to me on several occasions that he hates when pet parents research "google" on their own and try to obtain knowledge for themselves, he actually laughs out loud about people who do that belittling them & me. He began his practice in the 1980's when few people had computers. *I desperately want to find another regular vet in NJ, have tried one other that didn't work out. Any suggestions?* Smith Ridge is an option, they mainly treat wholistically, but I do want to also find a vet who closer by to where we live that we can see more easily. 





Snowbody said:


> Good luck tomorrow! I'm in agreement with all. Your vet may be trying to cover up his own tracks in finally getting Baby on the right track. He might worry that they might say she could have been helped earlier. Go with an open mind and remember you make the decisions. Eager to see how it goes.
> 
> And thanks for the foster good wishes. She's a little doll. We had horrible traffic getting home with her and she was as good as can be. Fitting in well. Eating, drinking, using the wee wee pads and eager to show she can sit, roll over, beg, shake. Many things about her make me call her Tyler's female counterpart! Spoiled may be one of them. :wub:


Hi Susan,
I'm glad to hear things are going so great with your little rescue :thumbsup:! What are you calling her? She sounds wonderful:wub:, someone who gets to adopt her will be very lucky indeed. Maybe Tyler needs a permanent sister? 
Our vet has a HUGE ego and I doubt any specialist telling him he could have done things in a better way would even phase him at all, he would probably deny it, rationalize it, and defend himself. His ego is hugely inflated. I desperately want to find a new and great vet in NJ do you know of one? Smith Ridge as a regular vet is a great option, but we would also like to find a great regular vet nearby in NJ that we can get to quickly if needed. 



edelweiss said:


> Thinking of you today!
> Also, Sue---spoiled is good! All the best for her!


Thank you Sandi :thumbsup:! Thankfully things are looking hopeful, in the beginning of this post I wrote an update explaining the visit to the specialist!



maddysmom said:


> Sandy, I'm hoping today went well. Anxious to hear how it went. I will wait for your update and hopefully you have good news to share.


Thank you so much! Things did go very well! Sorry I left you waiting so long to hear back, my computer was down. In the beginning of this post at the top I wrote a detailed update to everyone about our visit to the specialist. {maybe is a bit too detailed-I have a hard time editing myself down in certain long posts--oops!:blush:}


* * To everyone who cares about Baby Thank you! Thank you! Thank you! * *:sLo_grouphug3:


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## maggie's mommy (Mar 12, 2006)

What a wonderful report for Baby Sandy. I can see you smiling through your words! I know first hand how important having a good vet is. I almost lost my Maggie because the vet I was taking her to did not recognize that she had Addison's Disease and was in crisis. I was able to save her by getting her to an emergency hospital in Maitland, Florida. I grew up in New Jersey and still have family there in the Middletown, Red Bank, Long Branch areas. I have heard that Red Bank Veterinary Hospital in Tinton Falls New Jersey is excellent. I don't know how close that is to you, but it might be something to consider.


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## sherry (Jan 4, 2013)

Yay!! I was sure Baby was going to be fine. MVD is so very common in maltese. Riley's BAT numbers are really high, but he leads a normal life. It has been at least 5 years since he was diagnosed. I'm so happy you got such good news.


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## wkomorow (Aug 26, 2011)

Sometimes it is less expensive to see a specialist. I am so happy baby is doing so well. I continue to think that baby got into something he shouldn't. Which is good news because his liver is healing. It is really an amazing organ. In terms of MVD - I'd be surprised if 90% of malts did not have at least a very mild case.

Just so happy for you - very few vets understand small dogs, and the certainly do not understand liver disease in small dogs. What is important is that they accept the help from specialists. I had taken Luck to Tufts and was not happy because they could not decide on what to do - medically manage or operate. So my regular vet suggested Cornell to get a third opinion. He wrote up a really thorough report for Cornell. The vets said they rarely get such an extensive report. My point is you need a different vet - not one that has all the answers but one that really has you and baby as a priority and is willing to find the answers.

So happy for you.


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## Abella's Mommy (Mar 31, 2019)

WONDERFUL NEWS! :aktion033:
Very happy to hear you found a GREAT Specialist for Baby - Recording the visit was such an excellent idea - I don't think I could have remembered all the information he covered. Thank you for your very detailed report above! I have read it several times and am going to print a copy for Abellas file (yes I'm a "paper" person). Did the specialist recommend gradually taking Baby off her meds or doing it all at once? I will definitely be praying that this transition goes well and that Baby is not in the 5% of Malts that develop additional liver disease and other complications down the road! :wub:

Can you file a negative report against your current awful Vet? I don't know maybe terrible Yelp review? Need to warn others! :smmadder::thmbdn:

Baby holding her pee for 10 hours so reminds me of my first road trip with Abella - She was pee pad trained and I did not bring a pee pad with me. She would not go pee on grass, cement, the floor, anywhere........It was a long 12 hour day! How in the world can their little bladders hold it that long? Now I always make sure I have pee pads in the car.......and she is trained to go on request "Hurry-Up" is my request for her to pee and poop - so convenient for travel and at home when she wants to "lolligag" and Im in a hurry! :web:

Lots of HUGS - So glad you are on the right track now! Will pray this continues!:wub:


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## LOVE_BABY (May 5, 2015)

*Photos of nyc on the way home from amc*

For fun here are some photos I took out the window of the car on the way home from AMC, NYC is so beutiful B)., mostly not in a 'nature' kind of way, but in a 'humanity and it's creations' sort of way.


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## Snowbody (Jan 3, 2009)

Oh gee I can't believe how early you left NJ to get here. :w00t::w00t: But that ended up being a totally (worse than normal) traffic day. Everything backed up everywhere all day long. So glad you were impressed with AMC. I know I must have sounded like a crazy zealot on here before saying you needed to go there but each person I know who's gone, and when I went there, I just felt like I was in the best of the best. Professional yet so humane and taking the time to explain things and answer questions. PM me where you are in NJ and I can check with some of my friends. I know a lot like Red Bank and there's also Garden State Specialists in Tinton Falls. One of my adopters seems happy with her vet in another practice and I can find out whom she uses.
So meanwhile my new foster, Gucci, has a very high ALT number....889, max should be 131. And also a high ALK in the 300's. Just found that out before I headed to VT so following up but I'm thinking MVD too. Here former mom was feeding her pretty much full on protein so I'm trying to get the protein percentage down (anything is down from there!)


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## maggieh (Dec 16, 2007)

Such good news! The only thing I would say is on vaccines - titer for distemper and parvo before you vaccinate. With rabies, it’s required by law and they won’t accept a titer.


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## edelweiss (Apr 23, 2010)

I am so happy for the good results for Baby! I know you were very concerned & totally understand that these little ones steal our hearts completely. Do keep us in the loop!


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## pippersmom (May 21, 2012)

I am so happy to hear that you got good news!!!!!!


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## Jeep's Mommy (Apr 7, 2019)

*Baby*

Sandy, I’m so glad you got a second opinion. And what great news from the specialist. When your shopping for a new veterinarian, go to their website first and read their reviews. People always comment on the vet’s compassion or lack of. That will help you to weed out a few and save you time.


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## lydiatug (Feb 21, 2012)

Great news all the way around, I'm so happy you found a great resource and Baby is doing well!!!


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## Abella's Mommy (Mar 31, 2019)

AWESOME!
The loving/caring support and knowledge on SM is so amazing! So much to learn from the above thread. What a Blessing this Maltese family is! :heart:
:ThankYou:

"Life is good - Life with a Maltese is better!"


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## Aviannah's Mom (Apr 28, 2017)

So happy Baby is doing well!


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## LOVE_BABY (May 5, 2015)

*:biggrin:I'm back from our brief vacation visiting relatives, and getting back to respond to the rest of your kind and generous comments!:heart::thmbup: Sorry again for the delay! *



maggie's mommy said:


> What a wonderful report for Baby Sandy. I can see you smiling through your words! I know first hand how important having a good vet is. I almost lost my Maggie because the vet I was taking her to did not recognize that she had Addison's Disease and was in crisis. I was able to save her by getting her to an emergency hospital in Maitland, Florida. I grew up in New Jersey and still have family there in the Middletown, Red Bank, Long Branch areas. I have heard that Red Bank Veterinary Hospital in Tinton Falls New Jersey is excellent. I don't know how close that is to you, but it might be something to consider.


Thank God you got Maggie to a different vet wo recognized the true nature of Maggies problem!!! Yes! My husband and I are indeed soooo very happy that the specialist seemed so optimistic about Baby's health prognosis. I will know even more after one months time has gone buy after I get Baby's next liver blood test results repeated again, and then the specialist looks at the new results now that Baby has been off the meds. 



sherry said:


> Yay!! I was sure Baby was going to be fine. MVD is so very common in maltese. Riley's BAT numbers are really high, but he leads a normal life. It has been at least 5 years since he was diagnosed. I'm so happy you got such good news.


Thank you Sherry, I am so happy for you that Riley is doing so well despite high BAT numbers. I was so happy to learn from the Specialist and also from others such as yourself here on SM, that many Malts with MVD and/or high BAT numbers go on to live a long happy healthy life despite the BAT results. 



wkomorow said:


> Sometimes it is less expensive to see a specialist. I am so happy baby is doing so well. I continue to think that baby got into something he shouldn't. Which is good news because his liver is healing. It is really an amazing organ. In terms of MVD - I'd be surprised if 90% of malts did not have at least a very mild case.
> 
> Just so happy for you - very few vets understand small dogs, and the certainly do not understand liver disease in small dogs. What is important is that they accept the help from specialists. I had taken Luck to Tufts and was not happy because they could not decide on what to do - medically manage or operate. So my regular vet suggested Cornell to get a third opinion. He wrote up a really thorough report for Cornell. The vets said they rarely get such an extensive report. My point is you need a different vet - not one that has all the answers but one that really has you and baby as a priority and is willing to find the answers.
> 
> So happy for you.


Thank You! _& soooo very true!! _My husband and I have found that lesson out the hard way by wasting so many visits to the general veterinarians who couldn't tell us much. I hope there isn't any 'next time' health crisis for Baby, but God forbid if there is my husband and I will most likely go straight to a specialist at AMC rather than waste time. AMC is a wonderful place and Thank You and others for recommending it! We do love our doctor there! We realize we are very blessed to live so close to AMC. As far as a regular general vet goes, we very much do need to find a new local vet for the general/regular stuff. Linda, Snuggles Mom has kindly recommended a vet that she knows of and she thinks highly of in my area of NJ, and we are going to consider him.



Abella's Mommy said:


> WONDERFUL NEWS! :aktion033:
> Very happy to hear you found a GREAT Specialist for Baby - Recording the visit was such an excellent idea - I don't think I could have remembered all the information he covered. Thank you for your very detailed report above! I have read it several times and am going to print a copy for Abellas file (yes I'm a "paper" person). Did the specialist recommend gradually taking Baby off her meds or doing it all at once? I will definitely be praying that this transition goes well and that Baby is not in the 5% of Malts that develop additional liver disease and other complications down the road! :wub:
> 
> Can you file a negative report against your current awful Vet? I don't know maybe terrible Yelp review? Need to warn others! :smmadder::thmbdn:
> ...


Thank you so much! Abella does sound like Baby, and his having held it for so long. I can't even wait that long myself, so I don't know how these little ones do it with their tiny bladders as you said. I'm glad what I wrote about my experience of going to AMC might help you in some way, and that you found value in it for yourself and Abella. In answer to your question, the specialist told us to take Baby off of all meds 'cold turkey' so to speak, but not in those exact words. He said I could keep Baby on just the Denamarin if I want to, but that it wasn't necessary. He said the Denamarin won't hurt him if I decide to continue it. I decided to follow his advice and "take Baby off everything" until we take another liver blood test one month from the date we saw the specialist. If Baby's new liver test results remain healthy and normal even without the meds, then after that I am planning to ask the specialist if he thinks I can re-start Baby on the Denemarin again just as a sort of liver 'insureance'. I want to keep Baby's liver in optimum health, and if the Denemarin will keep it even healthier I'm all for using it. P.S. Yes, when we do leave the current {bad} local vet I will leave a Yelp review stating my opinion of the good, the bad, & the ugly....



Snowbody said:


> Oh gee I can't believe how early you left NJ to get here. :w00t::w00t: But that ended up being a totally (worse than normal) traffic day. Everything backed up everywhere all day long. So glad you were impressed with AMC. I know I must have sounded like a crazy zealot on here before saying you needed to go there but each person I know who's gone, and when I went there, I just felt like I was in the best of the best. Professional yet so humane and taking the time to explain things and answer questions. PM me where you are in NJ and I can check with some of my friends. I know a lot like Red Bank and there's also Garden State Specialists in Tinton Falls. One of my adopters seems happy with her vet in another practice and I can find out whom she uses.
> So meanwhile my new foster, Gucci, has a very high ALT number....889, max should be 131. And also a high ALK in the 300's. Just found that out before I headed to VT so following up but I'm thinking MVD too. Here former mom was feeding her pretty much full on protein so I'm trying to get the protein percentage down (anything is down from there!)


Hi & Thanks for the encouragement to go to AMC! No, didn't sound 'crazy' to me at all! And I'm so happy for the great recommendations to go there! Yes we left crazy early to go there that day, we figured better safe than sorry as we are not used to going into the city during rush hour so to put it mildly we 'beat' rush hour into the city lol. We had thought it would be a bad day but it turned out to be a quite enjoyable one. If the news the specialist gave us had turned out to be bad news, then the day would not have been any where near as enjoyable. We loved going into the city it's so beautiful. Even though we live so close to it we don't go in very often, so we still looked like obvious tourists because we were always looking 'up' lol. The architecture of the old buildings is something to behold along with all of the masses of humanity. We actually quite enjoyed ourselves, aside from the obvious stress of waiting to hear what the specialist would have to say. What a relief when he was optimistic & said stop the meds, & no invasive testing at this time! I hope Gucci is continuing to do well, & hope that her numbers will come down. What type of diet are you currently feeding her? Thanks also for the vet recommendations!



maggieh said:


> Such good news! The only thing I would say is on vaccines - titer for distemper and parvo before you vaccinate. With rabies, it’s required by law and they won’t accept a titer.


Thank you! We have tittered Baby for several years now for Parvo-Distemper, but regarding Rabies vaccine this year we have gotten an 'Exemption' from having the Rabies vaccine for Baby from our regular vet. A medical exemption is allowed by the state of NJ , it gives us permission not to have the Rabies vaccine for one years time. However next year we may get the Rabies vaccine for Baby if he is in good health at that time {prayersrayer: that he will be!} 



edelweiss said:


> I am so happy for the good results for Baby! I know you were very concerned & totally understand that these little ones steal our hearts completely. Do keep us in the loop!


Thanks so much Sandi! Yes Baby certainly stole my heart :wub: since the very first moment I lay my eyes on him! He is one of the most precious:wub: beings to enter my life and I am grateful every day for him!



pippersmom said:


> I am so happy to hear that you got good news!!!!!!


Thank you so much! We are relieved to have heard such optimistic & hopeful words come from the specialists mouth!



Jeep's Mommy said:


> Sandy, I’m so glad you got a second opinion. And what great news from the specialist. When your shopping for a new veterinarian, go to their website first and read their reviews. People always comment on the vet’s compassion or lack of. That will help you to weed out a few and save you time.


Good advice Thank you! I am a firm believer in reading reviews. Especially when there are many, many reviews for something or someone, or someplace, they can't possibly 'all' be fake or planted. I read reviews for everything I buy or pay for, and ESPECIALLY for doctors. Reviews usually don't steer me wrong. 



lydiatug said:


> Great news all the way around, I'm so happy you found a great resource and Baby is doing well!!!


Thank you! We are grateful for AMC, and last but not least, also grateful for the great people here on SM who so generously share their knowledge & support!



Abella's Mommy said:


> AWESOME!
> The loving/caring support and knowledge on SM is so amazing! So much to learn from the above thread. What a Blessing this Maltese family is! :heart:
> :ThankYou:
> 
> "Life is good - Life with a Maltese is better!"


Yes indeed!--Life with a Maltese is certainly _BETTER_!! I know mine is for sure:w00t:! SM & those therein are certainly a huge blessing!



Aviannah's Mom said:


> So happy Baby is doing well!


Thank you! Baby's still doing well & back to being himself. Every time he has a day when he sleeps a bit more than usual, or skips a meal it puts the fear right back into me though. Being his mommy I do worry when something seems abnormal especially now that I know he most likely has MVD.


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