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Liver Shunts

#16 User is offline   Millyo8 

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Posted 01 August 2012 - 01:27 PM

It was lovely to hear from you. I believe Dr. Landon has been replaced by Dr Alberto Gines who we saw in June. He had just taken the position and came out from England. He was quite experienced having done a shunt operation every week. His photo is on their website. I am trying to get Milly well enough to go back to him. She actually started eating again on Saturday and yesterday and this morning she actually ate from the plate herself. I have been having to put each piece of Hills in her mouth. She vomited a lot last night but I suspect after not eating much she suddenly ate too much. I will watch out for that today. May I ask what breed your dog is? Does she eat Hills l/s or now on other food? Can you tell me how long she was in Hospital etc?

#17 User is offline   jans 

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Posted 01 August 2012 - 01:59 PM

Hi Milly

She is a Maltese, around the age of 3 or 4 when diagnosed. Can't be sure of her age as she was a rescue. I made the decision post surgery to keep her on the Hills l/d, just to be on the safe side and while the shunt was closing and have never taken her off it. She gets a hand full of dry for breakfast and then half a tin of the wet at dinner time. I have 2 other dogs who think that the l/d dry is the best thing ever and will try to steal it from her if she drops a piece, so it must be OK. At diagnosis she was 3.8 kilos and is now 6.8 kilo. Ben said that I could wean her off the l/d but since she likes it and as I was nervous about doing so, I didn't. I do give her "normal" treats.

I'm trying to remember how long she was in hospital for. For the initial diagnosis, she was in for 2 days. They put a radioactive dye in her system and monitored that to watch the shunt. She then came home for a couple of weeks with the medications that you have already posted about, and the l/d, to build up her strength for surgery. I think she was in ICU for one day post surgery, then a normal ward for about 2 days or maybe 3 - I can't exactly remember. The first 24 hours are the worst, incase she rejected the band they put on the blood vessel.

The worst part was prior to surgery, watching her be such a sick little girl, and hoping that she'd make it through to surgery date. The recovery post surgery was a breeze compared to prior.

I wouldn't hesitate to do it again faced with the same diagnosis.

#18 User is offline   Millyo8 

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Posted 01 August 2012 - 04:47 PM

Jans you have given me such hope. I was trying to remember how long she has to be stable and I think they said 4 weeks. I will see how she is if she is still okay after the next two weeks.Radioactive dye wasn't offered. Maybe Melbourne is further advanced. She has had 2 ultra sounds with no sign of the shunt but the blood tests say Yes she has one. There is a chance it is internal shunts but they say they will find it with a C/T scan. When she was first on Hills she was fine for 6 weeks before she crashed so I missed a window of opportunity then. Dislikes the kibble but has mostly liked Hills cans. Having read the ingredients can't understand why any self respecting dog would eat it! I may ask you more questions as we progress.

#19 User is offline   jans 

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Posted 02 August 2012 - 08:01 AM

Hi Milly. All the best and certainly if you have any questions, ask away. Fingers crossed for surgery sooner rather than later.

#20 User is offline   WoofnHoof 

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Posted 04 August 2012 - 12:10 PM

My husky had a shunt as well, it was intrahepatic (inside the liver) and he had surgery at about 10 months of age which worked well.

Hope your girl has a simple shunt and a successful surgery :)

#21 User is offline   Millyo8 

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Posted 04 August 2012 - 12:31 PM

That is wonderful. I wonder if because your dog is bigger that they could operate? I was told if they find an intraheptic shunt they will not operate. One because it is a difficult op but also because those shunts tend to regrow.
I rang the Surgeon yesterday and I am to take her down to Sydney Uni on the 13th to have the CT scan on Tuesday morning and if it is an external shunt she will be operated on that afternoon. The Dr wanted her to be stable and in tip top condition for about a month but it is just not happening. Yesterday was the first day for a week that she hasn't vomited. At the moment she is bright in herself and I am just hoping she stays that way for the next week. I am so happy I have had these positive replies. I felt as if we were the only ones going through this. Was it a long recovery for your dog? Do they expect the operation to have cured her/him?

#22 User is offline   WoofnHoof 

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Posted 04 August 2012 - 01:47 PM

The intrahepatic operation is possible although it is very risky and much more difficult than an extrahepatic shunt operation. It's also less likely to be successful because it's difficult to put a constrictor around the vessel so they usually only clamp it a little and hope that the reduced blood flow will help the shunt close further, if it doesn't a second op may be required to close it down fully.
Intrahepatic shunts are less common in the smaller dogs it depends on the type of shunt but unless there are multiple shunts it shouldn't regrow after it has been closed down, it's generally only if there are other abnormal areas in there that things get more complicated.

The recovery was very good it helped that he was under a year old that improves prognosis, he was on siezure watch for 3 days following the surgery (post op seizures are a very dangerous complication for this surgery) so I wasn't allowed to see him during that time but it was a very short recovery time he was bouncing around happy and healthy even with staples running from between his front legs to between his back legs. He was kept on the special diet for a couple of months after to prevent overworking his liver, he never showed any more symptoms after that. He had a blood biochemistry test done (same as the diagnosis bile acid test) after a few months and this came back perfectly normal no sign of liver dysfunction and he was put on a normal diet. He was 10 months old when he had the surgery and he's 6 years old now and he's been a perfectly dog ever since :)

I was lucky, there were no dangerous complications, the shunt appears to have caused no further problem and therefore hasn't required further surgery, I was lucky to have an excellent surgeon in the country (Geraldine Hunt) unfortunately she's not at University of Sydney anymore but I'm sure they have great vets there.

#23 User is offline   Millyo8 

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Posted 04 August 2012 - 04:51 PM

Thankyou for being so generous with your information. I feel confident with my surgeon he hasn't been here very long and came from the Bristol University where he was doing at least one shunt a week so is very experienced. He is going to monitor her when I get to Sydney and I am sure he won't operate if he has any doubts. When we saw him last time he had such a lovely manner and was so gentle with her.

#24 User is offline   Millyo8 

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Posted 04 August 2012 - 06:47 PM

Jules, I am listening to everyone and have taken your advice. Milly was vomiting every night but I am now feeding her more often but with much smaller meals. She is probably eating a bit less but she is no longer vomiting and I reckon she is better off.

#25 User is offline   WoofnHoof 

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Posted 04 August 2012 - 07:01 PM

No worries hope your girl is feeling better soon :)

#26 User is offline   Millyo8 

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Posted 14 August 2012 - 07:33 PM

Update on Milly.
Milly had her shunt operation today. She wasn't stabalising so they decided it was better sooner rather than later to operate. She had the CT scan with dye this morning and then went straight to surgery. She has a very large shunt and they don't know if they will be able to completely close it. She may have more surgery later. The Surgeon will ring me tomorrow and if she is okay she will come home on Thursday.
I want to thank all of you who posted it really made me feel more confident and feel encouraged to go for the surgery.

#27 User is offline   Xyz 

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Posted 14 August 2012 - 08:44 PM

Great to hear! Hoping for a speedy recovery for her-)

#28 User is offline   jans 

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Posted 15 August 2012 - 08:58 AM

How is Milly doing ??

#29 User is offline   Millyo8 

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Posted 15 August 2012 - 09:47 AM

View Postjans, on 15 August 2012 - 08:58 AM, said:

How is Milly doing ??

I'll let you know as soon as I hear from the surgeon. But yesterday she had woken from the surgery and was fine.

#30 User is offline   Millyo8 

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Posted 15 August 2012 - 10:20 AM

Hey again.
The surgeon just rang and Milly is doing well. She was eating yesterday after the surgery and has eaten this morning! He will ring again tomorrow to confirm when she can come home. Soooo Happy!!!

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