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Good Thoughts Needed For Amber


JulesP
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Apart from the little niggly stuff Amber seems perfectly healthy. All a bit of a spin out really.

Lucky I didn't get her desexed as that could have been ugly with the anesthetic.

Yeah Sonny was ok but very very woozy after his desexing took him a little while to bounce back, in hindsight it was another sign that something was NQR but he didn't crash like he did with the xray but he was already crook when he had that. When I looked back there were a few little signs but in and of themselves there was nothing big enough to put it all together until he started showing the neuro signs and even then my vets had never come across a shunt before so it wasn't on their radar at all.

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I hope everything goes smoothly jules.... we just had our liver surgery lectures and the lecturer (a specialist surgeon) seemed to think that surgical treatment was really good and worth doing in most cases - it will give a fix and require no medication long-term all going well. Going over my notes it looks like most of the compications are from closing the shunt too quickly - they need to be closed slowly.

35% of larger dogs still have the extrahepatic shunt so if that is it, and it was my dog, I'd do surgery no question.

Feel free to PM me and I'd be happy to email you my lecture notes if you'd like a look.

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So sorry this has come along Jules, just devastating to hear. It has been a shocker week, seems one lot of bad news after another, animals and people. When do you hear from the vet again, tonight or tomorrow? Just so feel for you, it's not fair.

Yeah I was feeling fairly shit about Gen as it was. Bile tests will be back tomorrow.

I hope everything goes smoothly jules.... we just had our liver surgery lectures and the lecturer (a specialist surgeon) seemed to think that surgical treatment was really good and worth doing in most cases - it will give a fix and require no medication long-term all going well. Going over my notes it looks like most of the compications are from closing the shunt too quickly - they need to be closed slowly.

35% of larger dogs still have the extrahepatic shunt so if that is it, and it was my dog, I'd do surgery no question.

Feel free to PM me and I'd be happy to email you my lecture notes if you'd like a look.

Thanks for that info Flick_Mac. Did they give a life expectancy after the operation?

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So sorry this has come along Jules, just devastating to hear. It has been a shocker week, seems one lot of bad news after another, animals and people. When do you hear from the vet again, tonight or tomorrow? Just so feel for you, it's not fair.

Yeah I was feeling fairly shit about Gen as it was. Bile tests will be back tomorrow.

I hope everything goes smoothly jules.... we just had our liver surgery lectures and the lecturer (a specialist surgeon) seemed to think that surgical treatment was really good and worth doing in most cases - it will give a fix and require no medication long-term all going well. Going over my notes it looks like most of the compications are from closing the shunt too quickly - they need to be closed slowly.

35% of larger dogs still have the extrahepatic shunt so if that is it, and it was my dog, I'd do surgery no question.

Feel free to PM me and I'd be happy to email you my lecture notes if you'd like a look.

Thanks for that info Flick_Mac. Did they give a life expectancy after the operation?

I know Flick Mac will probably have more recent figures but I was given the 50/50 for the intrahepatic (I think there is a small risk of needing a second op with the extrahepatics but obviously not as much). Then I was told about 30% of patients have post-op seizures which can be fatal my dog was on 24 hour seizure watch for 3 days post op, you aren't allowed to see them in that time either in case they get overexcited they need to be kept very quiet. I can't remember what the risk of portal hypertension is but the risk is there I was told that if that happens they have to go back in and open the shunt back up either a bit or a lot to relieve the pressure on the underworked liver. If they make it through post op and the liver takes over and function becomes normal they have a normal life expectancy.

I was told that because of the lack of blood flow and 'work' for the liver it tends to shrink further and further and can shut down completely which then leads to other problems. That's why they don't tend to give an estimate of more than a year or so after diagnosis.

ETA just wanted to add recovery is amazingly quick I took my boy home after a week and it was a struggle to keep him quiet unitl he got the staples out he was feeling so good :)

Edited by WoofnHoof
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With regards to needing a second op that's if the first op doesn't completely close the shunt after 4-6 weeks. If you close the shunt any faster than that the main complication is the portal hypertension that WnH was talking about.

As far as my notes say, if surgery goes well life expectancy isn't reduced.

Minimising chances of post-op seizures is done by medical treatment for about 4weeks prior to surgery, and courses of antibiotics, worming them etc

The stats I have for complications for an intrahepatic shunt:

70-75% clinical improvement after closing a single intrahepatic shunt

Surgical mortality of 11-25%

There is sometimes no improvement despite surgery

She also says to get a liver biopsy prior to surgery to ensure it isn't Hepatic Microvascular Dysplasia - which is like lots of tiny shunts throughout the liver. This is managed with drugs and diet etc.

They also say that they can remove the urinary calculi at the same time as closing the shunt so that might be something to consider if you do go ahead if it is infact a shunt.

Hope that helps! It's pretty well straight from my lecture notes... sorry if it isn't totally logical... I had a chicken medicine exam this morning and am brain fried!

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Well she is feeling pretty damn good this morning! Barked at me to feed her. Is barking at Poppy to play and doing massive big play leaps into the air.

She ate the I/D tinned food I gave her.

Totally different dog today then the last couple of days. Think diet is going to be really key in all this.

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