Articles Index/Portocaval Shunt
On January 30, 2002, my brood bitch Ch. Jaeva Brandy Snap ME, CGC (Broady) whelped her second litter. She had three dogs and a bitch, all seemingly healthy at the time of birth. As the weeks passed, all of the puppies thrived, gained weight and were a delight to watch grow.
One night after dinner in the middle of May, one of the male pups, "Oxford," started acting funny. He seemed to be listless and went limp in my arms as if he were drunk. I tried to have him stand but he fell over. After a few minutes, he ran outside, threw up and almost passed out. I was very worried and called the vet immediately. I described his symptoms and they told me his blood sugar was low.
I gave him Karo syrup and waited about 30 minutes. He did not seem to be getting any better so I rushed him over to the office. When I arrived, the vet examined him and tested his blood sugar, which was still very low. He wanted to keep the puppy overnight to try to stabilize his sugar level. I described his symptoms and told the vet how they started about two hours after eating dinner, and was told he may have a problem with his liver.
This was the first time I heard the term "liver shunt." I had no idea what this condition meant. I later learned that one, or several, of the blood vessels might be bypassing the liver and some of his blood might be getting to the heart without being cleansed.
I left the office confused and upset. This had been a healthy puppy up till now. His weight was on par with his littermates and he had never had any prior problems. After picking up the puppy the next day, I scheduled an appointment with my regular vet to try to determine exactly what was causing Oxford's behavior.
A week passed and the same thing happened again on Thursday. He had the same symptoms, which again occurred two hours after dinner. I gave him the Karo syrup and held him for the next two hours, while he continued to be lethargic while his body shook. When I saw the doctor, I told him what had been happening and he agreed it could be liver shunt so a liver bile acid test was performed.
The test came back high enough to warrant an ultrasound to see whether a shunt could be seen. The ultrasound confirmed an extrahepatic liver shunt. Surgery was recommended and the surgeon told me his chances for a normal life would be good. His liver was of a good size and shape and should function well once the shunt was fixed. The surgeon also told me that I had a great vet to make a diagnosis of liver shunt from the symptoms I described.
Before surgery could be performed, Oxford had to go on K/D diet (a Hill's prescription product) and two medications: Lactulose and Metronidazole. I also had to watch his protein intake; he does not digest protein well, which only adds to the problem.
I am writing this article to inform breeders that this problem occurs in our breed. I have been told that liver shunt is common in many smaller breeds, especially Yorkshire Terriers.
Keep a close eye on your puppies as the symptoms usually appear when the puppy begins to eat kibble. Symptoms start approximately two hours after eating and can include falling asleep or lethargy soon after eating. Other symptoms may include shaking, whimpering, drunken like behavior, and in some cases even seizures.
I am thrilled to report that Oxford had surgery on July 9th and an ameroid ring was placed over the shunt. Over a period of two to three months the shunt will close. He remains on the two medications and K/D diet and will be weaned off each one slowly over the next few months.
Hopefully, he will eventually be able to eat a senior food instead of having to stay on K/D. He is doing fabulously. The wound has healed nicely and he is back to his normal terrier attitude. I neutered him and he will begin his training for earthdog and agility this fall.
Editor's Note: Also see Health Update: Portocaval Shunt in Norfolk Terriers in Autumn 1990 ANTIC or on ANTA's website -- look in the Articles Index under Portocaval Shunt.
Linda Maria Federici
ANTIC, September 2002
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