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Suspected liver shunt – Rocky aka Teddy

Rocky was a tiny thing at birth, weighing in at 1 7/8 oz.  He was a determined little guy from the get go and had better suction than most pups his size at birth. I could lift mom with him nursing and he would be hanging by her nipple which amazed me.  I still supplemented him in between feedings to make sure he was really getting fed and he continued to gain weight at a snails speed.  I took him into my veterinarian around 6 months of age and had a chemistry run.  All numbers were in the normal range except for the ALT. The results were 373 with a range of 8-75.  Results this high scream “liver shunt” so we scheduled a Bile Acid test.  The results were 53.4 pre – (0.0 – 14.9) and 112.9 post – (0.0 -29.9.  Again, results this high scream “liver shunt”

Rocky was amazingly normal acting but just a tiny little thing.  He weighed about 2 lbs by this time and as long as he stayed in zone, where he grew up he was a confident little guy.  However if I took him anywhere he would tremble and be very timid.

I decided to get a 2nd opinion so I went to another veterinarian that I use. This particular vet has probably seen more Maltese in her years of practice than many other vets bc the breeder that was my mentor bred Maltese for 20 years and most of her Maltese were sold in the same area and seen by this vet.  She is a book of knowledge when it comes to Maltese.  At this visit when she walked in the door, from across the room, she stated that Rocky had an open fontanel (soft spot).  I learned something new at that moment.  I asked her how she knew bc she hadn’t even felt the top of his head. She said it was apparent by his wide set eyes and once she said it, it made perfectly good sense. She warned me that sometimes with such an open fontanel, it came with symptoms of hydrocephalous and poor potty training. I let her know that I had already potty trained Rocky and told her how well he was doing. She was pleased and felt we needed to take the next step to rule out a liver shunt since his numbers were so high.

The next step I took was to get an ammonia test because that can indicate the toxins building up b/c of the possible shunt.  His ammonia test was Normal.

The next step was to have an ultrasound done.  That test was normal and proved no shunt.  As in most pets that have high ALT numbers but not an actual shunt, it was determined that Rocky has microvascular dysplasia.

The way I understand MVD is basically he has very tiny veins that  lead to the liver. Typically there isn’t anything you do in that case, you don’t switch foods or start on any prescriptions but you just monitor it.  A lot of vets suggest starting them on Denamarin which is not a RX and is an aid for the liver. I did try to give it to Rocky but he wouldn’t eat it half the time so it was forced when possible.

I finally found the best home for Rocky (now Teddy), one where the family also had another one of my Maltese. I can’t stress how perfect this family was for Rocky aka Teddy and how he has bonded with them.  They have taught him to go up the steps and he has potty trained for them as well. He has finally gotten above 3 pounds.

He recently went for a check up and there are the veterinarians comments.  His ALT rose from 373U/L to 574 U/L. (normal range 18-121) according to her vet.  Said there are some good signed that his liver is still able to do its job in his normal blood sugar, protein, and kidney values. His red and white blood cell counts are excellent! Bile acid pre 24.2  was down vs last year 53.4 however his post was up 170.4 vs 112.9. This means his liver is having more trouble processing fats in his diet. Which means to be careful adding things to his food that are high in fat (hard cheeses like parmesan are better than cheddar.  Ideally, he can get more carbs for extra calories.  Think rice, bread, pasta, etc. ) He seems to handle proteins fairly normal, so small amounts of lean meats are OK. The Nutro adult chicken and rice/ small bites dry kibble & Fresh Pet Moist are fine – but check the fat level on the fresh pet.  7% or less would be best. Physically I ws quite pleased with Rocky, Id just love for there to be MORE of him!

*Fresh Pet Moist can be found in some grocery stores in the refrigerated section.  Check the back for fat% less than 7%.

One Response

  1. Thank you for this info… I give Jazz very small slice of cheddar to disguise the chillax … I’ll switch to bread or parm. He has open fontanelle but we haven’t seen anything of concern.

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