Question from Ma Ma
Which are the symptoms of liver shunts in yorkies? My 4 years yorkie changed his behaviour in the last year, his afraid of a lot of things, is agressive with other dogs and looks quite tired all the time. Can be because of a health problem?? I thought is because we have a baby and we moved in a new house. Thank u
Answer from Shanika Winters (online vet)
Thank you for your question about liver shunts and the changes to your dog’s behaviour. It is possible that moving home and a new baby have had an effect on your dog’s behaviour but the symptoms you have listed are also found in cases of liver shunts.
What is a liver shunt?
Porto systemic shunt (PSS) commonly called a liver shunt is a condition where the blood vessels of the liver are abnormal; it is seen in dogs and cats. Miniature schnauzers and Yorkshire terriers are two breeds in which PSS seem to be found more often. The liver is a large organ found in the abdomen (belly) which processes and filters the products absorbed after food has been digested. The liver also produces vitamins, blood clotting factors and bile.
The blood full of nutrient and bacteria from the digestive system normally passes to the liver in the hepatic portal vein (large blood vessel) in cases of PSS the blood bypasses the liver via one or several vessels either inside (intrahepatic) or outside (extra hepatic) of the liver. The result of the PSS is that bacteria, unprocessed chemicals including ammonia stay in the blood and travel around the body leading to behavioural changes and poor body condition.
PSS can be congenital (present from birth) or acquired which occurs later in life. The symptoms are usually seen by 6 months of age and are accompanied by poor body condition and failure to gain weight.
What are the symptoms of PSS?
Polydipsia increased drinking
Anorexia decreased appetite
Depression quiet and uninterested in things
Lethargy less active than usual
Hepatic Encephalopathy (HE) a collection of neurological signs associated with liver disease
Ataxia lack of coordination when moving
Intermittent weakness weakness often within a few hours after eating a protein rich meal
Head pressing pushing head into corners of a wall or against furniture
Circling, Disorientation, Pacing, Altered behaviour, Seizures and Coma.
How is PSS diagnosed?
A detailed history of your pet’s behaviour, symptoms and general body condition will lead your vet to suspect liver disease and or PSS. Diagnostic tests start with routine blood tests, x-rays and ultrasound scans. If the test results point towards a liver problem the more specific liver function blood tests and or contrast imaging techniques can be used to detect the exact cause of the liver disease and where it is.
How is PSS treated?
PSS is treated medically in most cases but some cases can be treated surgically. Surgical treatment of PSS is when the shunt blood vessel is tied off so that blood is forced to pass via the liver again where it can perform its processing and filtering functions. Surgical treatment of PSS is usually carried out by a specialist vet after extensive diagnostic work up to locate the shunt vessels.
Medical management can help to keep the symptoms under control for a few years but does not cure the condition.
Medical treatment of PSS
Low protein diet, this is to reduce the amount of ammonia in the blood produced from the breakdown and digestion of protein. High levels of blood ammonia contribute to the signs of HE as listed. Lactulose can be given to reduce ammonia levels. Antibiotics are used to combat the increased levels of bacteria present in the blood and therefore increased risk of infections. Neutraceuticals are food additives that are thought to help in cases of liver disease these have not been proven to be beneficial and therefore only use after discussion with your vet.
I hope that this answer has helped you and that a diagnosis and treatment plan is put into place to help your dog soon.
Shanika Winter MRCVS (Online Vet)
Discussion
I sold my sons friend a 9 1/2 week old shorkie. 2 1/2 weeks later the dog is having liver failure and she feels i gave her a sick puppy. The puppy was eating and playing like a normal puppie up till 10 1/2 weeks old. She informed me that the puppy got into some essential oils, she also was taking the dog for walks and the dog had not shots yet and the flea collar was bothering the pup. I feel that what she did was probable part of the issue not that the pupply had liver issue when it was born. is there really anyway to tell.
It depends WHY the puppy is in liver failure – is it a shunt? If so, that’s congenital and would always have been there. Or is it a toxic or infective response? That could be more recent, although it would be quite hard to prove.
Do you have veterinary records from when the puppy was with you showing him to be clinically healthy?
I have just been told my 6 week old yorkie has shunt. He is currently at the vet. My two options are have the surgery or let him be put to sleep. My vet said without the surgery he will not live. What is the life expected range for him?
Our 4 year old has a liver shunt, she takes meds and was diagnosed about a year or so ago she isn’t getting better. We would consider surgery but Vet told us she probably wouldn’t come out of the anesthesia. Paces pukes bile a lot but just don’t want to put her to sleep 🙁
With the current techniques, the median survival is over 5 years after surgery. Unfortunately, we don’t know how much over 5 years as most studies stop at that point!
This is a useful paper if you’re interested:
https://pubmed.ncbi.nlm.nih.gov/25148094/
My 4 pound Yorky is four years old and has one extra hepatic liver shunt diagnosed by a vet. I am planning on getting the surgery this month. What is the percent success rate for this procedure. I’m very worried don’t want to lose him.
My 10 1/2 year old yorkie was diagnosed as having congenital liver shunt disease at 10 months old. We had the surgery to correct the shunt but got a call from the surgeon during surgery saying that the shunt was super small and difficult to close successfully. The vet gave it her best try. Over the years MIA had developed several more acquired shunts. She has been medically managed on a low protein diet, lactulose, metronidazole and zonismide to prevent seizures. Mia is now 10 1/2 years old and doing well. There’s hope for your dog to live a long life beyond the reported five years with proper management!
We’ve only got good data for congenital shunts – it’s between 90 and 95% survival at 3 years – especially if an ameroid constrictor is used. Much better odds than with medical treatment. There’s a review of a good paper here on it, with a 95% survival at 1000 days; more recent papers (such as this one) are a little less optimistic, at about 90% at 1000 days.
what kind of flea treatment can I give my 5lb Yorkie she has a liver shunt
You need to choose something that is not metabolised by the liver, ideally something that isn’t systemically absorbed at all – so I would advise you talk to your vet for advice given her medical history.
My Yorkies is 12lbs and has liver problems.
He drinks a ton of water and pees a lot compared to my other 8lb Yorkie. So I got him blood work and an ultrasound for a shunt. They couldn’t find the shunt but I did change his diet to liver care food only. An antibiotic and lactulose. His liver enzymes are now normal but his bun is high so he can’t have vaccines.
Would you give a yorkie metrobactin 250 mg with a liver shunt
Hello Linda, because your Yorkie is under a vet, it would be wise to ask them and discuss any worries you have with the medication. They of course, have all of the information and medical history. Best of luck.
I have a yorkie that is four and a half he had his first seizure 2 years ago and then had a cluster of seizures 6 months later and was put on anti seizure medication for epilepsy. He had blood works done and they did show bile level of 13 , his next seizure was six months later and his bile level was 21, he has had a cluster of seizures today Nd the vet has mentioned a liver shunt and suggested an ultrasound however he has a neurologist in 2weeks time and they say he is a large yorkie and liver shunt dogs are usually small in size . I’m so confused he is having an ultrasound to check his liver, will an ultrasound show up a shunt
Hi Dawn. I can appreciate your concerns and how this can be quite confusing for you. An ultrasound will help to give your vet more information as to what’s happening with the liver and will be one of many routine diagnostic tests used to determine the exact cause of the problem. If you’re not sure why a particular test is being performed, please do feel that you can discuss it with your vet in more detail and ask them to explain it to you clearly again. They have all of his clinical notes and will know why certain tests are required at this stage, and will be happy to answer any questions you have.
I think my 5 year old yorkie might have liver shun but I know L can’t afford the vet bill what can I do she has always been a well dog
Hi Helen, if your yorkie is displaying these symptoms she needs to be seen by a vet. Your vet will talk through the cost of treatment with you. If you have any friends or family that can help financially, it would be worth asking them. Alternatively, check out your local animal charities, some are able to assist. Best wishes.
I think my 5 year old yorkie might have liver shun but I know L can’t afford the vet bill what can I do she has always been a well dog
Hi Helen, if your yorkie is displaying these symptoms she needs to be seen by a vet. Your vet will talk through the cost of treatment with you. If you have any friends or family that can help financially, it would be worth asking them. Alternatively, check out your local animal charities, some are able to assist. Best wishes.
My yorkie is pacing the floor its like every other night now and we know she was tests for a liver shun t yrs ago but she’s only 3 lbs n we can’t afford it is there anything I can give her now so to stop pacing
Hi Kimi our Yorkie Rosie paces quite a lot also when she does my daughter gives her the seizure medicine. That is how we found out she had liver shunts, she paces follows the walls all night if you let her. 🙁
Hi Kimi, I’m afraid there is nothing we can suggest, other than speak to your own vet – we are based in the UK and for legal and safety reasons cannot advice on medicating pets.
My yorkie is pacing the floor its like every other night now and we know she was tests for a liver shun t yrs ago but she’s only 3 lbs n we can’t afford it is there anything I can give her now so to stop pacing
Hi Kimi, I’m afraid there is nothing we can suggest, other than speak to your own vet – we are based in the UK and for legal and safety reasons cannot advice on medicating pets.