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Liver Shunt

Not just a Westie problem

Portosystemic shunts formerly a common topic of conversation amongst breeders and owners of small and toy breed dogs are now being diagnosed with in dogs of all sizes - from the smallest to the largest - including Maltese, Dalmatians, Irish Wolf Hounds and even Collies. Kim Bailey has lived with this dreadful disease and lost to it. She has agreed to share her experiences in the hope of sparing other people the heartbreak of losing their best friend.

Liver shunt. How I hate those two words. Both my two darling Westies, Belle and Jade, have been diagnosed with liver shunt. You would be surprised how this condition - even though rarely heard of - is becoming a serious problem among some breeds. In some dogs, it is just an occasional occurrence due to other diseases. In others, it is hereditary and or congenital as in Belle and Jade's cases, auntie and niece by birth.

The problem normally occurs if both the parents are carriers. Unfortunately, being a carrier is not something that can be tested for as far as I know. However, it can be closely watched and regulated. This condition can pass undetected for many years and, unless your vet has experience with liver shunts, it is a very difficult to diagnose. The only way of assuring it is by Bile Acid Tests.

Over the last few years, I have read more and more about liver shunts and while I am not an expert, I will tell you everything that I know about them. Please forgive any medical errors. The liver is vital to life as it cleans the toxins from the blood system. Without it, the body would become poisoned. A liver shunt is a blood vessel that carries blood around the liver instead of through it. Toxins are not removed or metabolised from the circulation and build up, resulting in hepatic encephalopathy (neurological symptoms). It can result in fits, abnormal head pressing, disorientation, pacing, coma, energy loss, weight loss and/or diarrhoea. It can be slowly or can happen rapidly.

A worrying niggle
Belle had about a dozen multiple shunts. She showed no real symptoms. She was always a fussy eater but I just had the feeling that something was not quite right so I went to my vet. I nearly ended up arguing with him. He was insistent that there was nothing wrong with her. He said it would be a waste of money to have blood tests done as he was 99% certain she was okay. But I knew my Belle and I just knew something was not right, so I told him do the tests. He did and when they came back, he apologised and asked how I knew. To this day I donít know how I knew but when you have that special bond, you just know.

JadeJade, on the other hand, was very lucky and had just a single shunt, discovered because I was aware of Belle's condition and wanted to be sure. Jade could be operated on and now she has a normal life. With permanent happy go lucky attitude this little girl had her first clear round in March 2006 at Chippenham and first rosette at the Wye Valley show on 1 April 2006. But if I hadn't not had both of them tested, it is doubtful that either of them would have seen their first birthdays.

Belle was not so lucky.
She had too many to operate and could only be treated by medication. She went through a lot and now can rest in peace, terribly missed. Now donít quote me on this but I will tell you everything that I know and please forgive any medical errors. The main thing is if you suspect a shunt you must see a vet. It can only be treated by surgery and medication. I know, I looked for three years to find something to help my Belle, and there is nothing except conventional medicine that can treat it and then you must be aware that not all cases can be cured.

Belle went to see a specialist nearby us, supposedly for an operation to fix the shunt. God how I remember and hate that day. I could not stay with her and she would have to stay in the hospital for at least three days. It was the first time we had been parted. I received a phone call from the specialist at about 3.00pm to say that Belle was all right but that he could not continue the operation as she had 12 shunts, cirrhosis of the liver which was tiny compared to what it should be.

I was lucky that I had Belle for so long, but it was due to the medication she was taking. At one point she was up to 14 or more tablets and 10mls of lactulose a day. Thatís why I was glad I had Belle insured, though not the full insurance. I still paid 15% of the bill and special food was not included which did not matter in the end as she would not touch the special vets food. I had to cook for her. One of her favourite foods was homemade chicken stew with plenty of carrots, potatoes and of course chicken in it. Belle made regular visits to the Vet and I mean regular, every month at least when she was in her reasonably fit stages, but there were times when we went every week and every couple of days.

JadeAgility gave Belle a purpose in life
Belle started her career as a much loved pet and show dog and became an agility addict. I believe it helped her live as long as she did. We were told she would be lucky to see her first birthday but she nearly saw her fourth birthday. Belle never competed she became too ill but she still continued to train and then to visit up until a few weeks before her passing.

Belle last weeks were made worse because her heart was affected and enlarged. No matter what medication we tried it had no effect. Eventually her heart became that enlarged and it collapsed her lung. She became short of breath but still managed to enjoy life as best as she could.

One Monday morning she was sick. I rushed her to the vets and he checked her over and said that he did not think that she had much longer. I took her home and stayed with her, cuddling all day, but by mid-afternoon she started with the head shaking. At first I could not believe my eyes. Belle was fine one second and the next her head was shaking violently. This continued through the night and the next morning I rang the Vet. It was time to say goodbye. I could not let her suffer like she had the past 24 hours, but I could not let her go. I did not want my baby to leave me but it was a case of forget about me. I had to do what was the best for my baby. It makes it harder because she was only three years old a gentle and loving little girl who was friends to everyone. Life is not fair but I gained so much from knowing her. She brought love into my life. She taught me to live and love life and to grab hold of all the good things. And she brought agility and new friends as well.

Life goes on...
I always remember that Jade still has her shunt. So far, her operation has been a success, but I am ever cautious and watch her like a hawk. Maybe I am over protective, but I am not risking anything happening to her. I also have to be concerned over Jade's leg as she does not have a back right hip joint. It was removed due to Perthes disease and she is too small for a replacement joint. As some of you have now seen at the end of last year and the beginning of this, she still has a good time. She loves to run. Even when she is on a go slow. If she is running on wet uneven ground, she takes things more cautiously herself. Yes, Jade is that ball of fluff sniffing along the ground whilst her mother calls and calls her name, but she does love it.

So for some liver shunt babies there is hope; for others just give them the best you can whilst they are with us. Belle loved her agility. On training nights she would stand barking at me until I put her in the car. She never forgot which night it was. Even when ill she wanted to go to her 'play'  night, and I swear that the fun and love she had doing agility kept her alive for far longer than the experts had given her.

BelleWell I shall force myself to stop here as I kind of get on the band wagon when it comes to this illness which, I believe, could be prevented if breeders would take their puppies to the vets and get the appropriate tests done before they sell the puppies. The average cost of £15 per test is nothing compared to the £600 for a pedigree Westie, for example. Don't the puppies and their new owners deserve the truth before they have to go through the heartache that Belle and I went through? I would not have changed Belle for the world because she was my world, but some people would not have gone through the pain and expense that we have because I would rather loose everything than loose my darling girl.

I will repeat that the main thing is if you suspect a shunt you must see a vet. It can only be treated by surgery and medication. I know... I looked for three years to find something to help my Belle, and there is nothing except conventional medicine that can treat it and then you must be aware that not all cases can be cured.

For those of you who need to talk to some one who has been in the same position my email is always there KimberleyMBailey@aol.com or visit my website for up to date info on Jade at www.westie-agility.co.uk where I am trying to cover info on Westies and info on agility. If you have anything to share especially on this illness, please let me know the more we can inform people the fewer dogs will have to suffer. Don't forget this does not just affect dogs. I also know several cats who have had it and it is in humans. 

You'll find more information on liver shunts on these web sites

  1. http://www.vet.utk.edu/clinical/sacs/shunt/faq.shtml (essential reading)

  2. http://www.vetcentric.com/magazine/magazineArticle.cfm?ARTICLEID=951 http://www.yorkierescue.com/livershunt/research2.html

  3. http://www.barkbytes.com/medical/med0050.htm

About the author...
Kim Bailey trains with Staffs Agility in Cheadle
. She lives with Jade her Westie, Opal her new Japanese Spitz puppy and Lucky, a 14 year old cat whom the dogs adore. She lives in Stoke-On-Trent and works at her family's business, allowing her time to enjoy her new found addiction of Agility.