Liver Shunts? Possible cure without surgery? - YorkieTalk.com Forums

SugarPie · 12-18-2011, 05:57 PM

Tonight I had to take my 6 m.o., male, Cricket, to the hospital. He has been acting very, very strange for the past 2 months. Some signs were that he rubbing his ears with his paws like they were itchy, running his body around the couch, and becoming shaky every so often. Another concern of ours is that he's also had trouble gaining weight. His weight seems to go up and down every time the vet sees him.

The advice the vet gave me was to feed him by hand since that was the only way he seemed to want to eat, feeding him NutriCal and also giving him sugar water if he should become shaky. However, tonight Cricket came running into the room yelping and hollering. At first I thought he fell off the couch, which is rare because he can get up and down safely and has no issues or like has once happened before, my son who doesn't always look down when he's walking, might have went to close his door when he was standing there.

When I picked him up, he was whimpering in my arms but wanted down on the couch. A moment later he tried to stand up and kept slipping back down. I also began to notice at this point that he looked disoriented and vacant. I tried setting him down on the floor to see if he could walk there. He fell over but was able to get up after that and managed to make it to his dog bed where he started to look sleepy and unresponsive.

Minutes later, a family member pulled up into our driveway and usually, like most dogs, our dogs go running to the back door to say hello, but Cricket stayed in his dog bed, still lethargic and unresponsive. We decided to take him to the hospital and not to wait until the vet opened tomorrow.

At the hospital they told us that based on all the things we had told them about the nights events and the past couple of months and from all they saw of him in the examine room, it was most likely that he had liver shunts. They told us to find that out they would have to give him an x-ray to see the size of his liver but based on that, they could not know whether he had shunts unless they did blood work and gave him an ultra-sound.

When I asked how much the cost of all of this would be, they told us it would be $1,000 - $2,000 or more! There is simply no way we can pay for that. That's not including the cost of surgery (which they could not give us an exact price but said would also be in the thousands). I told them there was just nothing we could do. There are no funds there to cover that kind of thing. Instead, we were sent home with antibiotics, something called Lactulose and 2 cans of L/D dog food.

They did not give us much information as to whether this was going to be a cure or a temporary band-aid until we can pay for the cost of testing and surgery. What I am wondering is if any of you have had success with just the diet alone and have forgone the surgery. Is that even possible? What was your success (or failure) of forgoing surgery for the diet?

Any information would be greatly appreciated. Thank you.

107barney · 12-18-2011, 10:10 PM

I'm sorry that you are financially unable to do the recommended testing and treatment for your dog. If the dog does in fact have a liver shunt, surgery is usually the recommended treatment. Treating the dog with lactulose and cans of L/D will only be a temporary band-aid. There are dogs with internal shunts that are not surgically correctable, and those dogs are usually put on diet and medications. You might want to see if you can finance the diagnostics and treatment with care credit or something else. In the event you cannot take care of the dog, consider giving it to a reputable rescue who will take on the responsibility of getting it treated. Best wishes, I'm sorry you and the dog have to go through this.

kjc · 12-18-2011, 11:27 PM

Hi and Welcome to YT!

My dog has LS. This link will give you info about LS, including symptoms. What you describe as your dog's odd behavior could also be something else like AAI, which is a malformation of the spine where it joins the head.

http://www.vet.utk.edu/clinical/sacs/shunt/faq.php

Initial basic bloodwork will tell if his liver enzymes are abnormal. If yes, a Bile Acid Test would be run. An Xray can determine the size of the liver: LS dogs tend to have small livers in relation to their body size.

An Xray can also determine any malformation of the spine. Until the spine is checked by Xray, it would be wise to keep him crated, and have this verified or ruled out ASAP, like tomorrow. This is a very critical condition, and would be wise to take care of this first.

The cost you have stated seems quite outrageous to me. I would call around, and save some money by going to a vet clinic or teaching hospital where a neurologist is on staff, or at least available for a consult, also so you don't have to run all over the place to get your pup diagnosed.

kjc · 12-19-2011, 01:06 AM

Actually it would be best to get him to an ER, meds can be given to ease his discomfort. It is very risky to put off treatment for a pup with his symptoms.

Vets who do not see many Yorkies usually suspect Liver Shunt because it is a common congenital problem of the breed. Younger pups may have seizures right after a meal, headpress against a wall or furniture, inability to settle down. The LS usually does not cause them to become vocal.

AAI, Chiari, and similar diseases will cause acute imbalance, lethargy, pain (hence yelping or crying out), scratching behind the ears, falling down, etc. This is caused by fluid build up in the brain, which can be lethal. Dogs with these conditions should be handled infrequently as possible, crated, and like a precious China Doll when the need arises, until a diagnosis is made and treatment is initiated.

kjc · 12-19-2011, 01:14 AM

These conditions are congenital, so maybe your breeder may help with the cost of treatment.

Care Credit is a credit card that can be used for Vet services. Carecredit.com.... They can approve applicants in seconds, online.

kjc · 12-19-2011, 05:19 AM

I'm sorry, but I've been thinking and praying for your little one all night.

Another issue with Liver Shunt is the inability of the pup to put on weight. They may tend to look skinny all the time, and tend to be very picky eaters.

Your pup's weight goes up and down, and he will eat out of your hand. If he has a neuro/spinal problem, it may be physically painful for him to put his head down to the food bowl long enough to eat enough of his food to maintain a steady weight, or for a puppy, to eat enough to gain weight...

SugarPie · 12-19-2011, 09:02 AM

At this time, I just don't see our family making the unanimous decision to give up our boy. Although that may give him a new home and someone to take care of him, the research I have done says they take dogs on a case by case basis and that my Cricket might not even meet up to their standards of what they will take. This being due to lack of homes or funding for the care of these dogs. I just don't think a surrender is in his best interest if we can potentially find a place that will give him care cheaper (which is what I am actively trying to do now). Which is why I am hoping that if it is liver shunts, I can keep him stable until we have the funds or until we can find a place that is more reasonable about their prices.

We have a vet appointment scheduled for tomorrow. The secretary that I spoke to said they could do the blood work at the clinic and I am imaging that it would much cheaper to find out if it's shunts there than at the hospital. Not sure why that is, but just a hunch I have. They don't have an ultra-sound or x-ray machine but if they can determine that it's shunts or get closer to having a possible diagnosis based on the blood work, I can go from there.

However, based on what you said, kjc, I am wondering if you are right about the AAI simply because he has been stretching an awful lot since last night. He stretches out and pulls his back legs like he is trying to straighten himself. Is this a possible sign of AAI? It almost sounds like it could be to me. I will have to do more research on this. I am imagining that this surgery to fix AAI would be costly too but since the price of the x-ray scan was reasonable, it sounds like testing wouldn't be as pricey and the surgery would be doable. I am praying that it is neither though and that maybe he had a small accident yesterday that he's not quite gotten over the shock of, although that just doesn't seem likely.

The one thing I wasn't too sure of (but seems to be a good sign) is that Cricket seems to be able to eat the wet l/d food without any issue as to his neck hurting. He sat there and ate a whole small plateful and was still hungry. I've never seen him have such an appetite! There are just so many questions and little answers but hopefully the vet will be able to give us a clear answer on what is going on with our little guy.

Also, not to go on a tangent here, but the cost of pet care is outrageous. Of course, I would expect things to be a bit high when it comes to surgery but to simply use an ultra-sound machine and do some blood work? It's highway robbery almost. It seems to me like these private vet practices are looking to take all you have knowing that you will do practically anything for little fur family member, even shell out thousands to even diagnose them. These people should really be ashamed. Considering what I have heard in the past of people receiving quotes up in the $4,000 - $6,000 range for what includes testing, pre-op care, surgery, and post-op care. That's insanity. It really takes advantage of our big hearts and pull on it's strings knowing we would do anything to save our little ones from suffering. It's just stinkin' rotten is what it is.

Thank you for all the responses and your prayers. I hope by tomorrow we will have an answer for everything.

kjc, An especial thank you for all your information and advice. You've been very helpful. It's nice to know I have someone else out there praying for him along side myself and our family.

tem_sat · 12-19-2011, 11:07 AM

Quote:

Originally Posted by SugarPie

Also, not to go on a tangent here, but the cost of pet care is outrageous. Of course, I would expect things to be a bit high when it comes to surgery but to simply use an ultra-sound machine and do some blood work? It's highway robbery almost. It seems to me like these private vet practices are looking to take all you have knowing that you will do practically anything for little fur family member, even shell out thousands to even diagnose them. These people should really be ashamed.

I just happen to have a bill from my doctor for a sonogram. The total is $610.00 for that alone. There is very little difference for this type of thing from a cost standpoint, granted I have not needed to have an ultrasound performed on my pet so I cannot give you a veterinary comparison. I wish you the best of luck with your Yorkie and I do realize that it is quite painful when our pets come down with a serious illness that is not inexpensive to treat. Please keep us updated.

kjc · 12-19-2011, 11:44 AM

I don't see these symptoms as Liver Shunt. Stretching is seen in neck and/or back injury, and persistent scratching behind the ears. Please stress this to your vet.

My last post got blown away, I do not have time to repeat it all here again.... I'll check back later. If you want to talk, PM me, as I type really slowly.

kjc · 12-19-2011, 11:50 AM

Here's a link to a recent thread:

http://www.yorkietalk.com/forums/yor...appt-tues.html

107barney · 12-19-2011, 01:09 PM

Just wanted to chime in again and give you some prices that I've paid for these things in the Northeast.

Superchemistry (blood profile) with urine: $160
Bile Acids study $80
Internal Medicine consult $185
Ultrasound $165 plus $35 radiologist consult fee at a specialty hospital, (single organ ultrasound at regular vet without radiologist $95)

Perhaps the price you were quoted was for a ultrasound guided wedge biopsy ?? I don't know but I'd think $500-700 would get you blood, urine, BATs, ultrasound and that is in the northeast where everything is overpriced.

As for doing to a hospital w/o xrays or a ultrasound, you are wasting money you could use to get answers, in my view. Your money is better spent at an internal medicine consult. My dog also has liver disease and we started with a internal med consult and from there did blood testing and an ultrasound.

It should also be noted that an experienced ultrasound reader (i.e. a board certified radiologist) is the most likely person to pick up a shunt on an ultrasound as it is often not detected even when present.

As for AAI and it's differentials, my understanding from Teddy's neurologist is that a starting point is an oblique lateral xray of the neck, followed by MRI and spinal tap.

Roccosmommy · 12-19-2011, 01:21 PM

You've received great advice here already. I'm sorry I don't have any additional information to add, but just wanted to let you know how sorry I am that you and your pup are going through this. Sending prayers and hugs for this little one's pain to be eased until you figure everything out. And as kjc already posted, please go to carecredit.com. They offer an instant decision, and no interest for 6 months to let you pay it off. At the very least, maybe getting Care Credit can allow you to proceed with the necessary bloodwork and diagnostic testing. Please keep us posted.

gidget529 · 12-19-2011, 01:23 PM

You may want to contact your breeder. If your pup has a liver shunt, that is normally considered a congenital disorder. It may be covered by your health guarantee, which would be wonderful.

As for the cost you are seeing, unfortunately, ultrasound machines are a very costly purchase, plus the reader should have quite a bit of education. All these things cost money. I don't think vets are gouging ppl. It just costs a lot of money for equipment and education. I work in human med, and when the hospital I worked in purchased a new ultrasound machine for cardiology it was $200,000. Now, they were a large hospital w lots of ultrasound machines. That was just the price of one.

I think 107barney gave you wonderful info of what to look for cost-wise. I would definitely get a good consult and blood work/x-rays. This will give you some base to go from there. There are care credit lines also available. I am so sorry you are facing this w your little one. This must be heartbreaking and unexpected to face. I think you will find a wonderful support system here to help you help your little one.

SugarPie · 12-19-2011, 02:14 PM

Quote:

Originally Posted by 107barney

Just wanted to chime in again and give you some prices that I've paid for these things in the Northeast.

Superchemistry (blood profile) with urine: $160
Bile Acids study $80
Internal Medicine consult $185
Ultrasound $165 plus $35 radiologist consult fee at a specialty hospital, (single organ ultrasound at regular vet without radiologist $95)

Perhaps the price you were quoted was for a ultrasound guided wedge biopsy ?? I don't know but I'd think $500-700 would get you blood, urine, BATs, ultrasound and that is in the northeast where everything is overpriced.

As for doing to a hospital w/o xrays or a ultrasound, you are wasting money you could use to get answers, in my view. Your money is better spent at an internal medicine consult. My dog also has liver disease and we started with a internal med consult and from there did blood testing and an ultrasound.

It should also be noted that an experienced ultrasound reader (i.e. a board certified radiologist) is the most likely person to pick up a shunt on an ultrasound as it is often not detected even when present.

As for AAI and it's differentials, my understanding from Teddy's neurologist is that a starting point is an oblique lateral xray of the neck, followed by MRI and spinal tap.

Wow, that seems cheap compared to what I was told here. I just spoke to someone that the Veterinary Medical center at Ohio State as was quoted at $900 - $1200 for the LS testing and for surgery anywhere from $2,000 to $2,800. Now that I am also wondering if AAI is the culprit, I am thinking of going ahead and having an x-ray done. Like I mentioned to kjc, if it's liver shunts, they told me they can see whether his liver is small in proportion to his body size and they could probably also see if it was AAI from the same x-ray, right? It'd be like killing two birds with one stone and getting down to the bottom of what's wrong.

I also mentioned to kjc that there was an incident at the vet clinic awhile back where the vet tech had worn heavy gloves to handle Cricket. She turned his body and neck every which way so that the vet could examine him. She used the gloves because she thought he was being feisty but the truth is, he likes to be held close to someone's body when he's being handled like that. When she handed him back to me, he looked simply stunned. He held his neck to one side like he couldn't move it at all and whimpered while he stared off into space. I didn't like the way she was holding him AT ALL.

SugarPie · 12-19-2011, 02:25 PM

Thank you to everyone for the advice, information and prayers. I am glad to know I have such a great support system here to help me and Cricket out.

I will be sure to update all of you as soon as we find out any further information.

12-18-2011, 05:57 PM	#1
SugarPie YorkieTalk Newbie! Join Date: Dec 2011 Location: Ohio Posts: 7	Liver Shunts? Possible cure without surgery? Tonight I had to take my 6 m.o., male, Cricket, to the hospital. He has been acting very, very strange for the past 2 months. Some signs were that he rubbing his ears with his paws like they were itchy, running his body around the couch, and becoming shaky every so often. Another concern of ours is that he's also had trouble gaining weight. His weight seems to go up and down every time the vet sees him. The advice the vet gave me was to feed him by hand since that was the only way he seemed to want to eat, feeding him NutriCal and also giving him sugar water if he should become shaky. However, tonight Cricket came running into the room yelping and hollering. At first I thought he fell off the couch, which is rare because he can get up and down safely and has no issues or like has once happened before, my son who doesn't always look down when he's walking, might have went to close his door when he was standing there. When I picked him up, he was whimpering in my arms but wanted down on the couch. A moment later he tried to stand up and kept slipping back down. I also began to notice at this point that he looked disoriented and vacant. I tried setting him down on the floor to see if he could walk there. He fell over but was able to get up after that and managed to make it to his dog bed where he started to look sleepy and unresponsive. Minutes later, a family member pulled up into our driveway and usually, like most dogs, our dogs go running to the back door to say hello, but Cricket stayed in his dog bed, still lethargic and unresponsive. We decided to take him to the hospital and not to wait until the vet opened tomorrow. At the hospital they told us that based on all the things we had told them about the nights events and the past couple of months and from all they saw of him in the examine room, it was most likely that he had liver shunts. They told us to find that out they would have to give him an x-ray to see the size of his liver but based on that, they could not know whether he had shunts unless they did blood work and gave him an ultra-sound. When I asked how much the cost of all of this would be, they told us it would be $1,000 - $2,000 or more! There is simply no way we can pay for that. That's not including the cost of surgery (which they could not give us an exact price but said would also be in the thousands). I told them there was just nothing we could do. There are no funds there to cover that kind of thing. Instead, we were sent home with antibiotics, something called Lactulose and 2 cans of L/D dog food. They did not give us much information as to whether this was going to be a cure or a temporary band-aid until we can pay for the cost of testing and surgery. What I am wondering is if any of you have had success with just the diet alone and have forgone the surgery. Is that even possible? What was your success (or failure) of forgoing surgery for the diet? Any information would be greatly appreciated. Thank you.

12-18-2011, 10:10 PM	#2
107barney T. Bumpkins & Co. Donating YT Member Join Date: Dec 2008 Location: New England Posts: 9,816	I'm sorry that you are financially unable to do the recommended testing and treatment for your dog. If the dog does in fact have a liver shunt, surgery is usually the recommended treatment. Treating the dog with lactulose and cans of L/D will only be a temporary band-aid. There are dogs with internal shunts that are not surgically correctable, and those dogs are usually put on diet and medications. You might want to see if you can finance the diagnostics and treatment with care credit or something else. In the event you cannot take care of the dog, consider giving it to a reputable rescue who will take on the responsibility of getting it treated. Best wishes, I'm sorry you and the dog have to go through this. __________________ T. Bumpkins & Co. Washable Doggie Pee Pads (Save 10% Enter YTSAVE10 at checkout) Cathy, Teddy, Winston and Baby Clyde...RIP angels Barney and Daisy

12-18-2011, 11:27 PM	#3
kjc I♥PeekTinkySaph&Finny Donating Member Join Date: May 2009 Location: Baltimore, Maryland Posts: 18,872	Hi and Welcome to YT! My dog has LS. This link will give you info about LS, including symptoms. What you describe as your dog's odd behavior could also be something else like AAI, which is a malformation of the spine where it joins the head. http://www.vet.utk.edu/clinical/sacs/shunt/faq.php Initial basic bloodwork will tell if his liver enzymes are abnormal. If yes, a Bile Acid Test would be run. An Xray can determine the size of the liver: LS dogs tend to have small livers in relation to their body size. An Xray can also determine any malformation of the spine. Until the spine is checked by Xray, it would be wise to keep him crated, and have this verified or ruled out ASAP, like tomorrow. This is a very critical condition, and would be wise to take care of this first. The cost you have stated seems quite outrageous to me. I would call around, and save some money by going to a vet clinic or teaching hospital where a neurologist is on staff, or at least available for a consult, also so you don't have to run all over the place to get your pup diagnosed. __________________ Kat Chloe Lizzy PeekABooTinkerbell SapphireInfinity Last edited by kjc; 12-18-2011 at 11:29 PM.

12-19-2011, 01:06 AM	#4
kjc I♥PeekTinkySaph&Finny Donating Member Join Date: May 2009 Location: Baltimore, Maryland Posts: 18,872	Actually it would be best to get him to an ER, meds can be given to ease his discomfort. It is very risky to put off treatment for a pup with his symptoms. Vets who do not see many Yorkies usually suspect Liver Shunt because it is a common congenital problem of the breed. Younger pups may have seizures right after a meal, headpress against a wall or furniture, inability to settle down. The LS usually does not cause them to become vocal. AAI, Chiari, and similar diseases will cause acute imbalance, lethargy, pain (hence yelping or crying out), scratching behind the ears, falling down, etc. This is caused by fluid build up in the brain, which can be lethal. Dogs with these conditions should be handled infrequently as possible, crated, and like a precious China Doll when the need arises, until a diagnosis is made and treatment is initiated. __________________ Kat Chloe Lizzy PeekABooTinkerbell SapphireInfinity

12-19-2011, 01:14 AM	#5
kjc I♥PeekTinkySaph&Finny Donating Member Join Date: May 2009 Location: Baltimore, Maryland Posts: 18,872	These conditions are congenital, so maybe your breeder may help with the cost of treatment. Care Credit is a credit card that can be used for Vet services. Carecredit.com.... They can approve applicants in seconds, online. __________________ Kat Chloe Lizzy PeekABooTinkerbell SapphireInfinity

12-19-2011, 05:19 AM	#6
kjc I♥PeekTinkySaph&Finny Donating Member Join Date: May 2009 Location: Baltimore, Maryland Posts: 18,872	I'm sorry, but I've been thinking and praying for your little one all night. Another issue with Liver Shunt is the inability of the pup to put on weight. They may tend to look skinny all the time, and tend to be very picky eaters. Your pup's weight goes up and down, and he will eat out of your hand. If he has a neuro/spinal problem, it may be physically painful for him to put his head down to the food bowl long enough to eat enough of his food to maintain a steady weight, or for a puppy, to eat enough to gain weight... __________________ Kat Chloe Lizzy PeekABooTinkerbell SapphireInfinity

12-19-2011, 09:02 AM	#7
SugarPie YorkieTalk Newbie! Join Date: Dec 2011 Location: Ohio Posts: 7	At this time, I just don't see our family making the unanimous decision to give up our boy. Although that may give him a new home and someone to take care of him, the research I have done says they take dogs on a case by case basis and that my Cricket might not even meet up to their standards of what they will take. This being due to lack of homes or funding for the care of these dogs. I just don't think a surrender is in his best interest if we can potentially find a place that will give him care cheaper (which is what I am actively trying to do now). Which is why I am hoping that if it is liver shunts, I can keep him stable until we have the funds or until we can find a place that is more reasonable about their prices. We have a vet appointment scheduled for tomorrow. The secretary that I spoke to said they could do the blood work at the clinic and I am imaging that it would much cheaper to find out if it's shunts there than at the hospital. Not sure why that is, but just a hunch I have. They don't have an ultra-sound or x-ray machine but if they can determine that it's shunts or get closer to having a possible diagnosis based on the blood work, I can go from there. However, based on what you said, kjc, I am wondering if you are right about the AAI simply because he has been stretching an awful lot since last night. He stretches out and pulls his back legs like he is trying to straighten himself. Is this a possible sign of AAI? It almost sounds like it could be to me. I will have to do more research on this. I am imagining that this surgery to fix AAI would be costly too but since the price of the x-ray scan was reasonable, it sounds like testing wouldn't be as pricey and the surgery would be doable. I am praying that it is neither though and that maybe he had a small accident yesterday that he's not quite gotten over the shock of, although that just doesn't seem likely. The one thing I wasn't too sure of (but seems to be a good sign) is that Cricket seems to be able to eat the wet l/d food without any issue as to his neck hurting. He sat there and ate a whole small plateful and was still hungry. I've never seen him have such an appetite! There are just so many questions and little answers but hopefully the vet will be able to give us a clear answer on what is going on with our little guy. Also, not to go on a tangent here, but the cost of pet care is outrageous. Of course, I would expect things to be a bit high when it comes to surgery but to simply use an ultra-sound machine and do some blood work? It's highway robbery almost. It seems to me like these private vet practices are looking to take all you have knowing that you will do practically anything for little fur family member, even shell out thousands to even diagnose them. These people should really be ashamed. Considering what I have heard in the past of people receiving quotes up in the $4,000 - $6,000 range for what includes testing, pre-op care, surgery, and post-op care. That's insanity. It really takes advantage of our big hearts and pull on it's strings knowing we would do anything to save our little ones from suffering. It's just stinkin' rotten is what it is. Thank you for all the responses and your prayers. I hope by tomorrow we will have an answer for everything. kjc, An especial thank you for all your information and advice. You've been very helpful. It's nice to know I have someone else out there praying for him along side myself and our family.

12-19-2011, 11:44 AM	#9
kjc I♥PeekTinkySaph&Finny Donating Member Join Date: May 2009 Location: Baltimore, Maryland Posts: 18,872	I don't see these symptoms as Liver Shunt. Stretching is seen in neck and/or back injury, and persistent scratching behind the ears. Please stress this to your vet. My last post got blown away, I do not have time to repeat it all here again.... I'll check back later. If you want to talk, PM me, as I type really slowly. __________________ Kat Chloe Lizzy PeekABooTinkerbell SapphireInfinity

12-19-2011, 11:50 AM	#10
kjc I♥PeekTinkySaph&Finny Donating Member Join Date: May 2009 Location: Baltimore, Maryland Posts: 18,872	Here's a link to a recent thread: http://www.yorkietalk.com/forums/yor...appt-tues.html __________________ Kat Chloe Lizzy PeekABooTinkerbell SapphireInfinity

12-19-2011, 01:09 PM	#11
107barney T. Bumpkins & Co. Donating YT Member Join Date: Dec 2008 Location: New England Posts: 9,816	Just wanted to chime in again and give you some prices that I've paid for these things in the Northeast. Superchemistry (blood profile) with urine: $160 Bile Acids study $80 Internal Medicine consult $185 Ultrasound $165 plus $35 radiologist consult fee at a specialty hospital, (single organ ultrasound at regular vet without radiologist $95) Perhaps the price you were quoted was for a ultrasound guided wedge biopsy ?? I don't know but I'd think $500-700 would get you blood, urine, BATs, ultrasound and that is in the northeast where everything is overpriced. As for doing to a hospital w/o xrays or a ultrasound, you are wasting money you could use to get answers, in my view. Your money is better spent at an internal medicine consult. My dog also has liver disease and we started with a internal med consult and from there did blood testing and an ultrasound. It should also be noted that an experienced ultrasound reader (i.e. a board certified radiologist) is the most likely person to pick up a shunt on an ultrasound as it is often not detected even when present. As for AAI and it's differentials, my understanding from Teddy's neurologist is that a starting point is an oblique lateral xray of the neck, followed by MRI and spinal tap. __________________ T. Bumpkins & Co. Washable Doggie Pee Pads (Save 10% Enter YTSAVE10 at checkout) Cathy, Teddy, Winston and Baby Clyde...RIP angels Barney and Daisy

12-19-2011, 01:21 PM	#12
Roccosmommy Donating YT 1000 Club Member Join Date: Mar 2010 Location: Massachusetts Posts: 1,293	You've received great advice here already. I'm sorry I don't have any additional information to add, but just wanted to let you know how sorry I am that you and your pup are going through this. Sending prayers and hugs for this little one's pain to be eased until you figure everything out. And as kjc already posted, please go to carecredit.com. They offer an instant decision, and no interest for 6 months to let you pay it off. At the very least, maybe getting Care Credit can allow you to proceed with the necessary bloodwork and diagnostic testing. Please keep us posted. __________________ "The little furry buggers are just deep, deep wells you throw all your emotions into." ~ Bruce Schimmel

12-19-2011, 01:23 PM	#13
gidget529 Gidget & Sidney's Mom Donating Member Join Date: Feb 2011 Location: PA Posts: 3,462	You may want to contact your breeder. If your pup has a liver shunt, that is normally considered a congenital disorder. It may be covered by your health guarantee, which would be wonderful. As for the cost you are seeing, unfortunately, ultrasound machines are a very costly purchase, plus the reader should have quite a bit of education. All these things cost money. I don't think vets are gouging ppl. It just costs a lot of money for equipment and education. I work in human med, and when the hospital I worked in purchased a new ultrasound machine for cardiology it was $200,000. Now, they were a large hospital w lots of ultrasound machines. That was just the price of one. I think 107barney gave you wonderful info of what to look for cost-wise. I would definitely get a good consult and blood work/x-rays. This will give you some base to go from there. There are care credit lines also available. I am so sorry you are facing this w your little one. This must be heartbreaking and unexpected to face. I think you will find a wonderful support system here to help you help your little one. __________________ Mommy to Gidget, Sidney & Cricket(RIP)

12-19-2011, 02:25 PM	#15
SugarPie YorkieTalk Newbie! Join Date: Dec 2011 Location: Ohio Posts: 7	Thank you to everyone for the advice, information and prayers. I am glad to know I have such a great support system here to help me and Cricket out. I will be sure to update all of you as soon as we find out any further information.