My puppy has a liver shunt and I am concerned about his quality of life and prognosis. Please help me.

Question: 

I found out that my 10-month-old Morkie has a liver shunt. My vet told me to put him on a strict diet with small portions of food, eight times a day. His symptoms are lethargy, shaking, depression, and disorientation. I read that even without the surgery, my dog’s life expectancy will be cut short due to long-term side effects. That's not an option for me. He's my baby, and I will do whatever I can to make sure he will live a long happy life. What is involved with the surgery usually and does it cost a lot? 

Answer: 

Maltese/Yorkie breeds are prone to extrahepatic portosystemic shunts (liver shunts). This is an abnormal vessel that allows blood from the intestines to bypass the liver and go into circulation around the body. As this blood does not go to the liver, toxins are not filtered and accumulate in the body causing some signs of disorientation, depressed attitude, and seizures. Additionally, the liver is under-developed, as it does not get a normal amount of blood flow. This leads to low blood proteins, low blood sugar, etc., which can exacerbate signs of disorientation and attitude. Some dogs will also have urinary signs (frequent urination, accidents) due to decreased uric acid metabolism, which causes bladder stones to form.

Treatment is initiated with medications and diet to control clinical signs prior to definitive surgical correction. Surgical correction involves the placement of a device to gradually occlude (close) the shunt over time, resorting blood flow to the liver.

Prognosis with surgery is good provided that the patient’s liver is able to regain normal function long term. Patients can have a normal lifespan following successful surgical treatment. As with any procedure, there are risks and complications that should be discussed with the surgeon. Patients who do not receive surgery and are treated with medications alone do have a shorter lifespan, with some literature reporting average survival to only 2 years of age.

I recommend that you seek consultation with a board-certified veterinary surgeon for evaluation of your puppy to better discuss the diagnosis and related treatment options. The cost of a consultation at a specialty hospital is affordable and the specialist can give you an estimate for treatment and surgery at that time.