Liver Shunts
 

Most people ask, "What in the world is a liver shunt?" It is a deadly disease

which affects all sorts of dogs including Italian Greyhounds. Below is some information about this disease.  I am NOT a veterinarian and the information below is information I've obtained through researching the problem:

Portosystemic shunting is a term used to describe abnormal blood flow between the liver and the body. The liver is responsible for detoxifying the body, metabolizing nutrients and eliminating drugs. When the body’s blood flow bypasses the liver, as is the case with portosystemic shunts  (PSS), a multitude of signs may appear. There are two types of shunting: intra hepatic (the vein is within the liver) and extra hepatic (not attached). Since congenital shunts are believed to be hereditary, dog breeders need to be aware of early signs of liver disease so that potential carriers of the problem can be identified and eliminated from the breeding program.

In an affected dog the liver is not getting an adequate blood supply and this causes the dog to be smaller than normal. The liver is also not able to properly rid itself of all the toxins that it does manage to take in through the capillary system. Protein is the major culprit. Dogs with liver shunt are not able to assimilate the protein from food. Therefore most often the shunt is found because the dog suffers seizures from the build-up of toxins.

,Clinical signs of PSS are generally noticed before 1 year of age. However, it is not uncommon for symptoms to appear at around 2 years of age. Warning signs are: thin and/or poorly grown (small) dogs, depression, vomiting, atazie, aimless walking or compulsive pacing, circling, disorientation (weaving and bobbing) and apparent blindness. Seizures are another possible sign of this problem. Uncharacteristic aggression can also be a sign. All these symptoms may be multiple or singular to this disease.

Animals that are showing signs of liver disease should have a complete blood count, serum  chemistry screen, and urinalysis performed. If the test results are suggestive of a liver disorder, the animal's bile acids should be measured. Bile acids are considered to be the most sensitive screening test for portosystemic shunts. Two (2) blood samples are drawn, the first after a twelve (12) hour fast, the second sample is drawn 2 hours after a high protein meal. Elevation of bile acids (especially the second sample) is highly suggestive of a portosystemic shunt (rather than any other cause of liver disease). These patients should have the diagnosis of PSS confirmed. Diagnostic tests include radiographs, ultrasonography and intravenous portovenography. Portovenography involves anesthetizing the patient, injecting radio opaque dye intravenously, and taking radiographs of the liver as the dye is circulating through the liver vasculature.

It is possible for surgery to correct the shunt. If the problem is extra hepatic it is quite a simple operation. Veterinarians have had great success with this type. The intra hepatic type of problem is another story. The surgery is quite extensive and usually requires two surgeries and several days in the hospital. The veterinary surgeon first has to go into the liver to find a suitable vein (i.e., large enough) to reconnect. This part of the surgery takes quite a bit of time and current protocol is to find the vein, sew everything back up, let the dog recover for a few days and then go back in and connect the vein. So far only limited success has been achieved with this type of surgery. Management plays a critical role in the long term maintenance of affected animals, regardless of surgical intervention. Either a low-protein diet or a no-protein diet is usually recommended. The results of this are not entirely pleasant. These dogs are never quite 100% healthy. Their coats lack luster, they have no energy, etc.