# Maccabee has a Liver Shunt



## HannahBearsMom

Over the past several months, Maccabee has been sick on and off with various infections. He would start recovering and then come down with something else. Last week, we finally discovered what is wrong with him. He has a liver shunt. I'm still awaiting the results of one final test which should help determine whether it is a single shunt that can be surgically corrected (the internist visualized one large extra-hepatic shunt when she did the ultrasound) or one large shunt and additional smaller shunts. 

For the next several weeks he is on several medications and supplements, and a protein restricted diet. If we learn, as we expect to, that it is only one shunt he will have surgery in a few weeks. 

My vet referred us to a specialty clinic and he is being seen by an internist, who plans to refer us to a local specialty surgical group as well as the University of TN small animal clinic (my suggestion). UT is apparently THE place to go for this surgery.

I set up a consultation with Sabine (canine nutritionist) while I was still trying to figure out what was wrong with him. We are supposed to "meet" this week to come up with a diet.

As you can imagine, I am very worried about Maccabee. His breeder has been very helpful. We've spoken several times and she has contacted some people she knows regarding diets and supplements. She also offered to help care for Maccabee as he recovers. 

I know the surgery has a high rate of success, but it is still very scary. Please keep us in your thoughts as we navigate unknown waters.


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## davetgabby

hope all goes well. hugs.


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## Sheri

Aw, Laurie, that is scary news. It is a good thing that you are close to your very good breeders for their help, too. Are you close enough to take them up on help for caring for Maccabee during this time?

Hugs to you, tummy rubs for Maccabee.


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## whimsy

Oh I am so sorry to hear this. I can only imagine how stressful this must be for you.
You are getting the best care possible and I'm sure everything will be just fine. Keep us posted.... sending you positive thoughts!!!


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## misstray

Awww...I'm sorry to read this. I can only imagine how scary it is for you. Sending you and Maccabee positive thoughts and well wishes.


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## davetgabby

here's an article, good for you for reaching out to Sabine as well . http://healthypets.mercola.com/site...1/02/01/liver-shunts-disease-in-pet-dogs.aspx


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## sandypaws

Laurie, I am so sorry to hear this. I'm sure it is a very scary and uncertain time for you all. I hope and pray that all goes well for Maccabee. Is this a hereditary thing? I know your breeders do testing for this sort of thing so I was curious as to how it happens. Do you know? 
Keep us posted. Hugs and licks to you and Maccabee.


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## HannahBearsMom

davetgabby said:


> hope all goes well. hugs.





Sheri said:


> Aw, Laurie, that is scary news. It is a good thing that you are close to your very good breeders for their help, too. Are you close enough to take them up on help for caring for Maccabee during this time?
> 
> Hugs to you, tummy rubs for Maccabee.


The breeder is about 3 hours away. I have plenty of vacation time, and the internist said he should need close attention only during the first week after surgery. I'll stay home with him. If he needs more than a week or two with someone available around the clock, I may take Pam up on her very kind offer to help during his recovery.

He started on the new meds and supplements on Thursday and already seems to be feeling much better. After his bath today, he did RLH, which he has not done in months! Of course, he wore himself out and has been sleeping most of the afternoon!


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## lfung5

I am sorry to her about Maccabee. I do hope it is operable. If so, he will have a normal life. 

Bella had a shunt. It wasn't discovered until she was 1.5 years old. One week I noticed she was extra thirsty. I also noticed she lost .2 lbs. I took her to the vet and said, I think she has a shunt. I always thought she had a shunt because she was so small. Bella was my first dog, so when the vet told me she was small for a Havanese, I was worried. It still took awhile before it was discovered though. She ate hills LD diet until she could get the surgery. The surgery went fine. In fact, it was so fast! I dropped her off and got a call a few hours later telling me the surgery went well. I don't remember it was post op, as that was so many years ago. Bella will be 9 in a few months and is healthy and happy.

Please keep us posted....xoxo


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## HannahBearsMom

Thanks for sharing, Linda. Your story makes me feel hopeful that all will turn out fine. Is Bella still on a special diet? Maccabee is also small. His weight has fluctuated due to his many illnesses. He topped out at 8 pounds. He was 7 pounds 10 ounces last Thursday.


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## lfung5

Bella can eat whatever she wants at this point. After her surgery they checked her levels again to make sure they were normal. After that she ate a normal diet.

I got Bella at 7 months old. She weighed 4 lbs. That's when the vet told me she was small for a havanese. I had no clue as to what size Havanese were supposed to be. I asked then if we should check her for a shunt, but she wasn't concerned. She never had any symptoms except for increased thirst and weight loss, at 1.5 years old. My vet still insisted she was fine, but I told her I wanted them to do a bile acid test. The test came back elevated so that when we did the ultrasound. From there it was special diet. I think she got surgery soon after that. Then back on special diet for about a month...I think. 

Bella is now 7 lbs!


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## Missy

I am sorry to read this. I am hoping for the best for Macabee and your family.


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## krandall

Poor Maccabee! The good news is that I've heard of several dogs who have done very well after liver shunt surgery. Hopefully, the surgery will give him a new lease on life, and he'll be healthy from here on out!


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## HavaneseSoon

Hugs to you and lots of belly rubs for your fur baby. Can you explain to us what exactly is meant by a liver shunt?


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## RitaandRiley

Oh no, poor Maccabee! Sending best wishes for a complete and easy recovery!


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## gelbergirl

_Hope everything goes well for Maccabee - will be thinking of you both._


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## Tom King

We are, of course, very saddened by this. We do have high hopes for a full recovery.

For those that don't know what a liver shunt is, ( I didn't really either until this) all puppies have them before they are born. It's a bypass valve in the vessel that sends blood flow through the liver. The puppies don't need to use their liver while they are attached to the Mother. Sometime soon after they are born, it is supposed to close up, and send the blood through the liver, so the liver can extract toxins from the blood. The liver shunts you here about are the ones that don't close up.

There are different kinds of shunts. The easiest kind to fix is one that is outside of the liver. All indications seem to be that this is the kind that Maccabee has. They saw it on ultrasound, and his bile acid levels taken last week, while high, weren't extreme. Others may have them inside the liver, which of course would be more difficult, and more invasive to fix.


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## HavaneseSoon

Tom, thank you so much for the information.


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## klomanchiodo

*My Bella is a liver shunt dog*

My Bella is almost at her milemarker 6 months post-op from liver shunt surgery.

This journey to this day has been filled with a lot of learning. Bella's liver shunt wasn't detected until she was 2.5 y/o. We started our journey because she got a UTI that was persistant and had an unusal profile in terms of having two types of crystals in a pH that should only have had 1 type of crystal. It was only after a month of antibiotics and 3 urinalysis test that we finally found biurate crystals - a sign of liver problems.

We had many diagnostics locally, including x-rays, Bile Acid test and complete blood work including liver enzymes. We also requested a Protein C test (it was inconclusive). Bella's ultrasound did not show her shunt. Before proceeding with surgery I wanted to learn as much as I could and have as many diagnostics as possible to verify and locate a shunt, or avoid surgery if it was not needed.

After all that I learned, we took Bella to University of TN, where Dr. Tobias was her surgeon. It is a world class center, and Dr. Tobias is one of the lead liver shunt surgeons. Most research is based on humans and translated to canines. Once at UT they did another ultrasound and scintigraphy. Portal scintigraphy is the gold standard for confirming a liver shunt, but it does not show the location. Often people will have a CT to locate the shunt, we did not as it is not the protocol at UT. They also did a liver biopsy at the time of surgery. Bella did amazingly well (though I can't say she is happy when she goes to the vet) and you can't even tell that there is anything wrong with her. At 3 months her liver enzymes were back withing normal limits, she still had crystals in her urine but nearly as many, and her BAT values were one third what they were pre-surgery. I am anxious to find out her 6 month results. We are prepared if the BAT comes back high - we have been told to interpret a high 6 month BAT as underlying microvascular dysplasia (MVD) which we can continue to manage medically.

Along the way we have taken several interventions to help support Bella's liver. These are things that were presented to us as options but there is no scientific research that show any of these things help, but they won't harm (as per Dr. Tobias). We immediately put her an a reduced protein diet. I started with Dr. Dodd's liver cleansing diet and we saw Bella's liver enzymes return to normal pre-surgery. However, from a nutritional standpoint this diet is not complete and balanced. While many (including me) feel Hills L/D is not the most nutritious diet it meets the profile needed in terms of amount and source of protein for liver dogs. Bella has been on Hill's L/D since before her surgery (it is high in fat so dogs gain weight when eating it and you have to adjust the amounts. We also feed Bella a home cooked diet that is one the University of TN liver shunt page. We feed her three smaller meals to reduce the amount of ammonia her body must deal with at any one time (4 smaller meals are recommended but we opted for 3 to make it easier to remember). We also give her lacutlose with every meal, this helps her to have more frequent stool/poop to eliminate ammonia. Our vet gives us the prescription for the lactulose and we give it at a dose that gives her soft but formed stool (soft ice cream). Bella is also on a liver supplment called Denamarin.

I found a great yahoo group: Liver shunt and MVD where there is a ton of information and people that have had liver shunt dogs and are living with liver shunt dogs. They are very supportive and have a tremendous amount of practical experience.

Bella also has her own facebook page: Havanese Hope - We Love Bella, where we have shared our journey. Please feel free to "like " her page.

I am happy to be a resource for you and share my experiences. I can also send you some of the literature that I have that helped me to understand what Bella was going through and what she needed. If you would like to contact me via email please feel free, my address is [email protected].

If anyone or any dogs can benefit from Bella's experience I want to be able to give back to the community so please don't hesitate to contact me.


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## lfung5

klomanchiodo said:


> My Bella is almost at her milemarker 6 months post-op from liver shunt surgery.
> 
> This journey to this day has been filled with a lot of learning. Bella's liver shunt wasn't detected until she was 2.5 y/o. We started our journey because she got a UTI that was persistant and had an unusal profile in terms of having two types of crystals in a pH that should only have had 1 type of crystal. It was only after a month of antibiotics and 3 urinalysis test that we finally found biurate crystals - a sign of liver problems.
> 
> We had many diagnostics locally, including x-rays, Bile Acid test and complete blood work including liver enzymes. We also requested a Protein C test (it was inconclusive). Bella's ultrasound did not show her shunt. Before proceeding with surgery I wanted to learn as much as I could and have as many diagnostics as possible to verify and locate a shunt, or avoid surgery if it was not needed.
> 
> After all that I learned, we took Bella to University of TN, where Dr. Tobias was her surgeon. It is a world class center, and Dr. Tobias is one of the lead liver shunt surgeons. Most research is based on humans and translated to canines. Once at UT they did another ultrasound and scintigraphy. Portal scintigraphy is the gold standard for confirming a liver shunt, but it does not show the location. Often people will have a CT to locate the shunt, we did not as it is not the protocol at UT. They also did a liver biopsy at the time of surgery. Bella did amazingly well (though I can't say she is happy when she goes to the vet) and you can't even tell that there is anything wrong with her. At 3 months her liver enzymes were back withing normal limits, she still had crystals in her urine but nearly as many, and her BAT values were one third what they were pre-surgery. I am anxious to find out her 6 month results. We are prepared if the BAT comes back high - we have been told to interpret a high 6 month BAT as underlying microvascular dysplasia (MVD) which we can continue to manage medically.
> 
> Along the way we have taken several interventions to help support Bella's liver. These are things that were presented to us as options but there is no scientific research that show any of these things help, but they won't harm (as per Dr. Tobias). We immediately put her an a reduced protein diet. I started with Dr. Dodd's liver cleansing diet and we saw Bella's liver enzymes return to normal pre-surgery. However, from a nutritional standpoint this diet is not complete and balanced. While many (including me) feel Hills L/D is not the most nutritious diet it meets the profile needed in terms of amount and source of protein for liver dogs. Bella has been on Hill's L/D since before her surgery (it is high in fat so dogs gain weight when eating it and you have to adjust the amounts. We also feed Bella a home cooked diet that is one the University of TN liver shunt page. We feed her three smaller meals to reduce the amount of ammonia her body must deal with at any one time (4 smaller meals are recommended but we opted for 3 to make it easier to remember). We also give her lacutlose with every meal, this helps her to have more frequent stool/poop to eliminate ammonia. Our vet gives us the prescription for the lactulose and we give it at a dose that gives her soft but formed stool (soft ice cream). Bella is also on a liver supplment called Denamarin.
> 
> I found a great yahoo group: Liver shunt and MVD where there is a ton of information and people that have had liver shunt dogs and are living with liver shunt dogs. They are very supportive and have a tremendous amount of practical experience.
> 
> Bella also has her own facebook page: Havanese Hope - We Love Bella, where we have shared our journey. Please feel free to "like " her page.
> 
> I am happy to be a resource for you and share my experiences. I can also send you some of the literature that I have that helped me to understand what Bella was going through and what she needed. If you would like to contact me via email please feel free, my address is [email protected].
> 
> If anyone or any dogs can benefit from Bella's experience I want to be able to give back to the community so please don't hesitate to contact me.


Thanks for your story. Bella has a great mommy
This makes me confused though. I was under the impression after surgery my Bella could eat a normal diet. Am I wrong? She has been eating a normal diet since her surgery, so that's about 7 years now......Maybe I will talk to my vet about it and get some bloodwork done. She seems fine. She is still a picky eater but eats more than before she had surgery.


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## HavaneseSoon

Found some information on Liver Shunts, it was an education for me.

http://vetsurgerycentral.com/pss.htm Liver Shunt


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## sandypaws

*Maccabee has a liver shunt*



Tom King said:


> We are, of course, very saddened by this. We do have high hopes for a full recovery.
> 
> For those that don't know what a liver shunt is, ( I didn't really either until this) all puppies have them before they are born. It's a bypass valve in the vessel that sends blood flow through the liver. The puppies don't need to use their liver while they are attached to the Mother. Sometime soon after they are born, it is supposed to close up, and send the blood through the liver, so the liver can extract toxins from the blood. The liver shunts you here about are the ones that don't close up.
> 
> There are different kinds of shunts. The easiest kind to fix is one that is outside of the liver. All indications seem to be that this is the kind that Maccabee has. They saw it on ultrasound, and his bile acid levels taken last week, while high, weren't extreme. Others may have them inside the liver, which of course would be more difficult, and more invasive to fix.


You and I must have gone to the same website to learn about this, as your info is almost verbatim. It was very informative.

If you were not familiar with liver shunt, does that mean that this is the first pup you've ever had with this condition? I can imagine how upsetting it must be to both you and Pam and Pam's offer to help out is wonderful. From all I know about you as breeders, I wouldn't have expected her to react any other way. You are good people. Keep up the good work and let's all hope for a good outcome for Maccabee.


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## klomanchiodo

lfung5 said:


> Thanks for your story. Bella has a great mommy
> This makes me confused though. I was under the impression after surgery my Bella could eat a normal diet. Am I wrong? She has been eating a normal diet since her surgery, so that's about 7 years now......Maybe I will talk to my vet about it and get some bloodwork done. She seems fine. She is still a picky eater but eats more than before she had surgery.


Please don't be confused. If you were told by your vet to return your Bella to a normal diet that is fine. There is no scientific research demonstrating that a reduced protein diet will help a post-surgical liver shunt dog. If your Bella's testing indicated that there are no underlying liver issues such as MVD, and she is doing fine on a normal diet there should be no cause for concern according the the guidance I've been given at UT.

At our Bella's 3 month test she still had a slightly elevated BAT. At that time Dr. Tobia gave us the option of returning her to a normal diet or continuing on the liver protocol. We went the conservative route and continued with the liver protocol until the 6 month post-surgical check up. We chose this route because it is suspected that Bella may have some underlying MVD. We will be able to make that assumption after her 6 month results. It the choice was ours to continue with the liver protocol because it should not harm her in any way, and if there is the chance that it could help we wanted to give Bella that chance. I suspect that no matter what the results are of her 6 month test Dr. Tobias will again give us the option of returning to a normal diet based on the lack of scientific research that a reduced protein diet helps post surgical dogs.

I'm so glad to hear that your Bella is doing well. It give us all hope that dogs with liver shunts can lead very normal lives and live a normal life span.


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## klomanchiodo

Here is a link to the University of Tennessee website regarding liver shunts:

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

You can click on the different tabs on the left to see more information.

Here is a link to the latest publication on liver shunts for owners that have recently had a dog diagnosed with a liver shunt. This was written by Dr. Tobias and covers everything clearly and succinctly. It answers questions in the same honest manner that Dr. Tobias did during our visit to UT. I highly recommend this resource Interstingly, our Bellas scintigraphy photograph is used on pg. 9.

http://www.havaneseforum.com/showthread.php?p=511377&posted=1#post511377


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## klomanchiodo

My apologies: I copied the wrong link. Here is the correct one:

Here is a link to the latest publication on liver shunts for owners that have recently had a dog diagnosed with a liver shunt. This was written by Dr. Tobias and covers everything clearly and succinctly. It answers questions in the same honest manner that Dr. Tobias did during our visit to UT. I highly recommend this resource Interstingly, our Bellas scintigraphy photograph is used on pg. 9.

http://livershuntandmvd.com/PSS-PVH-MVDBrochure.pdf


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## Thumper

So sorry  I hope the surgery goes well, hugs.
Kara


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## Pipersmom

Hugs to you and Maccabee.

I wasn't sure what a liver shunt was so I appreciate the explanations. Hoping for the best for Maccabee and Bella :grouphug:


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## HannahBearsMom

Thanks, Kristy! Both my regular vet and the internist are happy to make a referral to UT. That is where I plan to take Maccabee. I also found the Yahoo Liver Shunt & MVD group. I've been mostly lurking, but I posted this morning as Maccabee is not doing well today.


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## trueblue

Sorry to hear about Maccabee. Prayers that the surgery is a success, and your sweet boy is feeling better really soon.


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## motherslittlehelper

So sorry to read that Maccabee is facing surgery. Hope it goes well for the little guy and that he is soon feeling well. Thinking of you. Best wishes to both you and Maccabee.


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## shimpli

Ohh Maccabee, I hope you feel better soon and recover nicely from surgery, if needed. Hugs, Mom. I can imagine how nervous you are.

Sent from Petguide.com Free App


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## Suzi

I'm so sorry to hear this about Maccabee. He is a lucky pup to have you and his birth family to love and take care of him.:hug:


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## Atticus

So sorry, sounds scary, at least you have an idea of what's wrong. Sending hugs, licks and best wishes for a fast recovery!


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## HannahBearsMom

Thanks for all your prayers, well wishes, licks and hugs!

I just made a May 1 appointment for Maccabee, with Dr. Karen Tobias at the University of Tennessee. If his shunt it correctable surgically, he will have surgery the following day. Dr. Tobias is supposedly the most experienced vet (research and surgical) for extra-hepatic liver shunts. She could see him as early as next week, but our locL vet-internist said we should wait a couple weeks for the meds and new diet to help stabalize and strengthen him. He had some pretty severe neurological symptoms last week (and some milder ones yesterday), so I am anxious to get the show on the road.


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## clare

Oh I do hope everything works out alright for dear little Maccabee,and your family.


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## Kathie

Hope everything goes well with Maccabee's surgery.


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## HannahBearsMom

Maccabee has been on his new medications for almost a week and off commercial food for a couple weeks.. After a rough start yesterday morning, he started feeling much better. He ate two dinners last night and went on a walk with me. Tonight he also wolfed down his dinner and then played fetch with me. He has not wanted to play fetch in months. I'm so pleased he's starting to feel better. 

Tonight I prepared the diet Sabine created for him. I gave him a taste and he loved it! Tomorrow he will start on the new diet. Gotta get the boy strong before his trip to the Univ. of Tenn.


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## Momo means Peach

Sorry about Maccabee. I'm sending good thoughts about a successful surgery.

Sent from Petguide.com Free App


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## sandypaws

*Maccabee has liver shunt*



HannahBearsMom said:


> Maccabee has been on his new medications for almost a week and off commercial food for a couple weeks.. After a rough start yesterday morning, he started feeling much better. He ate two dinners last night and went on a walk with me. Tonight he also wolfed down his dinner and then played fetch with me. He has not wanted to play fetch in months. I'm so pleased he's starting to feel better.
> 
> Tonight I prepared the diet Sabine created for him. I gave him a taste and he loved it! Tomorrow he will start on the new diet. Gotta get the boy strong before his trip to the Univ. of Tenn.


So glad that things are looking up for you and Maccabee. It's really tough on us when they are not feeling well, not to say how tough it is on them. They seem so helpless. Wanting to play fetch and go for a walk are certainly good signs, as well as eating. Our prayers and thoughts are still with you both. Hope all goes well at UT.


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## krandall

HannahBearsMom said:


> Maccabee has been on his new medications for almost a week and off commercial food for a couple weeks.. After a rough start yesterday morning, he started feeling much better. He ate two dinners last night and went on a walk with me. Tonight he also wolfed down his dinner and then played fetch with me. He has not wanted to play fetch in months. I'm so pleased he's starting to feel better.
> 
> Tonight I prepared the diet Sabine created for him. I gave him a taste and he loved it! Tomorrow he will start on the new diet. Gotta get the boy strong before his trip to the Univ. of Tenn.


That's fantastic news!!! I've been worried about the little guy!


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## HannahBearsMom

Maccabee's lab results are in and both the Protein C and Urinalysis are consistent with an extrahepatic liver shunt. Thankfully, the protein C was inconsistent for internal shunts within the liver. The vet is faxing the referral form and Maccabee's records to the University of Tennessee, and I'll take Maccabee there on May 1.

Thank you for all the support you've shown already. I'm sure I'll be whining more before this is over.


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## krandall

You are allowed to whine as much as you want. We'll be here for you. But you should try a little "wining" too... I think it might help!


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## sandypaws

*Maccabee has liver shunt*



HannahBearsMom said:


> Maccabee's lab results are in and both the Protein C and Urinalysis are consistent with an extrahepatic liver shunt. Thankfully, the protein C was inconsistent for internal shunts within the liver. The vet is faxing the referral form and Maccabee's records to the University of Tennessee, and I'll take Maccabee there on May 1.
> 
> Thank you for all the support you've shown already. I'm sure I'll be whining more before this is over.


From what I've learned since you started this tread, Laurie, it's good news that he has the extrahepatic liver shunt rather than the internal one. It's just one less thing for you to worry about with everything else you have going on. Take Karen's advice and have a little "wine" to unwind. Best of luck.


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## HannahBearsMom

sandypaws said:


> From what I've learned since you started this tread, Laurie, it's good news that he has the extrahepatic liver shunt rather than the internal one. It's just one less thing for you to worry about with everything else you have going on. Take Karen's advice and have a little "wine" to unwind. Best of luck.


Oh yes, definitely good news. It would be better if he didn'have a liver shunt, but if he has to have one, extrahepatic is the one you want.

My daughter is with her father tonight and my fiance is at our "country house." I think snuggling with Maccabee, a glass of wine, and a long bath sound like the perfect way to spend my evening alone.


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## jabojenny

Sounds like a great plan to me. I'm happy to hear that if he needs a shunt he's got the one to have. It sounds like you are going to the best place possible to get this corrected. I think it's fabulous that you are informing all us about this process, this is why this forum is such a GREAT and fun place. I've learned so much from the first post. Another great forum resource is that others have been through what you are going through and you know they will always be here for support. I'll be thinking of you guys and know that everything will turn out great. Boy these guys keep us on our toes... I thought human kids were hard!


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## lfung5

I'm glad it is operable. I know he is in good hands as you care so much for him by reading and learning as much as you can.


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## littlebuddy

Before my Django had his Addisons diagnosis, he too was very ill. No one could figure out what was wrong with him. We took him to a different vet and he believed Django had a liver shunt. We had to schedule surgery quickly because he was on a downward spiral and didn't have much time. We also took him to a clinic in Akron very well known and they had the same diagnosis.

However, they were going to open my puppy up, incision through the belly. The other vet, who is our vet now, was able to do the procedure through a scope, 2 tiny incisions. During the scoping, he found out that my dog did not have a liver shunt and decided to do one final blood test which came back with the addisons diagnosis.

So 2 things here, check to see if your vet can scope your dog should he need the liver shunt surgery and also, check to see if has addisons before you do anything. Unfortunately my dog had to go through the surgery however he did recover and we now know what's wrong with him and can keep him comfortable thanks to medicine.


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## Charleysmom

I am so sorry to hear about Charley's little brother Maccabbee. Sounds like you are doing all the right things and we'll be thinking of you and praying for a complete recovery. An extra special hug and lick from Charley to his brother. Please keep us posted.


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## HannahBearsMom

littlebuddy said:


> Before my Django had his Addisons diagnosis, he too was very ill. No one could figure out what was wrong with him. We took him to a different vet and he believed Django had a liver shunt. We had to schedule surgery quickly because he was on a downward spiral and didn't have much time. We also took him to a clinic in Akron very well known and they had the same diagnosis.
> 
> However, they were going to open my puppy up, incision through the belly. The other vet, who is our vet now, was able to do the procedure through a scope, 2 tiny incisions. During the scoping, he found out that my dog did not have a liver shunt and decided to do one final blood test which came back with the addisons diagnosis.
> 
> So 2 things here, check to see if your vet can scope your dog should he need the liver shunt surgery and also, check to see if has addisons before you do anything. Unfortunately my dog had to go through the surgery however he did recover and we now know what's wrong with him and can keep him comfortable thanks to medicine.


Thanks for posting your experience. i'm pretty certain Maccabee really does have a liver shunt. Our regular vet ruled out Addison's and the specialist saw the shunt on the ultrasound. Maccabee's surgeon is probably the most experienced liver surgeon around, so we will go with whatever surgical approach she recommends. Thanks again for your input.


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## HannahBearsMom

*Maccabee Update*

Maccabee has been on his new protocol of medications and supplements for a couple weeks, and a special diet (formulated by Sabine) for almost a week. Looking at him, you'd never know he's sick. He is once again interested in his toys, he can't get enough of playing fetch, he's once again barking whenever the phone or doorbell rings (in real life or on TV), he's back to RLH-ing. In short, my crazy puppy is back! Or as we say around here, the Mac is back!

Maccabee's appointment at the University of Tennessee Veterinary Medical Center is May 2. If all goes according to plan, he will have surgery to correct the liver shunt the following day. We'll stay in Knoxville that weekend and hopefully be home late Sunday.

Thanks for all your support. I'll continue to keep everyone posted.


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## Tom King

Great news!! We were so hoping he would respond favorably to the new diet. So glad he's feeling good!!!!


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## HannahBearsMom

Tom King said:


> Great news!! We were so hoping he would respond favorably to the new diet. So glad he's feeling good!!!!


Tom, seeing how active he is now, I really believe he was close to death when we finally figured out what was wrong with him. His decline had been gradual, beginning with his illness in December and culminating with the severe neurological symptoms a few weeks ago. I'm so happy and releaved he is doing this well! We are confident he is going to experience a full recovery.


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## sandypaws

*Maccabee has a liver shunt*



HannahBearsMom said:


> Tom, seeing how active he is now, I really believe he was close to death when we finally figured out what was wrong with him. His decline had been gradual, beginning with his illness in December and culminating with the severe neurological symptoms a few weeks ago. I'm so happy and releaved he is doing this well! We are confident he is going to experience a full recovery.


What a scary thought, Laurie! You must have been terrified. I'm so glad that he is doing better and becoming his old self again. What a relief for you. Keep us posted as we are all thinking of you and "the Mac".


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## krandall

HannahBearsMom said:


> Maccabee has been on his new protocol of medications and supplements for a couple weeks, and a special diet (formulated by Sabine) for almost a week. Looking at him, you'd never know he's sick. He is once again interested in his toys, he can't get enough of playing fetch, he's once again barking whenever the phone or doorbell rings (in real life or on TV), he's back to RLH-ing. In short, my crazy puppy is back! Or as we say around here, the Mac is back!
> 
> Maccabee's appointment at the University of Tennessee Veterinary Medical Center is May 2. If all goes according to plan, he will have surgery to correct the liver shunt the following day. We'll stay in Knoxville that weekend and hopefully be home late Sunday.
> 
> Thanks for all your support. I'll continue to keep everyone posted.


I'm SO glad to hear he's feeling better. It's SO much better having him in good shape to face his surgery! Yay!


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## jabojenny

Awesome news! I'm sure now that he's back to his old "self" you realize how much you missed you little guy. Thanks for the update, keeping my fingers crossed for you guys!


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## clare

Good to hear things are progressing well,your a good Mummy to the little fellow!


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## LJS58

HannahBearsMom said:


> Maccabee has been on his new protocol of medications and supplements for a couple weeks, and a special diet (formulated by Sabine) for almost a week. Looking at him, you'd never know he's sick. He is once again interested in his toys, he can't get enough of playing fetch, he's once again barking whenever the phone or doorbell rings (in real life or on TV), he's back to RLH-ing. In short, my crazy puppy is back! Or as we say around here, the Mac is back!
> 
> Maccabee's appointment at the University of Tennessee Veterinary Medical Center is May 2. If all goes according to plan, he will have surgery to correct the liver shunt the following day. We'll stay in Knoxville that weekend and hopefully be home late Sunday.
> 
> Thanks for all your support. I'll continue to keep everyone posted.


So happy that Maccabee's feeing better, just wanted to say that you are an AWESOME Hav mommy


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## misstray

Glad to hear sweet lil Maccabee is feeling more his old self!


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## davetgabby

good stuff, hope his surgery gets even better results.


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## whimsy

I just want to echo what everyone else has already said. Keep us posted!


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## gertchie

:cheer2: I'm so glad he's feeling better, he looks like such a sweet guy


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## Charleysmom

So happy the Mac is feeling better. Good luck with the surgery little guy.


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## littlebuddy

Good luck with the surgery, I'm so happy he is feeling better.


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## jabojenny

Keep us posted on Maccabee's adventure!


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## Beau's mom

Wasn't today the surgery?? How is sweet Maccabee?? You are all in my thoughts and prayers.


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## HannahBearsMom

Maccabee had his appointment with the world renowned Dr. Karen Tobias, her resident, and a student this morning at the University of Tennessee Small Animal Veterinary Center. Dr. Tobias said his history and prior tests are classic for an extra-hepatic shunt. He didn't have a few symptoms, he had every symptom. Heis Having some additional tests now, and will likely have surgery tomorrow morning. Dr. Tobias and the entire staff are wonderful!

I'll keep you updated.


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## sandypaws

Good luck Maccabee. We'll all be thinking of you and pray that all goes well for you. It sounds like a classic case, however, which is a good thing. Glad you liked his medical team as that means a lot. Good thoughts and we'll be waiting to hear how he's doing. Chin up, Laurie, sounds like he's in good hands.


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## clare

Fingers and paws crossed for Maccabee!


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## Pucks104

Sending best wishes for a smooth surgery and rapid healing!


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## Pipersmom

Best wishes Maccabee! We will be thinking of you both tomorrow.


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## Lila

Good luck Maccabee. Prayers are with you and the doctors for tomorrow's operation. Keep us posted Laurie. He's to cute to have to go through all this!!!


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## lfung5

Best wishes tomorrow! Hoping for a speedy recovery!


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## krandall

Good luck tomorrow, sweet Maccabee. Your big (half) brother is rooting for you! (as is his mom!!!)


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## HannahBearsMom

Thanks got all the well wishes, everyone! I'll keep you updated.


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## motherslittlehelper

The boys and I want to add our well wishes for Maccabee's successful surgery and a speedy recovery! Hope you are soon feeling 100%, little man!


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## Charleysmom

Brother Charley will be thinking of you. Sending lots of doggie kisses. Speedy recovery little guy.


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## shimpli

I hope everything goes fine during surgery and he recovers nicely. Hugs for you, Mom.

Sent from Petguide.com Free App


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## RitaandRiley

My fingers are crossed for a successful surgery and an easy recovery!


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## MarinaGirl

I've been thinking of Maccabee this week and I hope his surgery goes smoothly. He's definitely at the BEST place for liver shunts, which must give you such peace of mind. Just think, this time tomorrow he'll be on the road to recovery and ready for a fun summer with his mamma. 

I also think he's extra cute and reminds me of my little Emmie - I love black Havs with white markings! 

Hugs,
Jeanne


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## misstray

Sounds like he's got the best possible care. Sending out good thoughts for a very smooth surgery.


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## Pixiesmom

Our very best wishes for everything to go smoothly and that he'll be up and running around in no time.


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## HannahBearsMom

I don't know if i updated, so forgive me if i already posted. I spoke with Dr. Tobias' student twice since surgery. Maccabee is doing well. They corrected on large extra-hepatic shunt and removed a stone from his bladder. The last time i spoke with her, he was resting in ICU. We will go see him first thing tomorow morning. We may have the option of bringing him back to the hotel with us, but we will likely leave him in the hospital until we head home on Sunday morning.

Guy f prognosis for a fool recovery is excellent.


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## Pixiesmom

Great news!!


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## lfung5

That's great news!! Do they recommend a limited protein diet after that?


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## sandypaws

So glad to hear the good news. Hope his recovery is a fast one. Keep us posted.


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## krandall

Awesome news, Laurie!!!!


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## MarinaGirl

Woo hoo - you must be so relieved and happy you took him to UT! I can't wait to hear more good news. :clap2:


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## HavaneseSoon

Thinking of you ((((((((((Hugs))))))))))) for everyone. Keep us posted.


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## Pipersmom

Great news! Hugs to Maccabee.


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## jabojenny

AWESOME , :whoo: so happy to hear he's doing well. Thanks for letting us know.


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## Lila

YEAH!!! :thumb:


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## HannahBearsMom

We visited Maccabee at the hospital this morning. He was very anxious, but the vet said he was not in pain. He is on two pain meds and an anti-anxiety med. He ran around, wimpering, in the exam room in which we visited with him. he will be discharged tomorrow morning and we will travel home.


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## clare

What an ordeal,so glad it is over now and the little fellow is on the road to recovery.May you have many happy Hav years to come!


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## Pucks104

Best wishes to Macabee for a speedy recovery!


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## jabojenny

Good luck betting Maccabee home today. I'm sure he'll be so happy to be with you guys that he'll just want to snuggle all the way home, or at least I hope so!


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## HannahBearsMom

We are on our way home. Just stopped for lunch. Hopefully, we'll be home by 7:00 pm.


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## krandall

Awww, he's such an adorable little guy!


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## RitaandRiley

Poor little fella! Hope he feels better soon!


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## gertchie

What a sad little face, poor guy! I'll bet he will be so happy to be at home with you! Best wishes for a speedy recovery


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## sandypaws

You must be so happy to be bringing him home and that everything went well for him. He is a cutie. I think I can speak for all of us on the forum when I say, give him extra hugs from us and, of course, licks from his furry forum friends.:kiss: (Wow, that's a tongue twister).
Here's hoping for a speedy recovery.


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## motherslittlehelper

Oh My - that sad little face! Glad surgery went well and that you are on your way home with him.


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## NvonS

Very good news! Continued good wishes for healing.


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## Tuss

so glad his surgery went well. I hope the rest of his recovery goes without incident. You must be so relieved to have him home.


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## HannahBearsMom

Last night, I took off Maccabee's cone and put him in a onesie. He was much happier. All was well until this morning. He slept in my bed and woke-up dry. I tried to get him out of the onesie and direct him to his litter box, but one of the onesie's snaps was STUCK! Maccabee tried to hold it as long as he could, but with him wiggling and the snap not wanting to open, he started dribbling on my hand and my bed. I finally got him out of the onesie and onto the floor. He ran to the litter box and peed like an open faucet. Thankfully, he (we) got only a little pee on my bed -- sheets and mattress pad were damp but the feather bed beneath the matterss pad was dry. The mattress pad is in the washer now, sheets will be next.


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## krandall

Poor little guy. (and poor you!) He tried!!!


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## misstray

Aww poor guy. He definitely tried!


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## HannahBearsMom

Since Maccabee is actively playing with his toys and crying out only when he struggles as I pick him up, I don't think he is in pain. I stopped his pain meds this morning and he seems much happier. He has slept a lot today, which I think is good for him. Of course, I've been planted on my butt in the family room watching him all day. Tomorrow I have to work (from home) which means he'll have to weat the cone :-(


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## Brady's mom

I am so happy to hear that he is doing so well. 

Do you have any pet stores near you that sell the comfy cone? When Cassie had her cherry eye surgery, she was miserable in the plastic cone. She was a new dog when I got the soft comfy cone for her.


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## jabojenny

Brady's mom said:


> I am so happy to hear that he is doing so well.
> 
> Do you have any pet stores near you that sell the comfy cone? When Cassie had her cherry eye surgery, she was miserable in the plastic cone. She was a new dog when I got the soft comfy cone for her.


I second the comfy cone. It's the blow up ring thing right?


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## Brady's mom

Actually, the comfy cone is a soft cone. 
http://www.allfourpaws.com/the_comfy_cone.php


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## sandypaws

So glad Maccabee is feeling better. I hope that every day gets even better for him. He's been through a lot for a little guy.


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## HannahBearsMom

Thanks everyone!

I may look for a comfy cone tomrrow.


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## HannahBearsMom

Brady's mom said:


> I am so happy to hear that he is doing so well.
> 
> Do you have any pet stores near you that sell the comfy cone? When Cassie had her cherry eye surgery, she was miserable in the plastic cone. She was a new dog when I got the soft comfy cone for her.


What size Comfy Collar did you use? Small?


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## Brady's mom

I just checked, and of course, there is no size on it. I believe it is a small. Cassie is about 10 pounds and it worked perfectly for her. It was just long enough that she couldn't get to anything she shouldn't, but short enough that she didn't hit it on anything. I hope you find one and it helps. I have heard good things about the tube that blows up around the neck too. With Cassie, it was her eye and I was afraid that she would be able to reach with a paw over the tube. I felt more comfortable with a cone.


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## Brady's mom

How are you and Maccabee doing?


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## Milo's Mom

Brookie did great with the inflatable neck tube!


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## Pixiesmom

Get well soon buddy!


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## Eddie

*Sending hugs and kisses your way, what great parents you guys are.:grouphug:*


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