Wednesday, July 26, 2006

Portosystemic Liver Shunt

Does anyone know about this disorder? or know someone whose Pug has it and has had surgery???? As some of you may know I belong to a Pug Group. Mainly our purpose is to help educate people on the Pug breed. We are BIG into socialization and hold fundraisers to support Pug rescue groups. This week we were contacted by a young lady...her story is reprinted here with her permission:

I am looking for anyone who may have information regarding pugs who have had surgery to ligate a portosystemic liver shunt and how they have done. I work at the C***** Animal Clinic near Syracuse, NY. The veterinarian that I work for sees puppies at a local petstore and in April they brought in a sweet little pug puppy. She was having periods of disorientation and blindness. The petstore did not want to spend the money to find out what was wrong with her and instead were going to send her back to the H****** C****** where she would be put to sleep.I thought that this was terrible and that she deserved a chance to have a life and be loved. I asked the petstore owners if I could have her instead and that I understood she problem had many issues and I would not hold them responsible or go to them for any help with her medical problems if they would just give her to me. Finally they got back to me and said that if I wanted her to come and get her or they would ship her out on the next truck. That day I took her in and ran several blood tests to find out what was wrong with her.The results pointed to a portosystemic liver shunt. Her Doctor put her on L/D diet, Denosyl, Marin, Metronidazole/Amoxicillin compound and Alternagel. Since starting medications she has not had any problems and on the outside appears to be a normal wonderfull baby pug girl. Her bloodwork has not changed much since starting the medications. On 7/12/06 we went to see Dr H**** for an ultrasound where we were able to locate her shunt on the outside of her liver. She feels that Maggie Magoo is a candidate for surgery.Today we went to Cornell for a pre surgical consultation. The doctors there all feel she is a candidate for surgery and could benefit but that as with any surgery there are risks. The surgery will be around $2500.00 which I have been saving for but still have a way to go.I would really like to know if anyone knows anything about pugs that have had this surgery and how or if it has helped.Thank you so much for reading my story.Katie

I have been emailing Katie and she tells me she has saved $1,100 towards the cost for the surgery. She is trying to get a part-time job to raise the difference. The surgery is scheduled for August 17th. Her real desire contacting me is for information about the shunt...not to solicite money, however; being the sucker that I am, I am trying to come up with ways to raise money to help her out. I believe our group is going to pitch in for the surgery. Anyone got any ideas? We all know the costs for keeping our little Puggies healthy. Time is short. If anyone is interested in donating, I will arrange collection and payment to Cornell on her behalf.


♥Lisa and The Pug Posse ♥ said...

No Kidding I have never heard of this? Scary! Makes me sad to know there is a sick Pug out there. Grateful for people like you to help spread the word and raise $ for medication, surgeries....Ah heartbreaking!

Sandy said...

I don't know anyone who has experienced that myself, but the Alabama Pug Rescue site that I like to go to has had pugs with that problem before. I sure hope the surgery helps her. Thank goodness for the lady saving the little puppy with medical problems.

Anonymous said...

Our Pug was diagnosed today with the same condition. Needless to say we are very upset and are not sure what we are going to be able to do. I will try to keep you posted on our progress, if for anything just to let you know that you are not going throught this alone.

David and Nicole DaCosta
Attleboro, MA

Anonymous said...

My pug Piper was just diagnosed with this .... I don't know how I am going to afford the surgery.... for now I am going to have to just go with the $18 medication and $44 special food.

Mark Stolworthy
New Bedford, MA

Anonymous said...

I had a pug named SHmalz. He was diagnosed about 3 years ago. We didn't do the surgery due to risk and cost. Instead we put him on a no protein diet and he took lactulose and flagyl (antibiotic). He led a pretty healthy life. We came home 2 weeks ago and found him in a coma. It came back and affected his brain. We had to put him down. We are still grieving for him. I feel so bad that any dog has to go through this. I made him pancakes all the time. That was his favorite, and I think it prolonged his life. Hope this helps and good luck with your pug. They are the best dogs! I wish mine was still here...
M. Amato

Anonymous said...

Hello All. We just recently lost Troy to a Liver Shunt. He was only 1 year and 4 months old. He was full of life and considered to be a small pug. Little did we know that a liver shunt stunts growth in animals. We recently got another pug Toree as a companion and saw Troy go into what we thought was a depression. Our vet ran tests and saw that his white blood cell count was very high and with all the other symptoms (circling, off balance, loss of appetite) suggested a liver shunt. We had to travel 2 states to Arizona to a specialty hospital to find out YES that is what it was. It was outside the liver in a Y shape. Troy had his surgery, but 2 weeks of complications (seizures, vomiting, diarherrea, loss of appetite), we took him back to find out his liver was rejecting the new blood flow and created more shunts, He was so weak and hardly had any control of his body. He had this Parkinson's like shake to his body and he could barely squat to do the bathroom or bend over to eat. Not to mention his belly was starting to fill with fluid. My poor baby. At this point we couldn't go any further. Through much thought and heartache we chose to let him go. There is an 85% chance of survival with surgery. We unfortunetly were in the other 15%. We maxed a couple of credit cards with all his trips to the vet and med expenses (Total about $5000), I would of spent double if it would of saved his life. god bless to everyone who has to go through this.

Anonymous said...

Our pug owen (4 1/2 yrs) was diagnosed with this in November. We had the surgery performed for him last week at the AMC in NYC. Unfortunately our result was a very unhappy one. Two days after sugery he had several cardiac arrests and passed away at the animal hospital. We did research ahead of time and thought we were prolonging his life. He was beyond being an animal to us and was a member of the family with an amazing personality.

I do believe that this surgery is in general a good thing, however I would advise that anyone considering this try to to as much advance research on their dog's current condition to evaluate if the suregery is likely to be survivable.

Remember that vetenarians are human and can make mistakes. Ask as many questions as you can. You are the one with the financial and emotional investment. Get second and third opinions.

Sorry folks - wish I had a happier story to post. Anyone wanting to ask questions who is facing this situations or looking for words of support, feel free to email

Although our friend in gone, we take comfort in the happy times we had and love we were able to give him.

Anonymous said...

Hi all. Well, I am doing some research of this liver shunt "after the fact". My wife did read extensively before, and with good reasons, she was very concerned. So here I share with you our story.

Daisy Doo was a happy puppy, that started having what seemed to be urinary tract infections at an early age. She got antibiotics, and they would recede for a while. But they would always come back. Later on, we noticed she had passed a stone in her urine. We took her for an ultrasound, where many more stones, some as large as 0.5 cm (about 1/4") were found. They suggested surgery to extract the stones. Before her surgery, they ran some blood work, which came back with alarmingly high bile acids in her blood. That is when they started suspecting the liver shunt.

She seemed very healthy, although sometimes she would get tired very easily (We used to take her on "long walks", about 1/2 mile around the neighborhood). She also seemed to need to go peeing more often than usual. And she would probably go every half an hour to an hour in small amounts (always trying to aim her best at the pee pad).

So, as the vets suggested, we decided to do the bladder stones surgery, and while in there, they would check for the liver shunt. The surgery was done, and she did fine with it. They put a constrictor on the shunt, and extracted about 5 stones of her bladder. Surgery was on Thursday, and she was released on Friday afternoon. Friday evening she seemed alright, and was walking around. But then Saturday came by. My wife woke me up in panic mode, because Daisy seemed to be neuralgic, and blind. She was not able to stand on her own, and seemed to be blind on one side. She would walk and hit furniture and walls. We ran her into the Hospital where her surgery was performed, and they submitted us to another Hospital to see a neurologist. At this Hospital, they suggested going in and checking if the shunt constrictor had twisted, and that was causing the problem. Also, they mentioned they could do an MRI to check for a stroke.

They went in, and they ran an MRI. The constrictor was fine, and they decided not to remove it. The MRI went fine too, and there was no indication whatsoever of any brain damage due to a stroke. But she declined severely, and was showing no recognition of us. She also had some muscle "Parkinsons like" spams. After this, they were not sure if she was suffering of seizures, so they put some Valium. At this point, I still had high hopes for her. Her liver was not damaged, her brain was not damaged, and her overall bodily functions seemed to be doing alright. But I guess we were wrong. She did not recovered, and passed away on Monday morning.

Sorry for the long posting, but I just hope that Daisy's story does not repeat again. And that for those of you considering liver shunt surgery out there, that you are aware of the HUGE RISKS involved, including death. You may want to consider medical alternatives to the shunt surgery. Perhaps a special diet, drugs... I do believe it was the best we could do for her. And she may had been very sick at the time of surgery without us knowing so. But I also hope that liver shunt gets more attention out there, and that we can decrease the mortality from 15% to 1% somehow. More research, more information about it.

racers said...

I have a 9 week old english bulldog. We just came home from the NYC Veterinary Specialists. The doctor strognly suspects a liver shunt. Hopefully we will have the results tomorrow. The whole experience so far has been completely heartbreaking. IF surgery is needed does anyone recommend if we should get a second opinion and if so from where?

Punchbugpug said...

racers - not sure how to get back in touch with you? have you read other comments on this disease? some who commented left their email addresses...try contacting them

Anonymous said...

Racers, this is Troys mom. I told our story back in March. Troy was very sick when he was diagnosed. So we felt our only option was the surgery. It was as if his body was shutting down. There is the protein diet, but no matter what we tried, Troy didn't want to eat and when he did it was painful diarherrea and vomiting. We tried so many prescription dog foods and even a homemade diet. He wasn't making it. They also put him on all kinds of meds, Lactulose, clavamox, even benedryl for this terrible cough and congestion he had. Troy's liver was very small. So after the surgery for some reason it rejected the new blood flow that the surgery permitted. This a very hard thing to go through. Ask plenty of questions. Choosing diet or surgery is very hard. Some people have prolonged their dogs lives with the diet, and some surgeries have been a success. Hopefully your baby is strong and healthy at present and eating. Stay away from protein. They get so sick with it. It is hard to say where to get a second opinion. Ask your vet. We traveled two states to Arizona, for ours. We still lost our baby in the end. But we tried everything and had to stop our poor Troy's suffering. It just didn't work. I wish you all the luck in the world. Take Care of each other. This can become very stressful and emotional.. try this website to help with a little more understanding - Good Luck,
Troys Parents

Anonymous said...

It is very sad to hear all these tragic stories, but I have one with a somewhat happy ending!

I have a puggle (pug and beagle) named Curtis who is almost a year old. When he was about six months, he had three episodes of disorientation. It was mostly when we were on walks, and he would just sort of walk sideways and then act like he was drunk. The first two times, we thought he was just sick off something he ate, because he eats everything! The third time it happened, it looked like saliva was dripping from his mouth, so we took him to the vet. They suspected it right away from what we told them, and blood tests as well as an ultrasound confirmed it - a portosystemic liver shunt. The ultrasound showed it very clearly, and showed there was only one, so surgery was a definite possibility. We started him on liver diet, lactulose and metrinidozol and he never had any symptons again.

We took Curtis NC State Veterinary Hospital after our vet told us they were very experienced in this sort of thing. They said he was a good candidate for surgery because he is otherwise very healthy, he's never had any seizures, and he is also young.

When they did the ultrasound and MRI, they discovered that Curtis is shunt was extra large. They said it was the size of a mouse! Before they went into surgery, the surgeon told me they might not be able to do the constrictor ring because it was two large, sot hey would tie it with silk ties halfway, enough to allow blood to flow in the liver, but not overwhelm it.

SO, the surgery went well. They tied off the shunt halfway like they said, but they also said it was the largest shunt they'd ever seen! What this mean is Curtis MAY have to have another surgery to close the shunt entirely. He is still on L/D and lactulose, and he is a very healthy and happy dog with no symptoms. His bile acids are still pretty high, but knowing him, you would never know about his shunt.

We have another check up in six months to see if the shunt has closed up on its own (a rare but possible occurence after the silk tie closures!), but otherwise, we may have to go into surgery again. His liver is growing now with blood going to it, so hopefully he'll be in an even better place then.

I hope this helps anybody with shunt problems and gives them hope. Curtis is doing well despite it and hopefully will continue to do so!

Anonymous said...

Well... after reading all these posts I don't know how to feel.

I own a puggle- his name is Bauer. He's never been sick, is super active, loves his meals and loves playing nonstop! Just this past week, Bauer got stung/bit by something in the park - he was craying as his right paw hurt him. I tried to hold it and see if it had anything but he would not allow me to touch it. Within minutes he was vomiting and had diareah and then a minute later fell over and passed out! I was freaking out!

Called the petmedic whom rushed us to the clinic and Bauer had infact had an allergic reaction.

In doing his blood work- they found his protein levels real low and his bioacids real high!

They suspected that Bauer is having some liver issues and possibly a shunt on his liver- BUT were hoping that his allergic reaction may have made his blood all wacky!

So... today we went to the vet at 8am for blood sample #1 and we must go agian this afternoon for blood sample #2. A few days have passed this the alleric reaction and so now they must determine and see how the blood results come back.

Please Please Please say a prayer that Bauer's results come back clean and that we dont need to do surgery to determine which liver issue he may have.
1. Degenerative Liver Conition
2. Liver Shunts

The sonogram showed that his liver looked good.

I feel for all of you that have lost your babies to this. Bauer is my 1st. dog and he's my family and my baby 100% so right now I am scared. Plus, I am living in Europe- in Prague which I must say is an amazing place to have a pet as they are very pet friendly here!

Wish me luck and my prayers and with you all.

Anonymous said...

Coco is 9 months old and we just found out that she has a liver shunt. We are in the process of raising funds for the surgery. She has exhibited all of the signs of this disease. Please keep our little pug in your prayers. We are traveling to the University of Tennessee for the surgery next month. We have her on a low protein diet.

Mary Fry

Soffe said...

Hi My name is Diane my shih-tzu is 5 months old and has a liver shunt. She had surgery on her nose in November 2007 were they performed blood work and that is were we started. We got two differenct opionins and now we will heading down to UT to see Dr. Tobias for surgery on January 10, 2008. We hope it all goes well, as we could not stand to loose our Soffe. We have her on a special diet. No signs yet other then her wobbly legs. I pray that surgery takes care of her because she will die if it does not.

Soffe said...

My 5 month old shih-tzu Soffe, will be going to UT to see Dr. Tobias for a possible liver shunt. She is on a diet at this time and seems to be doing fine. We found out she possible could have a liver shunt in November 2007after she had surgery on her nose were her blood work came back and her enzymes were out of this world. We did further testing and all things are pointing to the shunt. I have cried to no end, but we will definately go through the surgery. If we don't have the surgery she will enventually die and we have to try surgery as this is the only option. She is our baby girl and we will be there for her through out the whole process. Please pray she pulls through.

Anonymous said...

My pug Turbo was diagnosed about 12 weeks of age. He has been on l/d canned and dry since then and he turned two years old last November. I chose not to pursue suregery due to the cost and risk. Turbo is a happy, healthy pug. He is thinner than most of his siblings but is a wonderful pet. He is on no other medications since the initial laxative with the food change. We have not had him neutered due to the anesthesia risk so we put up with his little dog - male attitude. Just my comments. I'd rather spend $75.00 on food every other month then risk surgery and not have him with me. Barb & Turbo in Idaho.

Anonymous said...

My shih-tzu (Soffe) had her surgery on January 11, 2008. She is acting like any normal dog. She will have blood work done in 2 months to check her bile acids. She had her stitches removed yesterday and she seems to be doing fine. We didn't know she had the shunt until blood work,she had no signs just blood work done. I just hope we are out of the danger zone. I recommend UT Dr. Hicks was wonderful with us and we have him to thank for our furbaby future.


Anonymous said...

Hi I am crying my eyes out right now. My beautiful almost 3 year old Pug, Rockie is the center of our family. He was diagnosed with a liver shunt about3 weeks ago after a trip to the pet E.R. and numerous testing after a seizure. We have spent more then $1,200 for his testing and are a pay check to pay check family of 4. His surgery is said to cost $3,000. I am wondering if anyone could talk to us about his symptoms. He refuses to eat his diagnosed food. He does take his Lactolose and his Metronidazole. WE are heart broken and just want someone to talk to. Thanks for any response.

Anonymous said...

I have some information regrading the surgery of a liver shunt. My shih-tzu had surgery on January 11, 2008 and she is doing wonderful. If you need further information or just someone to talk to please email at I know how emotional and financially this can be.

Joe said...

Hi we have a pug named Romeo since we had him he's been on medicine they thought he had infections than inAugust he had all these exrays and he had surgery because he eat all this stuff and it formed a ball in his intestines and still after that he contined to urinate frequently with blood at times. Now we took him back to the doctors and he has a liver shunt and blatter stones so we going to take him for the very costly surgery and than on Easter morning he woke up and could barely more so again back to the vet that said this is not from the shunt and she wants to run MORE tests on him plus he still has to have the surgery also and i really DON'T no what to do . My dog is a year and ahalf and we adore him b ut we alredy spent about four thousands this year so far and i don't no what i should do about this new surgery.

Anonymous said...


I have your same situation>

Where do I find Dr. Hicks?


Anonymous said...

It took 6 months and two vets to finally diagnose Ginger with a shunt (and a bladder stone the size of the tip of my pinkie.) $4500 later (with a very happy credit card company) - she had her surgery last Monday. We won't know for some weeks whether or not it was successful, but she hasn't had any post surgery siezures which is great. Ginger was already 2 1/2 when she was diagnosed, which is much older than the usual. It hasn't seemed to affect, but it is still early. She is precious to me, so I am hopeful. The choice between a dog on a limited diet, medicated for the remainder of her short life, or the possibility of a healthy dog living a full life was a no brainer to me. I know that it is expensive, but she is worth all that and more.

Anonymous said...

I have a female pug named Dutchess and she was diagnosed with microvascular shunts in her liver, meaning instead of one huge shunt, it is tiny microshunts going across her liver. She is only a 1 year old when I discoverd this condition. I work in a vet clinic as a vet tech and the first thing that made me aware that something was wrong with my pug was how tiny she was compared to all the other pug patients we see. She only weights 10 lbs! So we went for testing. Her blood work and bile acids were all wacky and then she went for a ultrasound and found nothing. The last resort we went to was to do a liver biopsy. The results came back with microvascular liver shunts. There is no cure or surgery for this condition, it can only be managed with tons of medication an a low protien diet. Even though she wont live a long life, at least I can keep her comfortable until she is ready to move on. I do feel envious to the other owners how they have the possibility to have a surgery done, I would definately recommend the surgery for any owners out there that is having second thoughts!
For new owners out there and that want to rule out their dogs having any liver problems, I would recommend asking your vets to do a bile acids test on your dogs. It is better to find out earlier than later!

RaNae said...

Our three and month old Mattie had been diagnosed with this disease,Will do what it take to give her a quality life, God bless you Pug Parents.

Anonymous said...

I have a cute boy pug named Bear and he is the best pug in the world! He was diagnosed with a liver shunt right after his labs came back with abnormal liver readings when he was prepped for neutering. One of his signs was that he was cryptorchid, which means his testicles never dropped. After the abnormal liver functions, he was given a bile acid test which confirmed a high possibility of liver shunt. His ultrasound didn't reveal much and he was checked for crystals in his urine, which were negative. So the two remaining options was to do an MRI or exploratory surgery of the liver to gather more information. I went the MRI route where it was discovered he had multiple shunts and was not a candidate for surgery. When the doctor told me this, I cried because I really wanted to do everything for him so that he would have a long, happy life. This all happened when he was about 8 months old. Although the specialist didn't want to put a limit of years this amazing Pug had on him, he was optimistic that he could have a very happy life. The good news was that he was heavier than normal dogs who have liver shunts and that his liver was a normal size. Finally, Bear was put on L/D diet, lactulose, and the metro drug. I am happy to say that he turned two years old last month, the vet is very pleased with his growth - although he is somewhat smaller than other pugs he does weight a nice 18 pounds - and I am just hoping that he will have a very happy life with me for a long time. I am not sure why we have been lucky with not having any signs of this disease, but if it helps anyone to insist that their dog gets a bile acid test prior to symptoms, perhaps treating the disease before the onset of symptoms will offer a better outcome. FYI, it is harmful for your dog to eat a diet high in protein if indeed he/she has a liver shunt. Think and be proactive and ask for your bile acid test for your loved one.

Unknown said...

I had a six-month pug who started having very bad seizures, several a day. Turned out he had a liver shunt. Knowing the risks, I didn't go with the surgery. Instead, I started feeding him raw food and giving him herbs for his liver and kidneys, such as milk thistle. Almost all of his seizures went away (two a month) and he was a happy, healthy, funny little pug. Unforunately, at three-and-a-half he developed a tumor between his heart and lungs, so I had to put him to sleep. But it was the tumor that did him in, not the liver shunt.

Unknown said...

I have a 5 month old Shih tzu who was diagnosed with a liver shunt at 3months after she started having seizures. My little Bella is the sweetest puppy but has had such a hard start to her young life. I have had her on the Hills K/D diet and lactulose but I feel that will not keep her around for long. She hasn't had any more seizures but she is not growing and has had continues problems such as eye ulcers, head pressuring, and neurological signs that the shunt is acting up. I don't know what else I can do to medically manage this disease. I can't afford the surgery cause I have had to use my student loans already to pay for ER bills from her. Can someone please help me?


Erin O'Connor
Orlando, FL

carrie RN said...

I have a pug Roscoe who has a liver shunt! I had the liver shunt surgery done and thought everything was great. Roscoe seemed great, eating regular dog food and very energetic. I took Roscoe back for a checkup 6 months later and UC Davis informed me that the surgery had not worked and there was still evidence of a shunt. I had just spent about $4000.00 and they were telling me it did not work. I was devastated. Roscoe continued to do well for about 1 year then had side effects from the shunt. He developed crystals in his bladder from the toxins the liver was not filtering. One day we had to rush him to UC Davis for emergency surgery because his urethra was blocked and he couldn't urinate. This was another $1800.00. This was when we had to put Roscoe on a special diet and 2 medications twice a day for life. He does not like the food or the meds but he was about 6 months to 1 year when all this happened. He is now almost five. He still has some problems periodically but he is my baby and I would do anything for him. I have tried every food in the book for liver shunts and it takes me about 1/2 hour every day to feed him and then I have to give his meds, but he is very happy and seems no worse for the wear. I would definetly reccomend the surgery because it works about 80% of the time. Do you reasearch and find a good doctor. Just a question, does anyone have good suggestions for food for liver shunt dogs? I would try anything.

annonymous said...

Makes me happy to hear about all these success stories of your puggies coming out of surgery. My sweet baby girl Ethel had what appeared to be bladder infections since i got her from her breeder. I was constantly going to the vet, running tests, and nobody said anything about liver shunts. She was constantly on special diets, antibiotics and steroids. In my last year of college, I took her to my parents house because i was super busy with work and school. My parents began to deal with the same problems, constantly taking her to the vet. Finally, a specialist told them what it was and about the surgery. They were told it was a difficult procedure but that it was helpful for her to have a healthy life. My world was abruptly turned upside down last year July 17th, 2010 when my baby girl Ethel went into seizures after her surgery. After a day, they took her off the life support, while my parents held her and wept in the room (I didn't even have time to come say bye). TO this day, I dont think about whether she should or shouldnt have done the surgery, or if there was someone who would have done a better job, just believe that even though she was only 4, it was her time. I hope that you pug parents really take in all your choices and resources before going through with something so serious. I miss her everyday, and only hope that you pug lovers out there don't have to ever experience what I did.

Anonymous said...

Our baby 5 month old pug named Chooch has had the symptoms of the shunt issues for the past week. His blood test are indicative of the disease and we have to go for the ultrasound tomorrow. It is helpful reading all these comments written in, but i am not sure what we will do yet. It is a shame that money is so much a part of the decision, but it is a reality. I hope that it is something we can handle.........please pray for our little pug chooch..


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