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What are Liver Shunts?

The portal vein is an important blood vessel which normally enters the liver and allows toxic elements in the blood to go through the normal detoxification process. When your dog has a liver shunt, the portal vein is not properly connected and therefore, blood normally detoxified by the liver will bypass it and go directly into circulation throughout the body. Additionally, the liver will often have poor development.

A congenital shunt is the most common liver shunt. A liver shunt acquired outside of genetics is usually seen as a secondary problem of the liver. A congenital shunt can present two ways; an extrahepatic shunt is found outside of the liver (mostly seen in small breeds) while an intrahepatic one is found within the liver (typically found in large breeds). 

A liver shunt is known medically as a portosystemic shunt, hepatic shunt, or PSS. This condition occurs when the portal vein forms abnormally, causing blood to evade the liver.

Symptoms of Liver Shunts in Dogs

Some dogs with liver shunts may exhibit stunted growth. As well, your dog may show signs of gastrointestinal upset, causing diarrhea and vomiting. There are various clinical symptoms to look for. These may include:

  • Anorexia
  • Disorientation
  • Lethargy
  • Seizures
  • Stumbling
  • Constipation
  • Circling or pacing
  • Blindness
  • Changes in behavior
  • Frequent urination
  • Staring excessively
  • Straining while urinating
  • Weight loss
  • Blood in the urine

Types

Breeds predisposed to liver shunts are:

  • Yorkshire Terrier
  • Cairn Terrier
  • Miniature Schnauzer
  • Golden Retriever
  • Labrador Retriever
  • Australian Cattle Dog
  • Irish Wolfhound
  • Maltese
  • Old English Sheep Dog
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Causes of Liver Shunts in Dogs

  • Proteins, nutrients, and toxins bypass the liver and go right into the system
  • Blood from the abdominal organs does not enter the liver, again directly entering systemic circulation
  • Dogs may take a long time to recover from a procedure using anesthetic if they have a liver shunt
  • A liver shunt can cause kidney and bladder infection, as well as stones
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Diagnosis of Liver Shunts in Dogs

Your veterinarian will conduct a physical examination and in order to give the proper diagnosis will need your pet’s medical history. Your pet’s pattern of behavior will be necessary as well. Therefore, you may have to describe how your dog has been acting lately, specifically noting the concerning behavior. A biochemical profile and complete blood count will be done since these tests provide specific information that can help with the diagnosis. Information revealed may be:

  • Measured levels of electrolytes in the blood
  • Functioning of the kidney and liver
  • Increased levels of enzymes in the liver
  • Low blood urea nitrogen
  • Low albumin

Your veterinarian will also do a blood test to check for the dog’s blood count. The blood platelets, white and red blood cells will be examined as well. Some dogs may show mild anemia or small changes in the shape and size of the red blood cells. 

The veterinarian may also do a urinalysis, which will show any abnormality of the liver function such as bladder stones and urinary tract infection. A bile acid test may show an elevation. Imaging tests include abdominal ultrasound, nuclear scintigraphy, x-ray and MRI.

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Treatment of Liver Shunts in Dogs

For treatment, the veterinarian may do a surgical closure. However, your pet has to be stabilized before this treatment is administered. Because of the risk of anesthesia to dog’s with a liver shunt, health stability is essential. To balance the levels of electrolytes and restore your dog’s hydration, IV fluid therapy will be administered.

Levels of ammonia will be lowered and toxins absorbed in the intestine using lactulose. Antibiotics could also be administered to reduce the level of ammonia and bacterial overgrowth. For dogs showing signs of diarrhea and vomiting, the veterinary specialist may order gastric protection medication. A high protein diet will be recommended.

Once your pet’s health condition improves surgery can take place. Most often the shunt is narrowed or tied off completely with the goal of having the blood pass through the liver as it should. It is important to note that not all dogs will require surgery or are candidates for surgical intervention (depending on factors such as the location of the shunt). Many canines will be treated with medical management only in the form of a diet change and medication.

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Recovery of Liver Shunts in Dogs

Typically, surgery is successful although regular liver evaluation will be necessary from now on. Recovery steps will include dietary therapy as prescribed by your veterinarian as well as continued lactulose administration. The liver can repair itself and begin to function as it should, allowing your pet further improvement.

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Liver Shunts Questions and Advice from Veterinary Professionals

Need pet health advice? Ask a vet

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Ask a Vet

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Yorkshire Terrier

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3 months

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Unknown severity

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1 found helpful

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Unknown severity

Has Symptoms

Disorientation Vomiting

I have a 3 month old yorkie. He has been diagnose with liver shunt. I’m currently treating him at home with metronidazole, lactulose and amoxicillin. I still have to speak with an internal medical dr to see if it’s worth to keep treating my puppy without surgery. I’m willing to do anything to keep my puppy. Can you please advise me from your point of view in regards to this matter. I don’t want him to suffer, right with the meds he’s already playing, barking, running, biting..

Aug. 5, 2020

Owner

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Dr. Michele K. DVM

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0 Recommendations

Thank you for your question. Unfortunately, without knowing more about your dog's lab work, there is no way I can comment on medical treatment. Many liver shunts are treatable through medication, and that may be an option for your dog. It would be best to discuss that with your veterinarian, as they know more about your dog, your situation, and the lab work, I hope that all goes well for your puppy.

Aug. 5, 2020

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Vinnie

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Shitzu

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4 Months

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Serious severity

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0 found helpful

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Serious severity

Has Symptoms

Liver Shunt

My little shitzu is only 4 months old and he is a very likeable and friendly dog and both my kids and the rest of the family love him he loves to spin around and nip toes playing around. He’s so small and cuddly and never seems to bark a lot or be bothered about the kids.

Sept. 7, 2018

Vinnie's Owner

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Luna

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Siberian Husky

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2 Years

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Serious severity

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0 found helpful

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Serious severity

Has Symptoms

Head Bobbing
Dizziness,
Dizziness, Lethargic

My Husky has developed multiple acquired liver shunts, we are guessing due to a sago palm she ate last year. We took her back to the vet where they did blood work and suggested we send her to an animal hospital for an ultrasound. That`s when we received the bad news. The Vet at the hospital says surgery is not an option(due to the severity of her case) and just keep her on the high quality/low protein diet and she may live 1-2 more years. My dog is only 2 years old.Is this the only option is to just sit around for the next year or 2 just to put her to sleep at the oldest age of 4? Please tell me there is another option, this is tearing me apart. Thank you

Aug. 24, 2018

Luna's Owner

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3320 Recommendations

In cases like this where there are multiple shunts which are not in a surgically convenient position, there are few options available apart from medical and dietary management; this may be something to discuss with a Specialist Surgeon, but the prognosis may still remain the same. Regards Dr Callum Turner DVM

Aug. 24, 2018

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Max

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Husky

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18 Months

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Mild severity

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Mild severity

Has Symptoms

Diarrhea
Vomiting

My 18 month old puppy had and intrahepatic liver shut closed with the ameroid constrictor at 10 months old. His levels have been normal and they have taken him slowly off his lactulose. He has been off the lactulose for 1 week now. He has vomited the last 2 days and has diarrhea as well. He is still very pink and is not showing any neurological effects as he did before the surgery. Could the vomiting 1-2 times a day and diarrhea be his body adjusting to not having the lactulose anymore? He is going for a follow up blood test next week, but yesterday and today this has started. He is also still on his RX LD food.

July 13, 2018

Max's Owner

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3320 Recommendations

As far as I am aware withdrawal of lactulose doesn’t lead to vomiting and diarrhoea although any sudden changes in oral intake may cause some gastrointestinal discomfort; keep an eye on Max but if the vomiting gets too much or any other symptoms present visit your Veterinarian sooner than the appointment time to be on the safe side. Regards Dr Callum Turner DVM

July 14, 2018

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Rusty

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mix large breed

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10 Weeks

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Mild severity

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1 found helpful

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Mild severity

Has Symptoms

(Weak At Times)
(Weak At Times) Head Wobble
(Weak) Head Wobble, Lethargic

Writing with urgent concern. I own a 10 week old shepherd lab/rottie mix. We have owned him for roughly 2 weeks. The last 3 days he has been showing very unusual signs. We had him to the vet and they first thought it was his blood sugar hypoglycaemia (we tried him with honey on his tongue) when he first took a reaction "attack" it worked he was himself right away, the second time he didn't respond in the attack, he collapses and lays there and can not get back up even when we try to stand him (after 20 minutes or so he does). His head wobbles side to side. After he comes out of these "attacks" he is his good old self. He doesn't shake. He eats normally and drinks well, bowels move normal, peeing fine. We had him to the vet today he stated all blood work was normal, except for a slightly elevated white blood cells and a temp. They perscribed him an antibiotic "metronidazole". After doing much of my own re search I came across this disorder, I am concerned he may have this. My next step is to get his bile acids checked. Will this pin point me in the right direction? I would appreciate any information. Thank you

June 13, 2018

Rusty's Owner

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Dr. Michele K. DVM

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1611 Recommendations

Typically dogs that have liver shunts have abnormalities in their blood work that points us in that direction, but he may be a dog that is not having blood changes. Given your description, this is possible, and a bile acids test is probably a good idea. If his bile acids are normal, then he does not have a shunt, but if they are elevated, he may indeed, and an ultrasound of his liver would be the next step.

June 13, 2018

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Angel

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Yorkie

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11 Months

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Moderate severity

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Moderate severity

Has Symptoms

Constipation
Appetite
Constipation /Loss Of Appetite
Constipation / Loss Of Appetite
Constipation / Loss Of Appetite /

i have a 11.5 month old yorkie female named Angel she is 3 weeks post op from liver shunt and had a ameroid constrictor placed on her vessel, she was fine until 2 days ago now wont eat or drink any dog food so i was making A/d mixed with pedialyte for babies and syringe it to feed her but today i decided to give her 1 scrambled egg and she ate that on her own! No bowel movement for 2 days and no fever! she is on lactulose wondering if i increase it will that help? she is 4.5 lbs and on 3.5ml three times a day HELP im going outta my mind with worry

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Cassie

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Border Terrier

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12 Years

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Mild severity

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Mild severity

Has Symptoms

Hair Loss
Urinating
Drinking

I have a 12 year old border terrier cross who was diagnosed 7 years ago with a liver shunt. She has reacted well to medical management and she has hepatic medicated food, lactolose​ and daily medication to fight infections. At her routine check up​, we were advised that there is a possibility that she may have cushing​ disease as she has lost her hair on her ears (which we put down to old age). The vet said this might be why she drinks and urinates a lot, howeve​r she has always dran​k and urinated a lot due to the liver shunt. The vet is now suggesting that we pay for further tests to see i​s she has cushings, even if we cannot treat it. Does anyone have any experience of treating cushing disears​e in a dog with a liver shunt or if it would be best to leave her medication as it is?

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Milly

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Shih Tzu

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11 Years

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Critical severity

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Critical severity

Has Symptoms

Nausea
Nausea.

Milly my 18month old Shih Tzu was not thriving and became so ill she was put on a drip. The Vet then decided to xray her and discovered a large liver shunt. I was told she would not be able to survive but to enjoy her while I still had her. No way! I started making phone calls and checking online and found that an experienced surgeon had just arrived in Australia and was at the Sydney Uni Vet Hospital. We immediately arranged for her to visit him and after tests he operated. Unfortunately he was unable to completely close the shunt which meant a lifetime diet of low protein food and lactulose. Milly is now 11 and apart from her vision getting poorly and a bit of arthritis she is very happy and I am hoping she will go on for a few more years. Her lovely Surgeon was only here for a short time before leaving the Country so we were so very fortunate that he arrived just at the right time.

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Tink

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Yorkshire Terrier

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8 Years

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Serious severity

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0 found helpful

pill-rating-filledpill-rating-filledpill-rating-filledpill-rating-filledpill-rating-filled

Serious severity

Has Symptoms

Liver Shunt

I have an 8 year old Yorkie, weighing 3 and a half pounds. She first had a bad turn about 4years ago. One morning we couldn’t find her and she had somehow wedged herself behind our cooker. She was on deaths door and my husband rushed her to the vets. She had various tests and they told us she had a liver shunt. We didn’t think she would survive the surgery so they put her on permanent medication and a heptactic diet. She had another bad turn about two years ago and they called us in to say our last goodbyes as they said she wouldn’t make it. As me and our family went into the room she jumped up to meet us, they vets couldn’t believe it. We call her our miracle dog that should of been a cat as she has nine life’s. She has good days and bad days we always no if she has a built up and she starts pacing and her back leg will go funny. If anyone has any more advice on this condition and if there is anything else I can help her with would love to here about it. I worry about her everyday. I also give her milk thistle to help her liver.

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Murphy

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Jack Russell

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4 Years

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Moderate severity

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0 found helpful

pill-rating-filledpill-rating-filledpill-rating-filledpill-rating-filledpill-rating-filled

Moderate severity

Has Symptoms

Bile Vomit
Throwing Up Bile At Night

We have a 4 year old rescue Jack Russell Terrier that we rescued from the JRT rescue group. We have had him 15 months. After the neurologist, internist, nuclear imaging, regular vet, and multiple tests it was determined he has a congenital liver shunt that is measured at 45%. He has a nutritionist that developed a diet for him with very low protein. We also had him tested at Nutriscan for food allergies. We cook all organic and he is on vitamins and minerals. He is on lactulose 1Ml X 2 times a day. As a side note the nuclear imaging identified an extra disc in his back so he also has a chiropractor once a month. He has had two liver bile tests. The last one had high results before and after the test. He has thrown up bile in the middle of the night three times this month. We are at a loss. Thank you for your response.

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