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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 back 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 and is mostly seen in small breeds, while an intrahepatic one is found within the liver and is typically found in large breeds.
A liver shunt is known medically as a portosystemic shunt, hepatic shunt, or PSS.
Symptoms of Liver Shunts in Dogs
Growing dogs with liver shunts may exhibit stunted growth. Dogs may also show signs of gastrointestinal distress, urinary issues, and unusual behaviors. Clinical symptoms of a liver shunt can include:
- Loss of appetite
- Vomiting
- Diarrhea
- Constipation
- Stumbling
- Circling or pacing
- Head Pressing
- Changes in behavior
- Staring excessively
- Anorexia
- Disorientation
- Lethargy
- Frequent urination
- Straining while urinating
- Blood in the urine
- Weight loss
- Stunted growth
- Seizures
- Blindness
Types
There are two types of liver shunts.
- Extrahepatic shunt outside of the liver
- Intrahepatic shunt inside the liver
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Causes of Liver Shunts in Dogs
A liver shunt can either be present at birth, or develop as a result of another medical condition of the liver. Causes include:
- Congenital shunt caused by a genetic predisposition before birth
- Acquired shunt caused by a complication due to progressive liver failure, or other liver problem
A congenital shunt is most common in certain predisposed breeds, including:
- Yorkshire Terrier
- Cairn Terrier
- Miniature Schnauzer
- Golden Retriever
- Labrador Retriever
- Australian Cattle Dog
- Irish Wolfhound
- Maltese
- Old English Sheepdog
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Diagnosis of Liver Shunts in Dogs
Your veterinarian will conduct a physical examination, and will need your dog's medical history. Be sure to relate any symptoms your dog has been experiencing, along with any behavioral changes. Your veterinarian may also ask about your dog's eating habits, or if they may have come into contact with new animals or places in order to narrow down the possible problem.
If your veterinarian suspects a liver shunt is occurring, they will conduct several tests, including blood tests, a urinalysis, and liver function tests that measure bile acids. These may be followed by imaging tests, such as an ultrasound, X-rays, CT scan, or nuclear scintigraphy. A portography test uses a special dye to help detect an issue with the liver and surrounding blood vessels. In many cases, a suspected case of a liver shunt is confirmed during surgery.
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Treatment of Liver Shunts in Dogs
Once your veterinarian has determined that your dog has a liver stunt, treatment can begin. For some dogs, a surgical procedure called a portosystemic shunt ligation can help by totally or partially cutting off the shunt to encourage blood flow back into the liver for detoxification. This procedure does require your dog take anesthesia.
Due to the risk of anesthesia to dogs with a liver shunt, health stability is essential before surgery can begin. To balance the levels of electrolytes and restore your dog’s hydration, IV fluid therapy may be administered. Levels of ammonia should 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, your veterinarian also may order gastric protection medication.
Not all dogs will require surgery, or can safely undergo the procedure, and may be treated with a diet change and medication.
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Recovery of Liver Shunts in Dogs
Surgery to repair a liver shunt is generally successful, with 85% of dogs experiencing complete recovery. Another 10% may have recurrent symptoms and may need more care. A small percentage of dogs can experience severe symptoms after surgery that can lead to death.
Once your dog has been released, keep an eye on any complications that may occur, such as abdominal swelling. You may need to clean and redress the incision site, and feed your dog a new or specialized diet. If the liver shunt was caused by a liver condition, your veterinarian will direct you on how to treat and manage the original condition.
Your dog will need regular
liver evaluation and check-ups throughout the rest of their life to ensure
they stay healthy. Dietary therapy as prescribed by your veterinarian is often
prescribed, as well as continued lactulose administration.
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Cost of Liver Shunts in Dogs
Depending on your dog's condition, a portosystemic shunt ligation can range from $2,000 to $12,000. This should include surgery, medications, and hospitalization, with specialized diets and follow-up appointments adding to the cost.
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Liver Shunts Questions and Advice from Veterinary Professionals
Need pet health advice? Ask a vet
Ask a Vet
Yorkshire Terrier
3 months
Unknown severity
0 found helpful
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
Dr. Michele K. DVM
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
Shitzu
4 Months
Serious severity
0 found helpful
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
Was this experience helpful?
Luna
Siberian Husky
2 Years
Serious severity
3 found helpful
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
3 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
Husky
18 Months
Mild severity
3 found helpful
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
3 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
mix large breed
10 Weeks
Mild severity
5 found helpful
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
Dr. Michele K. DVM
5 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
Yorkie
11 Months
Moderate severity
0 found helpful
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
Cassie
Border Terrier
12 Years
Mild severity
0 found helpful
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, however she has always drank and urinated a lot due to the liver shunt. The vet is now suggesting that we pay for further tests to see is she has cushings, even if we cannot treat it. Does anyone have any experience of treating cushing disearse in a dog with a liver shunt or if it would be best to leave her medication as it is?
Milly
Shih Tzu
11 Years
Critical severity
0 found helpful
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.
Tink
Yorkshire Terrier
8 Years
Serious severity
0 found helpful
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.
Murphy
Jack Russell
4 Years
Moderate severity
0 found helpful
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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