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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:

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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

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                Luna

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                Pomeranian

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                8 Months

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                Mild severity

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                0 found helpful

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

                Mild severity

                Has Symptoms

                None

                Luna had the operation to correct her shunt at 5 months old, they couldn’t tie the whole vessel off as she couldn’t cope with the flow so they tied 75% of it hoping to do the rest at the end of this month. However Luna is showing huge improvement, no clinical symptoms, she’s eating well and growing steadily. Is it possible the last bit left could close itself? I’d rather not put her through a 2nd operation if it’s not needed

                June 11, 2018

                Luna's Owner

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                At this point I wouldn’t think the shunt closed itself and the overall improvement may just be from the first surgery coupled with medical and dietary management; there is an easy solution where an ultrasound may be made to look at blood flow to determine if the shunt is open if you have concerns or questions that is the deciding factor. Regards Dr Callum Turner DVM

                June 12, 2018

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                Princess

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                American Eskimo

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                3 Months

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

                Fair severity

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                0 found helpful

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

                Fair severity

                Has Symptoms

                Frequent Urination

                Hi there. We recently purchased an American Eskimo puppy from a breeder with the intent to breed the puppy in the future. One month later the breeder informed us that two of the three pups in the litter had developed a liver shunt, had seizures and were put down as a result. We are having our pup tested for liver shunt. She has frequent urination but no other symptoms. My question is if we were to get genetic testing done on the pup would it show any genetic predisposition to having a liver shunt or passing on the gene to any future pups if we were to breed her? Thank you so much!

                May 28, 2018

                Princess' Owner

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                Dr. Michele K. DVM

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                There is no genetic test that i am aware of for a liver shunt. Princess can be tested for her liver function, and it may not be a good idea to breed her if many of her litter mates had a problem, but she may be perfectly fine. Your veterinarian can examine her and let you know if she is showing any signs of disease.

                May 28, 2018

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                Piper

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                Yorkshire Terrier

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                4 Months

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                Serious severity

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

                Serious severity

                Has Symptoms

                Loss Of Appetite

                I have a 4 month old yorkshire terrier puppy who was just diagnosed using ultrasound with a single vessel extrahepatic liver shunt. She is currently 2.3 lbs and has been on the liver diet for 2 weeks along with lactulose and kepra. She presented with a seizure which is how we found the problem and thus the kepra. We are planning on doing the banding but the surgeon would like her to be a bit bigger. Weight gain is slow and was wondering what the best age/size is typically for this surgery and other items we can safely use to help with weight gain.

                May 2, 2018

                Piper's Owner

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                Dr. Michele K. DVM

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                Without knowing the specifics of her surgery, I have a hard time commenting on your question, unfortunately. Those are excellent questions for the surgeon who will be performing the procedure, as they are specialists. I hope that everything goes well for Piper.

                May 2, 2018

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                Benny

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                Poodle

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                8 Months

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                Mild severity

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                Mild severity

                Has Symptoms

                None

                I have a 10 month old pup with a liver shunt. Is it possible it came from the stud, and Should I stop using the stud? He has fathered several other litters, with no other problems.

                April 30, 2018

                Benny's Owner


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                There is a debate especially with dog breeders on whether liver shunts are hereditary or not, there are congenital shunts (which may be hereditary especially in some breeds) and acquired shunts; to determine if there is an hereditary link you would need to look into both parents to look for other signs of shunts. There is an interesting article on the subject linked below. Regards Dr Callum Turner DVM www.ncbi.nlm.nih.gov/pmc/articles/PMC3275728/

                May 1, 2018

                I have a little pup and I can’t afford surgery because I’m on benefits and both my twins love there dog any help we’re I could get help and funding for this please cheers

                Sept. 7, 2018

                Jade W.

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                Stella

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                lab great pyrenees mix

                dog-age-icon

                3 Years

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

                Fair severity

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

                Fair severity

                Has Symptoms

                Weight Loss
                Vomiting
                Lack Of Appetite

                We are not sure what to do next after these reports...we were told the next steps would be a CT scan and a biopsy that could cost up to $4500. She is now not really eating anything and throwing up when she does eat. All of the information is overwhelming and the options are all expensive so we want to make the best decision possible. This is the report from the vet so far: "young dog, anorexia, weight loss low BUN, low Potassium, low Albumin, elevated ALT, AST, & ALKP and bilirubin, low cholesterol, urine SG is 1.004, Bile Acids 262 & 252 pre&post." After this, we had an ultrasound done with these reports: "The liver was small, hyperechoic and irregularly marginated. The gallbladder was within normal limits. The abdominal fat was diffusely hyperechoic, more severely so in the cranial abdomen. A small volume of anechoic abdominal effusion was detected. Insufficient portal vasculature was visible to reliably assess for portosystemic shunting. The adrenal glands were slightly small. The spleen, kidneys, urinary bladder, GI tract, pancreas and abdominal lymph nodes were within normal limits. Conclusions: Evaluation for portal vascular anomalies was not possible due to the patient's body conformation, the hyperechoic abdominal fat graft interposed GI gas. Intrahepatic and extrahepatic portosystemic shunting remain possible. CT would be necessary to further evaluate. A small liver would be compatible with a shunt, although the hyperechoic parenchyma and irregular contours are not characteristic of a simple portosystemic shunt, and chronic acquired liver parenchymal disease should also be ruled out. Histopathology is recommended to further evaluate this possibility. Unfortunately, due to the small size of the liver and the patient's body conformation, ultrasound guided sampling would not be possible. The hyperechoic abdominal fat and abdominal effusion may be due to the reported hypoalbuminemia, portal hypertension or combination of processes. The slightly small adrenal glands may be a normal variant in this young patient, although Addison's disease is also possible. Adrenal function testing may prove useful in further evaluating this possibility."

                March 14, 2018

                Stella's Owner

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                Normally a liver shunt can be visualised with an ultrasound, however it seems like the Veterinarian performing the ultrasound was unable to confirm whether there was any portal shunting due to poor visibility which is why they are recommending a CT scan to get better definition of the area so that a diagnosis can be made; additionally the small liver made ultrasound guided biopsy no possible due to position. I would look at testing adrenal function first as this would be the less expensive of the tests to try first before moving on to more expensive tests like CT scans. If cost is an issue, you could try reaching out to an animal charity which may be able to help with some of the cost of an expensive test; check the link below. Regards Dr Callum Turner DVM www.dogingtonpost.com/need-help-with-vet-bills-or-pet-food-there-are-resources-available/

                March 14, 2018

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                Nala

                dog-breed-icon

                Doberman Pinscher

                dog-age-icon

                7 Months

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

                Moderate severity

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

                Moderate severity

                Has Symptoms

                Diarrhea

                My dog is 7/8 months old. I have been trying to get her spayed for the past month or so. When I took her for her pre-op blood work, her liver enzymes came back high. We waited and did some natural liver detoxing and tried again. Some of the levels fell, but are still too high for her spay. The vet recommended having an ultrasound done because they believe she may have a Liver Shunt. The more I am reading about liver shunts, the harder it is for me to believe she falls in this category. She is a very high energy Doberman mix that loves to play, she has been gaining weight (last weigh in 53/54 lbs), eating is normal/regular. The only symptom she occasionally has and hasn't had in a while is loose stool/diarrhea .... however, this has not happened in a while. Additionally, I have contacted the foster family and none of the other puppies in the litter have had any issues in bloodwork, with their spay/neuter, or with their liver. I would appreciate any direction/information/guidance as I am feeling very overwhelemd and unsure of what to do.

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