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Liver shunt

Pomeranian Liver Shunts

Question: Hello again, I previously wrote an email regarding her feeding situation causing her to be very weak and lethargic. Come to find out my Pomeranian has a liver shunt, I was curious if any member is familiar with this procedure and if they have any insight from their experience. As expected we are very worried about her. 

We do have a high coverage of insurance for her- but weren't sure how it'll be covered for this situation, so if any one has experience with that as well, any information will be helpful. I'm also curious if that was normal for her only symptom to be acting a bit weak and not wanting to eat as much. And if there is more than one kind of shunt problem. Thanks for your continued support. Owner Nadia, Pom Boots
Answer: Hi Nadia and Boots. We are so very sorry to hear that Boots has a liver shunt. This not among the health issues that the Pomeranian breed is prone to; however it can happen to any breed.

Each case we have run into was different. When a dog has a liver shunt, there is an issue with the flow of blood between the liver and the body. Because the liver takes toxins out of a dog's body, when this is interrupted it creates a huge build up of toxins; and can be fatal if surgery is not performed. 

We have know of 3 Pomeranians that had liver shunts; two puppies and older, adult Pom. A dog of any age can develop this but it is usually diagnosed between the ages of 1 and 2 years old.
Of the 3 Poms that we have had liver shunt experience with: One, sadly, did not make it. One is doing wonderful and the 3rd is a trooper...hanging on with long-term effects that she will have for the remainder of her life, but doing well. 

In regard to symptoms, the signs of a liver shunt varies widely from dog to dog. There is a surprisingly large list of possible signs and most dogs will only show one or two...and these may come and go at random times. This includes:
  • Weakness
  • Lack of coordination
  • Acting confused
  • Barking or whining excessively 
  • Excessive drooling
  • Pressing the head into surfaces such as bedding or the flooring
  • Pacing in circles
  • Becoming easily over-excited
  • Vomiting
  • Dry heaving
  • Stool changes (diarrhea or constipation)
  • Decreased appetite
  • Excessive appetite
  • Coprophagia (eating feces)
  • Traces of blood in the urine
  • Frequent urination
  • Increased thirst
  • Poor coat quality
  • Itchy skin
As you can see, the symptoms of a liver shunt mimic countless other health conditions and one or two of these signs often is not enough for most owners to red flag things and have their Pom checked out. This is one reason why regular checkups are a vital part of proper caring for a Pomeranian. It's a good thing that your vet was on top of things and made the diagnosis. 

More serious symptoms that often show once it has progressed include:
  • Kidney stones
  • Delayed growth (seen in puppies)
  • Seizures
  • Coma
If this is not treated, it can be fatal
In regard to the pet insurance that you have; there are so many different types of plans, it is recommended to call your agent to find out what your deductibles will be. The surgery that will be involved to help Boots will be expensive. The sooner you find out what you are covered for, the better. 

Regarding the liver shunt with your Pomeranian; there are 2 types. In layman terms, one type is when the needed vein for proper blood flow is inside the liver. The other is when the vein is not attached at all. 

We are assuming that your Pomeranian was given a complete testing: a blood count, serum chemistry screen and urinalysis. 
The blood tests should be done after your dog does not eat for 12 hours and a 2nd test done after your dog eats a very high protein meal. This should be followed by radiographs and ultra sound testing.

For any owners who are concerned about a possible liver shunt, if these particular tests have not been performed, please do get a 2nd opinion. If it is indeed a liver shunt, the surgeries will be quite different depending on which type of liver shunt your Pomeranian has. If it is an unattached vein, this is a much simpler operation and success is high.  

When a vein is not attached at all, most often a dog must have 2 surgeries; 1 to find a suitable vein and the 2nd to connect it. This type has limited success; quite a bit will depend on the follow up care including a heavy round of antibiotics. 

Sadly, the majority of dogs that have this type of surgery will show life long effects long after they have healed. Most common will be a lack of energy. In either case, a dog should be on a very strict no or very low protein diet indefinitely. 

Please keep us informed on how Boots is doing and our hearts and prayers go out to both of you.
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