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What
is a Portosystemic Shunt?
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There
are several different types of shunts. One is the extrahepatic.
This
means the vessels bypass the liver. In YORKIES, the single
extrahepatic
shunt is most often seen. This involves a single large
vessel
which can be corrected. There can be more than one vessel
bypassing
the liver which increases the problems. This is a multiple
extrahepatic
shunt and is more difficult to correct. There is also an
intrahepatic
shunt seen more often in other breeds. This means the
vessels
are inside the liver but not allowing blood TO the liver. I
recently
learned that U.C. Davis is experimenting with a new surgical
technique
that has a greater success rate. There are new surgeries
for
single extrahepatic shunts too. The Armaroid Ring (which was
used
on my Pepper) is a small ring which looks very much like a washer
from
your garden hose. It is made of porous material which, over the
following
21 days or so, absorbs moisture from the body and swells.
In
effect, it constricts the flow of blood through the vessel gradually to
allow
the liver and body to adjust. This is a wonderful improvement
from
the old method of using suture material to abruptly stop the flow.
The
newer surgery has had a dramatic effect on lowering the mortality
rates.
.
With
advanced methods of detecting the Portal Systemic Shunts,
the
vet is able to see a
better "picture" of what he is dealing with, I.E.,
single
vs. multiple. Nuclear imaging called Transcolonic Portal
Scintigraphy
is the absolute "gold standard" of definitive diagnosis.
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I
thought you might be interested in reading a recent liver shunt story
and
what it can mean to a breeder. As a breeder, I was aware of
shunts
and made every effort to plan my breeding very carefully.
Despite
doing what I thought was a well planned and very safe
breeding,
one puppy was diagnosed with a shunt. While Pepper
never
exhibited any of the traditional symptoms (head pressing,
drooling,
confusion, seizures) at 5 months, I noticed blood in his
urine.
When treatment with antibiotics failed to work, an x-ray
reveled
a single stone. The bladder stone surgery was done and
the
stone sent to the University of Minn. for analysis. A preliminary
report
came back stating that this type of stone (uric acid or
ammonium
urate) often indicates a liver shunt. Two days later, I
had
him scanned (Transcolonic Portal Scintigraphy) by Dr. Michael
Broome
in Irvine and discovered that the stones were indeed an
indicator
of shunt ! He had a 76% calculated shunt. I was able to
secure
the funds for the surgery and travel to U.C. Davis. I also
had
the other 3 pups and a half sister scanned. Thankfully, all were
free
of shunt. I was lucky in that if he hadn't had the stone, I wouldn't
have
known about the shunt until his liver had been damaged. The
Amaroid
Ring has brought this surgery a long way in terms of safety.
Pepper's
rescan at 21 days post surgery showed complete success,
a
BEAUTIFUL full size liver with no shunt ! He requires no restrictions
on
diet or on activities.
.
Dr.
C. Gregory, Chief of Surgery at U.C. Davis, performed
the
surgery. He is one of the leading surgeons in the country.
I have
the
highest esteem for UC Davis. State of the art surgeries are
performed
everyday ! U.C. Davis is currently working on locating a DNA
marker
to aid us in identifying dogs who are carriers. As of now, we
are
unable to determine the mode of inheritance.
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Now,
in real life terms, what does this mean? I have considerably
less
in my bank account. Total cost of this one litter was
$3500.00.
It
was money well spent. I was responsible for bringing Pepper into
this
world and I was responsible for making his life worth living. I
have
had to start a large part of my breeding program over.
Thankfully
I have had the support of my friends and family.
However,
the biggest tragedy of all was an innocent puppy who had
to
endure two surgeries while he should have been playing and
learning
and loving life with his litter mates. Portosystemic shunts
bring
devastation to everyone concerned. Pepper's dam has been
spayed
and placed in a loving pet home. The other 3 pups have been
spayed/neutered
and placed.
.
.
While
we feel we have ended this problem in our breeding
program,
we scan all puppies whether they are staying
to try to
make
their mark in the show ring or found homes as cherished pets.
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As
guardians of our beloved breed, we have a moral
obligation
to be open and honest. Responsible breeders
must
put an end to this genetic problem. No longer can it
be
quietly swept under the rug and ignored. The conspiracy
of
silence must Stop !!!
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Thank You Kel-lee's Copyright ©
98/99/2000
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