What is a Portosystemic Shunt?
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 
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. 
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.
   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.
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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