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Lifeline for Yoda

posted Sep 25, 2009 1:13 PM by drea peters   [ updated Oct 15, 2009 9:43 AM by Lori Swett ]
Background Story - July 2009

Yoda is a sweet 6 mos old pug puppy that came into Curly Care from a local shelter about 1 month ago.  For Yoda to be in a shelter at that age, we strongly suspected some sort of illness.  We weren't sure what it could be but we were definitely going to find out.

Yoda had a wobbly gait and would lose his balance occasionally...we suspected neurological damage.  We conducted a battery of tests and found out that there is nothing wrong with him neurologically BUT he has a liver shunt.

Update 10-14-09 - One week Post Op

Yoda is doing great, almost one week post surgery.  He is running around pretty good and there is no appearance of any pain and he does not have any issues with his incision.  Yoda is feeling pretty strong and he appears  to his foster mom and dad that he is feeling better that he did before the surgery - he doesn't stumble nearly as much!  We have started to wean him off the liver medications one week after surgery and we are continuing to check his bloodwork.





Update 10-6-09 - Liver Shunt Surgery Complete....now we wait and see

Yoda had his liver shunt surgery today and did great!  He is home now and resting comfortably while his foster siblings (amazingly) quietly watch him and let him rest.  He will have a couple of days of touch-and-go while foster parents watch him like hawks for any signs of shock or seizure.

Once he's out of the woods & with our vet's guidance, we'll start weaning him off the oral meds.  His eyes are also doing amazingly well on the topical regimen he's on.....so far we haven't needed any surgical intervention to this point. 

Thank you everyone for your thoughts and prayers for this little guy!! Jen & John (foster parents) and the Gang at Curly Tail






Update 9-25-09 - Yoda's Eyes

The new medical issue: Little Yoda is have a difficult time at the moment.  Due to his condition, the toxins in his system and failing "internal filter" has caused both of his eyes to ulcerate.  We are aggressively treating both eyes with around the clock medication with a scheduled re-evaluation this Saturday.  We brought him to the specialists at VESCONE earlier this week to determine an initial POA and discuss surgical options. 

The sad news: This is a particularly dangerous situation b/c he simply does not have the option for multiple surgeries (as we did with a case like Butter's for example).  One of his eyes is dangerously close to rupture and the other eye may need a graft.  He physically cannot have a surgery once the shunt surgery is performed.  His body will not be able to withstand and process another time under anesthesia. 

The immediate POA: We postponed the shunt surgery for 5 days to monitor the progress in his eye treatment so that we can make the most educated decision on his treatment plan when we have the shunt surgery performed.  If we need to enucleate an eye and / or do a graft, it all needs to happen during his liver shunt surgery.  This means that we will need TWO specialist surgeons to work on him simultaneously.  One surgeon will deal with the eye removal and/or graft while the other is performing the shunt portion. 


Update 8-14-09:  Things are looking much better for Yoda!  We found out that his shunt is external and operable.  That is a HUGE relief b/c we didn't know if we even had the option to try and save this sweet little puppy.  We will be doing all that we can to save Yoda b/c he can have a full & happy life if this surgery is successful.

We have discussed the options with both of our NYC and Massachusetts medical teams, Dr. Solomon at Center for Veterinary Care  & Dr. Meade at Burlington Veterinary Hospital.  The recommended course of action is explained in simple terms below.  We have had the surgery quoted in both NYC and Boston (Curly Tail's Headquarters) and the average costs for this procedure is between $4000 and $4600. 


Excerpt taken from: Portosystemic Shunts
Liver Shunt Research Study
Karen M. Tobias, DVM, MS, Diplomate American College of Veterinary Surgeons
Professor, Small Animal Surgery, University of Tennessee Department of Small Animal Clinical Sciences

Small and toy breed dogs usually have "extra hepatic" shunts: the blood vessel is located outside of the liver. These shunts are easier to find and treat and therefore the outcome of surgery is better. 

Most dogs are taken to surgery to have the shunt closed. Because the liver has not developed properly, many dogs cannot tolerate rapid closure of the shunt. Many veterinarians are now placing ameroid constrictors around the shunts to gradually occlude them. These constrictor rings will slowly close down over 4-5 weeks, allowing the liver to get used to its new blood supply. Survival rates after ameroid constrictor placement are about 95%. Most dogs are completely normal within 3 months.


From Yoda's Foster mom 8-14-09:
Hi everyone. 
 Little yoda is still doing well with us.  No change in his behaviors (on his new meds & diet) and he is getting a lot of love and playtime with the older dogs.  He loves to nibble on Molly (my female BT) like he is trying to nurse from her.  She tolerates it to a point which is so cute to see and then she lets him know that she's had enough.  They have an interesting relationship.  He has a great appetite and takes his meds just fine.  He sleeps great and is a total adorable puppy.
: )
Jen, Curly Foster Mom

Update 8-12-09:  Today we are taking Yoda in for an ultrasound to see what level of severity we are dealing with and whether or not surgery is an option.  We are hoping for little Yoda b/c without surgery, his liver is not functioning properly and it poisoning his own body.  He will not survive without this surgery...and yet we do not know if he even has that option. 
                                                                                                                                                                                                                                                             Thank you so much to the team at VESCONE - Veterinary Emergency & Specialty Center of New England  where little Yoda was seen for his ultrasound &
given extraordinary care.  The team absolutely fell in love with this baby and are doing all they can to help him!

To diagnose a liver shunt, we needed to rule out toxicity, hydrocephalus ("water on the brain"), and low blood sugar.  We then looked for abnormalities on blood work that indicate poor liver function, such as low protein, albumin, and blood urea nitrogen, which are chemicals produced by the liver.   We took X-rays of the abdomen to see the size of his liver, which indicated that it is has not developed properly.  We had to do a urine analysis.

We also ran special diagnostic tests.  Blood ammonia concentration needed to be measured; this test diagnoses liver disease in 90% of affected animals.  (Blood for ammonia concentration measurements must be kept chilled and must be analyzed within 30 minutes after it was drawn.)



To be even more accurate, we examine bile acid concentrations.  A blood sample is taken after a 12 hour fast.  (Bile acid concentrations are high in most types of liver disease, including shunts.)  These tests tell us that liver disease is present but do not verify the presence of a shunt. 

To be 100% sure that a shunt is present, we need to use ultrasound.


   
      
 Please visit our Curly Tail Pug Rescue Blog, Success Page or Rescue Story Page for final updates on our Rescues.

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