My puppy had seizures, labs are normal. Could it be a liver shunt?

Thanks for the picture! Unfortunately the way they have it printed out, it doesn't include what is normal for their lab machine, so I still can't fully interpret the results. From the lab that I use, the liver values that you have gotten would be considered normal, or very close to the normal range. Did the vet that ran the bloodwork give you any indication that they were abnormal? Seizures in a young dog could be caused by many things, including portosystemic or liver shunt (which may need ultrasound or bile acids testing to diagnose), epilepsy, hypoglycemia, kidney disease, intracranial disease, infection, among several others. I would recommend that you discuss these possibilities with your vet and see what other testing can be done to look at these other systems.

Congratulations on your new baby! He is adorable! The most common tests we start with to evaluate for liver shunts are baseline labwork (which includes a full chemistry, complete blood count and urinalysis) as well as a pre and post prandial bile acid profile. The bile acid profile is to specifically look at the liver function. Any of those tests results are available within a couple of days. Unfortunately, sometimes those test results are inconclusive, and we have to do additional testing. I have included a link below with more information about liver shunts. https://www.veterinarypartner.com/Content.plx?P=A&S=0&C=0&A=2533 Good luck! I hope that was helpful! Thanks for using PetCoach.

There is really very little sense in speculating. Even a positive bile acid test will not definitively diagnose a portosystemic shunt. Only advanced imaging techniques can capture this condition. Alkaline phosphatase is an enzyme that is sometime utilized to support diagnoses of the liver and bile duct system. However, alone the number doesn't tell us much particularly in a young and from what it sounds like otherwise healthy puppy. The elevation you mentioned is also very mild, and we frequently see elevations in this enzyme in young growing animals. Just as it is found in the liver, it is also found in the bones which is why it is elevated during the time that pups are getting larger. I obviously don't know the whole situation and there is always the possibility your dog could have a shunt. However, so far you have given me no reason to suspect a serious problem. Please feel from to obtain a consult if you want to discuss the case in any greater detail.

I'm sorry to hear that! It really depends on the severity of the shunt and what kinds of symptoms she's showing, so this would be a good question to discuss with your veterinarian - but in general, surgery is strongly recommended for dogs with liver shunts who are having neurologic symptoms. Medication and diet are usually not sufficient to control their symptoms without surgery.

They could have it or not. Liver shunt can have a congenital origin. I would strongly recommend to check all of them at your local vets. Abdominal ultrasound and specific blood tests are very sensitive way to diagnose this disease.

Hello, sorry to hear about Jericho. Baseline bloodwork may run anywhere from $120 to 180 dollars. Urinalysis will run anywhere from $45 to 100 dollars. Bile Acids will likely run from $120-180 dollars as well. Most of the places vary depending on which lab they use to send out the blood to and what hey get charged from sending that blood to them. Other diagnostics to consider when working up a liver shunt include an abdominal ultrasound ($250-400) and a CT Scan ($700-1000) . You'll also have to consider medications and special diets for pets with liver shunts. If he is not having any symptoms, you may choose to continue monitoring at home until he gets a little older and bigger so that they can safely obtain all of the blood they may need for this testing. The laboratories will need at minimum 3-5mls of blood to run these tests and 3-5mls of urine. Hope this helps and best of luck.

I assume when you say liver enzymes you mean ALT? There a few enzymes we look at and elevation in 1 value makes us consider different causes then elevation in another. ALT elevation is caused make liver cell injury and leakage of enzymes in to the bloodstream. As the liver sees all the blood of the body it can be quite a reactive organ. So the question is whether the liver enzyme is up because of something wrong with the liver/vessels to liver themselves (such as an infectious or inflammatory cause (hepatitis) or a shunt (more common in younger dogs)) or something the liver is responding too (toxicity, disease of over organs). Unfortunately all parts of sago palm are toxic to dogs with the seeds (nuts) being most toxic. And it can be quite challenging to know if this is the cause. If it is sago it depends on the degree of ingestion as to how severe the case is. Unfortunately the treatment for this is supportive as you have been doing. The values may continue to increase or hopefully may plateau off and remain mildly elevated or decrease again. Ultrasound will help to rule out other things going on in the abdomen, assess the liver for changes in texture (although a liver can appear normal on an ultrasound and not be functionally normal), and sometimes identify a portosystemic shunt. After the ultrasound then sampling either first by fine needle aspirate or with a biopsy (needed for many cases of hepatitis, some other issues) can be performed. Checking platelets and clotting times should be performed prior to liver sampling in patients whose livers are not normal to decrease the risk of bleeding from sampling. As shunts are more common in younger animals , if this is suspected, additional imaging may be recommended prior to sampling as ultrasound will not identify all shunts. There is also a disorder called microvascular dysplasia that can be found in the liver. This is best diagnosed by liver biopsy and the sample sent to a pathologist who specializes in liver pathology. I hope this has helped and not confused you more. It sounds like your vet has taken the appropriate steps thus far and has recommended the next best steps to try to rule out some other causes. Thank you for using Petco Pet Education Center, formerly Petcoach!