High ALT Liver Enzyme Count Shih Tzu

[D'tails]

If anyone has insight on this could you please let me know?

My in-laws purchased a Shih about a year ago. When I groomed her for the first time I noticed her lower ribcage felt like it had some deformity. The ribcage feels as though it is missing a few bones, is shortened, and the bones do not extend down and around underneath her chest like they should. The vet mentioned something about incomplete closure and I have no idea how/if this could affect the liver. Liver shunt crossed my mind but I have no experience with this.

They have been having issues with very elevated liver enzymes and have been changing her diet, giving her meds and worrying themselves to death. They have been obsessing over her diet, cooking for her and trying different diets to help bring down the liver levels. This dog is like their child.

The dog was purchased form a BYB after I tried to lead them to a reputable breeder. I even told them I personally knew a reputable breeder of chocolate Shihs, and there was another show breeder near them with quality dogs that their good friend bought a very nice dog from. They were convinced that this was a good breeder because "she selected the parents for their chocolate noses." It was clearly a case of impulsive buying and immediate gratification since they found the dog in an online classified and went right away to purchase it. In the meantime, they have spent thousands on this young dog and refuse to notify the breeder because they feel bad. Aaaaarg. THIS is why so many of us feel like we are banging our heads against a wall when we try to educate people!

I do not understand why the vets cannot find out what is causing the elevated enzymes and would appreciate any experience of info anyone could give me here to help them. Years ago I remember hearing something about a congenital liver issue in this breed, but i could not find anything through Google.

I am trying to get them to switch to a natural diet and see a holistic vet, we shall see...

[Helly]

An Holistic vet (who probably isn't really Holistic) and diet changes are not going to do a thing for this dog if the problem is a liver shunt. And I think that's a pretty good starting point.

Liver shunts cannot be diagnosed by blood tests, although the elevated ALT certainly makes one think about it. How are the other blood values? BUN, AST, in particular? Is the dog showing any symptoms that might also be attributed to liver shunt?

She's kinda young for some of the other liver problems one might suspect, but that doesn't mean she couldn't have one. A full work up, including advanced imaging, would really be needed to rule out liver shunt or some of the other genetic liver disorders.

[D'tails]

Thanks for the response, Helly. I will pass on those questions and recommendations to them. I am unsure of all of the details other than the fact that her liver reading keep skyrocketing then dropping down.

[AmyChristine]

This just happens to be my first post here but I have had alot of experience with liver problems in one of my Yorkies. The test that they have had done can be indicative of a shunt but liver enzymes can be elevated for other reasons to. The further testing should go as follows.. They need to have a "serum bile acid" test done first, this will require the dog to be fasted, tested and then fed and tested again. If the results come back higher than normal then the next step would be to have a "protein C" test this test is less invasive and less expensive than alot of other tests and is a good way to differentiate between livershunt and other liver problems like hepatic microvasular displasia if this test is indicative of a livershunt then I personally would have a scintigraphy done this is an imaging test and much more efficiant than an ultrasound. They could also choose the ultrasound or biopsy to confirm a shunt. If a shunt is confirmed it is usually operable, the university of TN is one of the best places to go for this and there prices are good enough that it would be worth the traveling. If they choose to go with a different surgeon it is still better to go to a specialist or university. There are alot of dogs that have this surgery and live completely normal lives afterward.

If it is not livershunt but microvascular displasia then the dog would be treated with special diet(low purines, lower protien) and supplements, some require lactulose. These dogs can also live a fairly normal life once you get all the diet and sups figured out. I could go on and on.... anyway I hope that this helps them i know that I am seeing it a bit late

[SwissNChow]

Liver shunts are unfortunately fairly common in Shih Tzus, and indeed can be and often is genetic. Contacting the breeder isn't about feeling bad, it's about what is in the best interest for their puppy. That breeder may have a very important piece to this veterinary puzzle. They don't have to make the breeder feel bad, in fact, they really want to be sure the breeder knows they don't blame them, or expect anything from them, they just want information. But, it sure would be good information if it turned out there were other puppies in the litter with a problem, or mom or dad has developed a problem, or what if a puppy from a previous litter had a problem, etc. If they call, and find out two other littermates have been diagnosed, it could save quite a bit of money in diagnostics.

My experience is that most BYB don't mean to do bad things, they just don't know better and are not really educated in the aspects of breeding. Learning about this puppy's problem may not change a thing in their breeding plans, but then again, it may spark them to talk to their vet who will most likely counsel them to spay their girl and get a different dog to breed with. If the puppy's owner doesn't call the breeder, then they are keeping valuable knowledge from the breeder, who may very well breed that same male and female together to create more puppies with the same problem. Would they seriously wish that on another poor puppy?

Maybe the breeder won't care, but you never know until you call. When I worked for a vet and we dealt with a Shih Tzu BYB that produced liver shunts, she actually spayed and neutered all of the dogs in that direct line and started over!

[lefty]

I've read that Milk thistle can help with some live problems, as well as altering diet. As far as letting the breeder know, I absolutely would.

[SwissNChow]

Ultimately you have to know what is going on before you start "trying" things. One of my breeder friends almost killed her bitch when she put her on milk thistle. Just because it is a natural product doesn't mean it's safe.

[AmyChristine]

I agree that you should most definately let the breeder know... They are still working on identifing the gene/genes that cause LS... But because of the high occurance in some breeds it is believed to be genetic. It is important to know that it is infact LS/MVD before you start supplementing with things like milkthistle but there is nothing wrong with starting a lower protein diet if you suspect liver disease. Lowering the protein can cut back on symptoms or even save the dogs life, by preventing the build up of too many toxins.

[flyingfur]

Here is a link to a very informative website....

http://pet-information.peteducation.com/search?w=liver

[D'tails]

Thx all for the additional info; I will pass it on.

[4thedog]

My dog sweetPea's liver enzymes were elevated slightly at one vet visit. in between that visit and when i had to take her next she was licking her lips, drinking a lot more water, was throwing up after she ate and had begun to throw up bile. i took her to a different vet who took bloodtests and her liver enzymes were REALLY elevated. she gave sweetPea meds which treated for hepatitis and sweetPea's liver enzymes went way back down.

as everyone has said, i would take the dog to the vet and request a full work up bloodtest (or whatever it is called) to begin with. my dog was relieved of her symptoms almost immediately. and i wouldnt hesitate to call the breeder to inform them. if they continue to breed they need to know about potential problems for future litters.