1295. Porto-systemic shunt in a young dog?

Feb 18, 2013

I note that many young vets who have grown up in an era of abundance don't have much spare time for more detailed research as they have their own hobbies and friends who want to go on vacations and spend late nights networking.  The start up of their new clinics are paid for by benefactors and not from their sweat and tears.

However, research needs to be done if they want to excel in their profession and gain a solid reputation for being good at diagnosis and treatment. There is no short cut to veerinary excellence and the necessary sacrifices of hours must be spent in doing reading and reviewing challenging cases.

One example of a challenging cases I encountered was this very thin Maltese puppy who barked a lot, mostly at night and liked to lick objects and things. "He barks mostly at night because we don't permit him to enter our bedroom," the young lady side of a couple said to me.  "My dad has to work overnight shifts and gets disturbed."

"Why don't you cage him at night and put him in the kitchen?" I said.
"He still barks."
So there was no solution.

"He has another problem. He will like all foreign objects and things and would vomit hairs! Can we muzzle him the whole day long?"

"Dogs need to breathe through panting and muzzling for a long time may kill them," I said. So there was no solution.

"He also urine marks all over the apartment," the lady said.
"Neuter him early," I said. "It will reduce his dominant personality. You will note that he is a dominant male and has no respect for female family members."

"You are quite correct," the young man confirmed. "He only listens to me if I am around."

"This dog is very thin, as if he has not been fed much," I said. "Or is there something wrong with his health? I advise a health screening blood test to check the liver and kidney functions as well as the blood system."

A blood test was agreed. The results show liver disorders in that ALT/SGPT = 294 (normal <59 0.02="" 262="" 6.8="" acid="" and="" ast="" at="" high="" nbsp="" normal="" slightly="" urea="" uric="" was="">and creatinine was low at 82 (normal 89-177).
 Haemoglobin was high at 19.6 (normal = 12-18).

The main disorder was the high liver enzymes. Uric acid is normal. Serum urea is slightly high.   Is there an early onset of a  porto-systemic shunt or not? Congential liver disease? Liver damage due to licking of floors and objects getting poisoned?

I phoned the owner for a urine test to check for urate crystalluria. Due to economics, I did not ask earlier.  Will need to follow up on this case.