Liver shunt. X2!

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Andyyyc
Posts: 3
Joined: 21 Mar 2019, 12:02
First Name: Andrea

Liver shunt. X2!

Post by Andyyyc » 09 Apr 2019, 16:52

Hi there,long time lurker, first time poster!

After a little advice if you're able, I've read the previous posts and they were very interesting.

So a month ago, purely by chance, I noticed that Pepper had blood in her wee. Off we go to the vet & home with a course of antibiotics and a wee-catcher with the thinking it was probably cystitis. Results back clear so booked in for an ultrasound. Results show a large stone in her bladder and plenty of sediment. She is completely fine in herself, no other issues at all so mildly surprised by this.
Vet suggests that as she is insured, why not have a blood test to make sure it's just this. She says, and I quote, 'theres a very tiny chance she could have a liver shunt but I highly doubt it, her liver looked pretty good on the ultrasound but theres no guarantee'.
So a bile acid test is done and comes back with elevated numbers, we're referred 2 hours away to a specialist who want £275 just for a consultation. She is absolutely priceless but so far I've had to pay out for everything and money is tight, so I self refer to a local hospital for a CT just to confirm if she has a shunt or not before we go to the specialists.
£1100 and yes, she has a shunt so off we go.
To cut a long story short, my vets cause delays and extra expenses but in the end we discover that Pepper does indeed have 2 congenital liver shunts, a large calculus in her bladder and a small liver. Quite unusual as Pepper is nearly 4 and shunts usually present much earlier.

So, those of you with any experience, I have yet to speak to the surgeon but can anyone share anything? Any ideas on how much cost we're looking at? She was only insured for £3000 and that's basically gone so I need to get saving! Has anyone attempted crowdfunding for their dog?

Fortunately she is doing well and providing the bladder stone doesn't suddenly cause an issue, we've been told to wait at least a month until surgery.
Look forward to hearing from you!

Oscar 12345
Member
Posts: 915
Joined: 02 May 2017, 11:28
First Name: Julie
Dog #1: Oscar RIP Sweety
is a: P/S Mini Dog
Born: 21 Dec 2002
Dog #2: Otto
is a: B/S Mini Dog
Born: 04 Jul 2017

Re: Liver shunt. X2!

Post by Oscar 12345 » 10 Apr 2019, 09:54

Hi Andrea, there seems to be a lot going on with little Pepper. I have absolutely no experience of these issues however just a few thoughts that are in my head after reading your post.

Is any surgery really essential? The effects and after effects, pain medication etc. is going to put a huge load on her liver.
Can the bladder stone be treated with ultrasonic dissolution rather than surgery or is it worth trying a diet designed for breaking the stone up or at least making it smaller (without putting extra strain on the liver)?
Do you need to treat the liver shunts, Pepper doesn't seem to have been effected by them so far. Will a special diet or supplement help with this to protect the liver? If you hadn't had the tests you would never have know this was a problem.

I feel for you with these decisions. It isn't easy but get all the specialist advice that you can and I really hope you all get through it ok. :ymhug: :ymhug:
Every snack you make
Every meal you bake
Every bite you take
He'll be watching you......

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zeta1454
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Posts: 3802
Joined: 19 May 2011, 16:58
First Name: Leigh
Dog #1: Magic
is a: P/S Mini Bitch
Born: 20 Apr 2010
Dog #2: Trilby
is a: P/S Mini Bitch
Born: 15 Mar 2012
Dog #3: Pip
Born: 21 Feb 2014
is a: P/S Mini Bitch
Location: North Yorkshire

Re: Liver shunt. X2!

Post by zeta1454 » 10 Apr 2019, 16:34

Hi Andrea - sorry to hear about poor little Pepper.

As Julie says above, Pepper has been through a lot of investigative work and (unless her condition worsens) could probably do with a break from any more for a while. There are other options than surgery for some bladder stones but your vet or a specialist should be able to advise if these are a better option. The liver shunts too would not seem to be an emergency if Pepper is fit and well in herself.

Sadly many vet practices, especially those which are owned by corporates rather than the vets themselves, do seem to operate a policy of trying to encourage clients who are insured to have multiple investigations, treatments or procedures carried out on dogs for what can seem the flimsiest of reasons rather than reserving these for really seriously ill dogs. We were told some years ago by a consultant that, if a client is insured, they will often go down a lengthy route to investigate issues when a single procedure may be all that is needed. The situation has worsened with corporate owned surgeries where the corporate owners also have their own (or contracts with) referral centres and S pecialists who may be neither local nor the least costly, and market their own brand pharmaceuticals for treatments.

I have no experience with either bladder stones or liver shunts in our dogs so cannot advise re costs or treatment options.

Crowdfunding is a method used by some people who are struggling financially to meet the costs of procedures or lifetime drugs for their sick dogs but I have only seen these on social media platforms such as Facebook where individuals (and their dog) may already be known to members of a group or a wide audience of "followers" or FB "friends". It is probably harder to get donations from total strangers who also may be wary of possible "scams".

I have heard people recommend taking out a separate credit card (possibly with a delayed repayment start?) to at least spread additional costs for treatment for their ill dogs, if funds are not available. We have not used pet insurance for our dogs for about 15 years now after being advised (by our vet) to put money aside in a savings account instead and it has paid dividends in our case, despite the occasional large vet bill.

I do hope that other Forum members may be able to advise re costs etc. and that Pepper does keep well for as long as possible.
Dogs are not our whole life, but they make our lives whole. ~Roger Caras

Magic - Silversocks Sharade at Darksprite
Trilby - Darksprite Rosa Bud

Andyyyc
Posts: 3
Joined: 21 Mar 2019, 12:02
First Name: Andrea

Re: Liver shunt. X2!

Post by Andyyyc » 12 Apr 2019, 19:49

Oscar 12345 wrote:
10 Apr 2019, 09:54
Hi Andrea, there seems to be a lot going on with little Pepper. I have absolutely no experience of these issues however just a few thoughts that are in my head after reading your post.

Is any surgery really essential? The effects and after effects, pain medication etc. is going to put a huge load on her liver.
Can the bladder stone be treated with ultrasonic dissolution rather than surgery or is it worth trying a diet designed for breaking the stone up or at least making it smaller (without putting extra strain on the liver)?
Do you need to treat the liver shunts, Pepper doesn't seem to have been effected by them so far. Will a special diet or supplement help with this to protect the liver? If you hadn't had the tests you would never have know this was a problem.

I feel for you with these decisions. It isn't easy but get all the specialist advice that you can and I really hope you all get through it ok. :ymhug: :ymhug:
Thank you for your reply! You've raised some very good points, some of which are already on my list of things to ask the vet but also some new ones. The medical consultant that I saw did say that the bladder stones could be treated medically if surgery wasnt recommended, but now I have to have a consultation with the surgeon to discuss that...Part of me feels that of course they are going to say operate, that's their job and I've already told them she is insured (just not how much for) but that feels very cynical of me.
You wouldn't guess she has a 'problem', currently there isn't even any urinary issues either. But I do know that liver issues can cause problems with anaesthetic so are we putting her through more than necessary? It's a minefield isn't it!
zeta1454 wrote:
10 Apr 2019, 16:34
Hi Andrea - sorry to hear about poor little Pepper.

As Julie says above, Pepper has been through a lot of investigative work and (unless her condition worsens) could probably do with a break from any more for a while. There are other options than surgery for some bladder stones but your vet or a specialist should be able to advise if these are a better option. The liver shunts too would not seem to be an emergency if Pepper is fit and well in herself.

Sadly many vet practices, especially those which are owned by corporates rather than the vets themselves, do seem to operate a policy of trying to encourage clients who are insured to have multiple investigations, treatments or procedures carried out on dogs for what can seem the flimsiest of reasons rather than reserving these for really seriously ill dogs. We were told some years ago by a consultant that, if a client is insured, they will often go down a lengthy route to investigate issues when a single procedure may be all that is needed. The situation has worsened with corporate owned surgeries where the corporate owners also have their own (or contracts with) referral centres and S pecialists who may be neither local nor the least costly, and market their own brand pharmaceuticals for treatments.

I have no experience with either bladder stones or liver shunts in our dogs so cannot advise re costs or treatment options.

Crowdfunding is a method used by some people who are struggling financially to meet the costs of procedures or lifetime drugs for their sick dogs but I have only seen these on social media platforms such as Facebook where individuals (and their dog) may already be known to members of a group or a wide audience of "followers" or FB "friends". It is probably harder to get donations from total strangers who also may be wary of possible "scams".

I have heard people recommend taking out a separate credit card (possibly with a delayed repayment start?) to at least spread additional costs for treatment for their ill dogs, if funds are not available. We have not used pet insurance for our dogs for about 15 years now after being advised (by our vet) to put money aside in a savings account instead and it has paid dividends in our case, despite the occasional large vet bill.

I do hope that other Forum members may be able to advise re costs etc. and that Pepper does keep well for as long as possible.
Thank you for your reply! You are right, Pepper 100% deserves a break!
I worry about what you mentioned re.corporate vets on a regular basis, even pre-shunt! My vets are constantly recommending Royal Canin food which, of course, they sell on site. I've told them that she only eats what I can pronounce! Perhaps I need to search out a 'private' vet practice, although sadly they seem few and far between nowadays.
Thanks for your thoughts on crowdfunding, Mum is convinced this is the way to go, but I have about 10 Facebook friends :)) it's just not something that interests me so we may have a slight issue there! All of Peppers treatment so far has been on credit, but again, the limit will soon be reached.

You've both given me some food for thought and I think I'm going to really have an in depth look at if the surgery is absolutely necessary, and go from there. Now just to figure out who exactly will give me this information unbiased!

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Dinkum
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Posts: 2524
Joined: 10 Jan 2011, 12:47
First Name: Dean
Dog #1: Rupert
is a: Black Mini Dog
Born: 24 Dec 2010
Dog #2: Watson
is a: Black Mini Dog
Born: 21 Feb 2012
Location: Tunbridge Wells, Kent

Re: Liver shunt. X2!

Post by Dinkum » 13 Apr 2019, 11:14

Hi Andrea

If you read through some of my previous posts, you will see that Watson had a liver shunt repair 2 months after his 2nd birthday. I will give a quick breakdown of what happened and our vet bills over the period. Our local vet is private and not part of a big chain. Watson was referred to Royal Veterinary College for the major operations. Watson had an external portosystemic shunt, which is repairable in most cases. The internal ones are not and it is worth reading up on the differences.

In April 2014, Watson stopped peeing. He was diagnosed with a bladder stone lodged in his penis. Our local vet operated and removed the stone - £1755

In May 2014, Watson stopped peeing again and underwent another operation to remove a stone. Watson now has a urethrostomy which he pees through. This is allow stones to pass without getting stuck - £1862

During the first operation, Watson regurgitated stomach acid and burnt the inside nasal passages and he could no longer breathe through his nose. Our vet referred us to RVC for a CT scan to diagnose the issue in June 2014. At the scan, I asked that he have an abdominal scan to check for stones and potential causes. Watson was operated on and the scar tissue from the nose was removed and 2 small pipes fitted in an attempt to create nasal passages for him to breathe through. This didn't work and Watson has not breathed through his nose since. £3098

At the scan in June 2014, Watson was diagnosed with the external portosystemic liver shunt. Due to his age and the nature of the shunt, we decided to have it repaired and this was done at RVC. We were fortunate that Watson only required one operation to repair the shunt. Sometimes two are necessary - £3830

Watson was insured with a lifetime policy with our insurer. Our insurer refused to pay out for the bladder stone operations, but did pay for the nasal operations and the liver shunt operation. Our premiums increased from £200 per year to £1700 this year and we have now cancelled our insurance on the dogs.

In total, we spent over £10,000 on Watson in 2014, of which our insurer paid out just under £7000. Today he is still a lively, active little dog that snores constantly and doesn't breathe through his nose. He is so noisy, he is not allowed to sleep on the bed at night. At the time, it was tough finding the money as we had to pay up front and we were spreading it across various credit cards. Looking back, I am glad we did and have no regrets about spending the money.

Watson has the occasional urinary tract infection, but that is quickly treated with antibiotics. He has just had his 7th birthday.

If you have any questions, please feel free to get in touch.

Image
Watson in a baby grow after his first bladder stone operation.
Dean & Jolyon
Rupert, black mini born 24/12/10
Watson, black mini born 21/02/12

I offer my advice freely, but I am not an expert, breeder, groomer or behaviourist. It is simply my experience of raising pups in a way that seems to make sense.

Oscar 12345
Member
Posts: 915
Joined: 02 May 2017, 11:28
First Name: Julie
Dog #1: Oscar RIP Sweety
is a: P/S Mini Dog
Born: 21 Dec 2002
Dog #2: Otto
is a: B/S Mini Dog
Born: 04 Jul 2017

Re: Liver shunt. X2!

Post by Oscar 12345 » 13 Apr 2019, 12:08

Dean, why did your insurance company refuse to pay out for bladder ops on Watson?
Every snack you make
Every meal you bake
Every bite you take
He'll be watching you......

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Dinkum
Tech Team
Posts: 2524
Joined: 10 Jan 2011, 12:47
First Name: Dean
Dog #1: Rupert
is a: Black Mini Dog
Born: 24 Dec 2010
Dog #2: Watson
is a: Black Mini Dog
Born: 21 Feb 2012
Location: Tunbridge Wells, Kent

Re: Liver shunt. X2!

Post by Dinkum » 13 Apr 2019, 15:58

Oscar 12345 wrote:
13 Apr 2019, 12:08
Dean, why did your insurance company refuse to pay out for bladder ops on Watson?
Every year I changed insurers. I thought that cover continued uninterrupted, as it does with house and car insurance. It doesn't. There is a 14 day period where any illness on a new policy is not covered. I called our vet on day 14 when Watson wasn't urinating for advice. He had had his rabies injection the week before and I was worried that that may be causing issues. The nurse I spoke to, recorded the conversation on their system. Our insurer requested a copy of Watson's medical records and excluded the bladder stones removal on the basis of the call. That call was the first indication that he had a stone lodged in his penis and this was causing him not to urinate.
Dean & Jolyon
Rupert, black mini born 24/12/10
Watson, black mini born 21/02/12

I offer my advice freely, but I am not an expert, breeder, groomer or behaviourist. It is simply my experience of raising pups in a way that seems to make sense.

Oscar 12345
Member
Posts: 915
Joined: 02 May 2017, 11:28
First Name: Julie
Dog #1: Oscar RIP Sweety
is a: P/S Mini Dog
Born: 21 Dec 2002
Dog #2: Otto
is a: B/S Mini Dog
Born: 04 Jul 2017

Re: Liver shunt. X2!

Post by Oscar 12345 » 13 Apr 2019, 18:38

What a difference a day made! Glad Watson is doing ok now though, long may it continue.
Every snack you make
Every meal you bake
Every bite you take
He'll be watching you......

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