#1 Update By Author
AUTHOR: Pomlover - Newburgh (U.S.A.)
SUBMITTED: Sunday, August 17, 2008
POSTED: Sunday, August 17, 2008
I just want to say again, I am in no way trying to bad mouth Tammy Price, she was a nice lady. I just want people to be aware of things like this so they don't experience the same thing!
#2 Update By Author
AUTHOR: Pomlover - Newburgh (U.S.A.)
SUBMITTED: Tuesday, August 19, 2008
POSTED: Tuesday, August 19, 2008
I want to say AGAIN I am not saying Tammy sold us the puppy knowing it had all of these problems, or that she gave the Metronidazole knowing he had liver problems.
#3 Consumer Comment
AUTHOR: Alovingbreederofseveralyears - EVANSVILLE (U.S.A.)
SUBMITTED: Wednesday, August 20, 2008
POSTED: Wednesday, August 20, 2008
Hi
I would like to start by saying how sorry I am that she and her poor puppy experienced these things.
As a breeder that works very closely with three licensed VETs and as a person who has bought several poms from Tammy I can attest to her cleanliness and conscious attempt to do PREVENTIVE CARE on all her dogs. Tammy has several helpers that are paid to keep the kennel as clean as heavenly possible. All the puppies that I have purchased from her kennel have on their health records PREVENTIVE Care meds as listed. By that I am refering to flagel (metronidozole) Strongid along with the normal shots and bordetella/Kennel Cough. All these meds are recommended by her vet and also my own. I strive to be as good of a breeder as she is..... She is AKC inspected yearly and is very professional. She stands behind her dogs/puppies 100%
Oddly enough a friend of mine and I where at Tammys house just two days before this puppy was purchased. We held him and commented on how precious and tiny her was. He was smaller at 10 weeks of age than my 6 week old puppies. Which does put him at higher risk to have a weaker immune system. I was there picking out my next female to add to our family. The puppy had no visible signs of illness. He was very active and appeared strong. He was perfect acting and looking. I did not see any visible signs of poor health nor conditions.
The problem with this report is that people whom read this young ladys story are going to think the breeder tammy is a dirty bad person whom is hurtfull to animals and that would rip you off. The parasites listed are commonly associated with dirty living conditions which is not always the case. Whether or not she meant to make it sound like that the fact that it is on A RIP OFF REPORT website says enough. What if someone reads her report and then decides not to purchase a puppy from Tammy? Tammy has done nothing wrong. Why should she and her future puppy off spring be punished because of her report. I feel the report facts are correct but not in the correct context.......
In knowing this person I felt compelled to write a statement so others wouldnt get a bad impression of a WONDERFUL WONDERFUL LOVING BREEDER. I truly feel Tammy is an awesome breeder and I strive to be like her... She works so hard to do preventitive care with her dogs/puppies to give them the best chances of a happy healthy life.
The lil white pom that had no hair is NOT from a breeding of her own and is fixed and strictly a pet. She does NOT have a communicable issue. If Tammy was just in it for the money she would have sent her away or worse had her put to sleep...
Intestinal parasites are normally in the intestinal tract in low numbers. With a healthy immune system these bugs rarely raise their ugly heads. But with a weak immune system a puppy/adult are suseptable to infestation. Most of all the nasty infections that our poor lil babies get are kept in the intestines normally just in manageable levels. Humans also have several intestinal bugs that when our immune systems are low or the good florra in the GI tract gets killed off with over antibiotic usage named CDIFF. Thus those nasty lil parasites run rampit in the body making havic. Possibly even killing the host/puppy/dog/human.
With time the number of puppies increases and the chances of irregularities thus hereditary abnormalities increases. Just like people. People pass hereditary issues through several generations and no one knows until it pops up.
The barn she is refering to is a very nicely kept new construction kennel that has AC heating running water. A top knotch kennel. Just ask AKC whom has inspected her several times.
I feel the true problem lies in the fact that the first few vets did not see the warning signs in the first place. HMMM.... fecal float vs fecal smear... it really only takes gram staining to see the microorganisms so why is Tammy mentioned by name and her business but not the vets that she took him to. They dont get marked as being mentioned on a ripped off website. THERE IS AN ISSUE ALL TO ITSELF. I can understand that the writer believes he has a shunt due to the fact that the vet told her in his opinion he had a shunt. The truth of the matter is that if she did not have the VERY SPECIFIC TEST DONE nor a AUTOPSY then the vets are only working on assumptions/opinions. The fact that liver enzymes where out of wack can be explained by poor health of that that he had been experiencing. So we will never know for sure. A liver shunt is a diagnosis that I have heard all to often. THe vet recommends the test. The test is done and no shunt.... I understand we all have opinions but to say with definety that this pup had a liver shunt is NOT GOOD JUDGEMENT. Her vet may think it was a liver shunt but their where no test done to conclude those findings. Thus this young lady has gone through all of this spent her time and money and is now getting the cost of the puppy back even though the breeders contract states all she is entitled to is a puppy with the conclussion of an autopsy with diagnosis.
She is getting her money back for the puppy but All without CONCLUSIVE EVIDENCE. Does this sound like a ripped off buyer or seller....?
Unfortunely the poor puppy did die. For that I do understand placing a blog that the intentions where to educate that public but I sure wouldnt have place the breeders name and business name in the article OF A RIPPED OFF WEBSITE if I truly where not ripped off...
My hope is that someone whom is experiencing these issuer will read the article/rebutle and learn from it and save their puppy/dog... being in constant contact with the breeder, picking a trusted VET and doing the correct testing is key...
#4 Update By Author
AUTHOR: Pomlover - Newburgh (U.S.A.)
SUBMITTED: Sunday, August 24, 2008
POSTED: Sunday, August 24, 2008
I really find your posting amusing..
How funny it is how peoples stories can turn around when brought to the public eye.
I first want to start by saying one of the vets I went to is one of YOUR very own veterinarians... Remeber, you recommended me to him?
Secondly, although your trying to retract it now, when my puppies symptoms first arised and I called you- you told me of your puppy who had the parasite, told me Tammy had a history of having dogs with the parasite, and warned me of what I needed to do to find out if he had the parasite that killed your puppy. You even told me if I ever mentioned that you told me that, you'd never speak to me again... Now your trying to change your story around a little bit.. Even admitting to me that you were caught in the middle and did not want to go to court over this. (The only person who threatened a law suit was you, telling me Tammy could sue me for slander, when she infact has no grounds to considering everything I have said is fact.) The threadworm was found in a FECAL FLOAT at the emergency vets- not a smear, I have proof in the records if you want to dispute that. When a smear was done only Spirochetes were found. It has also been VERIFIED by a licensed VET that my puppy did not die from any of the parasites he had. When he was taken to the vet the last time no parasites were found. But his health was still declining.
I'm not really sure what grounds you have to say that I don't know for a fact that my puppy had a liver shunt? If you would like to see the records we recieved from the vet with the results saying he infact did have a portosystemic liver shunt, your more than welcome. Let me remind you he had more than ONE congenital issue. I'm pretty sure you haven't seen the records, weren't present and really don't know what testing was done on the puppy. You have nothing to back up anything your saying besides what you know about Tammy. This situation has nothing to do with you. The only way and reason you are involved is because you have involved yourself.
I said in my first posting the puppy was PERFECT when we got him, for perfect for a week or so after we got him. We all know congenital problems do not develope overnight.. So even though the symptoms werent present right away, does not mean the problems weren't there.
As I have said before, the money is not important. Yes, it is only right we do get our money back (even you told me that yourself), but that doesn't make up for the pain and suffering we and the puppy endured. I never said Tammy was a dirty person, or a bad person. The person making the biggest issue of this is you. Not Tammy or I...
You were a huge help for me during some of this terrible situation, but please before you say anything make sure you know exactly what your talking about and have proof to back it up.
#5 Consumer Comment
AUTHOR: Alovingbreederofseveralyears - EVANSVILLE (U.S.A.)
SUBMITTED: Tuesday, August 26, 2008
POSTED: Tuesday, August 26, 2008
BRITTANY I DO KNOW YOU HAD GOOD INTENTIONS...BUT YOU HAVE TO OPEN YOUR HEART AND MIND. YOU JUSTWENT ABOUT THINGS IN THE WAY IS ALL.
MY PRAYER FOR YOU IS THAT YOU CAN SEE WHAT REALLY HAPPENED HERE.. AND APPOLOGIZE.
YOU CAN SEND ME ALL THE NEGATIVE WORDS YOU LIKE BUT I WONT LET IT GET TO ME. I AM OK WITH YOUR OPINIONS... ITS LIKE THEY SAY EVERYONES GOT ONE.
LIFE IS TOO SHORT.. AS I AM LEARNING.... AGE IS A BEAUTIFUL THING. LIFE EXPERIENCES ARE WORTH EVERY SINGLE TEAR FOR THAT WHICH DOES NOT KILL YOU WILL WILL WILL WILL MAKE YOU STRONGER.
CHARLOTTE
#6 Consumer Comment
AUTHOR: Joann - Bunnell (U.S.A.)
SUBMITTED: Tuesday, September 02, 2008
POSTED: Tuesday, September 02, 2008
This was a very disturbing report to read as I have delt with Tammy on a few occations and have been to her place to pick up puppies and adults. I am a breeder in Florida and have bought puppies and adults alike from Tammy and have never found a better breeder.
I have had a few puppied shipped to me wth things from worm to Parvo (and yes, it did kill the puppy that was shipped to me) but never, have any of the dogs/puppies that I received from Tammy had any health issues what so ever.
I do know of the time when she had a problems with sick puppies but, they did not come from her house but, of another breeder. When Tammy was going though Chemo theropy, this breeder took a few of her females that were bred and whelped the litters at her house and kept the puppies there. This particular breeder lost several of Tammy's puppies due to these parasites. Tammy did go and get her dogs and puppies when she found that this was happending.
I really can not believe that someone would write horrible things like this about her, I myself have experianced liver shint in a puppy before and the only way to know if they have it is to do blood test and test for specific liver functions. If the puppy did have liver shunt, the puppy would not have lived without knowing it for as long as he did.
If you are that ready to slander someone for this puppy and want to warn the public of a bad experiance, then I sincerly suggest that you also mention the names and address of the vets and the names of the clinics that told you that is was just Hypoglycemia. I think that people have the right to know of these bad vets as well then. I really think people ought to think before they speak. What If I would want to talk to you as well? why don't you say who you are? instead, I guess it is easier to not give a name or location. In any case, as I HAVE stated, Tammy has a very nice set up and I do know that AKC is VERY strict on there policies and since she has passed with FLYING colors for the past several inspections and they have not found her to be the DIRTY person that you are callikng her; Then, I guess she is just fine and that it is just you.
#7 Update By Author
AUTHOR: Pomlover - Newburgh (U.S.A.)
SUBMITTED: Friday, September 05, 2008
POSTED: Friday, September 05, 2008
Joann, being a breeder yourself I would hope you know dogs with liver shunts can live up to years with the disease depending on severity.. Our puppy only lived for almost 3 months of his life. You also would know that liver shunt symptoms can resemble hypoglycemia in many cases. We had blood and liver testing done on our puppy that confirmed the portosystemic as well as some other internal issues (kidney, heart, infection). Everyone coming at me is thinking purely on the business side of things, rather than emotional and worried said breeder would lose a sale over this. Notice how anyone with anything negative to say is also a breeder who has dealt with her? I never said she was a dirty person. Never said negativity about her at all. Maybe also before you come at me with your petty attempt to make what I said seem wrong or dirty whatever you want to say, you should say things in correct context. Slander is an untrue thing SAID about another person, not written. That set aside, everything I've stated is nothing but fact. I will scan and post vet reports if I have to. I'm not some dense person lying and trying to hurt someone, I am a person who went through a very heartbreaking experience and thinks it should be known. If you want to bad mouth me because of that, be my guest. Your opinions don't affect me, and they certainly don't change my very true story.
Unfortunately, we still haven't seen the money we were promised from the breeder.. Our phone calls are being ignored..
#8 Update By Author
AUTHOR: Pomlover - Newburgh (U.S.A.)
SUBMITTED: Sunday, September 07, 2008
POSTED: Sunday, September 07, 2008
REFER TO TREATMENT WHERE YOU WILL CLEARLY SEE METRONIDAZOLE IS IN FACT OFTEN USED IN PSS PATIENTS.
Web address: http://en.wikipedia.org/wiki/Portosystemic_shunt
Portosystemic shunt
From Wikipedia, the free encyclopedia
A portosystemic shunt (PSS), also known as a liver shunt, is a bypass of the liver by the body's circulatory system. It can be either a congenital (present at birth) or acquired condition.
Congenital PSS is a hereditary condition in dogs and cats, its frequency varying depending on the breed. The shunts found mainly in small dog breeds such as Miniature Schnauzers and Yorkshire Terriers, and in cats such as Persians, Himalayans, and mix breeds are usually extrahepatic (outside the liver), while the shunts found in large dog breeds such as Irish Wolfhounds and Labrador Retrievers tend to be intrahepatic (inside the liver).[1]
Acquired PSS is uncommon and is found in dogs and cats with liver disease such as cirrhosis causing portal hypertension, which is high blood pressure in the portal vein.
Contents [hide]
1 Pathology
2 Symptoms and diagnosis
3 Treatment
4 Heredity
5 References
6 External links
[edit]Pathology
Congenital PSS is caused by the failure of the fetal circulatory system of the liver to change. Normally, the blood from the placenta bypasses the liver and goes into circulation via the ductus venosus, a blood vessel found in the fetus. A failure of the ductus venosus to close causes an intrahepatic shunt, while extrahepatic shunts are usually a developmental abnormality of the vitelline veins, which connect the portal vein to the caudal vena cava. Thus in the juvenile and adult animal with PSS, blood from the intestines only partly goes through the liver, and the rest mixes into general circulation. Toxins such as ammonia are not cleared by the liver. Most commonly, extrahepatic shunts are found connecting the portal vein or left gastric vein to the caudal vena cava.[2]
Congenital shunts are usually solitary. Acquired shunts are usually multiple, and are caused by portal hypertension in dogs with liver disease. This is most commonly seen in older dogs with cirrhosis, but may also be seen in younger dogs with liver fibrosis caused by lobular dissecting hepatitis.[3]
[edit]Symptoms and diagnosis
Symptoms of congenital PSS usually appear by six months of age[1] and include failure to gain weight, vomiting, and signs of hepatic encephalopathy (a condition where toxins normally removed by the liver accumulate in the blood and impair the function of brain cells) such as seizures, depression, tremors, drooling, and head pressing. Urate bladder stones may form because of increased amounts of uric acid in circulation and excreted by the kidneys. Initial diagnosis of PSS is through laboratory bloodwork showing either elevated serum bile acids after eating or elevation of fasting blood ammonia levels, which has been shown to have a higher sensitivity and specificity than the bile acids test.[4] Rectal portal scintigraphy using 99mtechnetium pertechnetate, a technique of imaging involving detection of gamma rays emitted by radionuclides absorbed through the rectum and into the bloodstream, demonstrates the blood vessel bypassing the liver. Surgery definitively shows the shunt if it is extrahepatic.
[edit]Treatment
Surgical treatment is best, when it can be performed. Pressure within the portal vein is measured as the shunt is closed, and it must be kept below 20 cm H2O or else portal hypertension will ensue.[1] Complete closure of extrahepatic shunts results in a very low recurrence rate, while incomplete closure results in a recurrence rate of about 50 percent. However, not all dogs with extrahepatic shunts tolerate complete closure (16 to 68 percent).[5] Intrahepatic shunts are much more difficult to surgically correct than extrahepatic shunts due to their hidden nature, large vessel size, and greater tendency toward portal hypertension when completely closed.[6] When surgery is not an option, PSS is treated as are other forms of liver failure. Dietary protein restriction is helpful to lessen signs of hepatic encephalopathy, and antibiotics such as neomycin or metronidazole and other medicines such as lactulose can reduce ammonia production and absorption in the intestines. The prognosis is guarded for any form of PSS.
[edit]Heredity
The intrahepatic shunts found in large dog breeds are passed on in a simple autosomal recessive way, while the extrahepatic shunts of the small breeds are inherited on a polygenic basis.[7]
[edit]References
^ a b c Ettinger, Stephen J.;Feldman, Edward C. (1995). Textbook of Veterinary Internal Medicine, 4th ed., W.B. Saunders Company. ISBN 0-7216-6795-3.
^ Miller J, Fowler J (2006). "Laparoscopic Portosystemic Shunt Attenuation in Two Dogs". J Am Anim Hosp Assoc 42 (2): 160–164. PMID 16527918.
^ Agg E (2006). "Acquired extrahepatic portosystemic shunts in a young dog". Can Vet J 47 (7): 697–9. PMID 16898115.
^ Gerritzen-Bruning M, van den Ingh T, Rothuizen J (2006). "Diagnostic value of fasting plasma ammonia and bile acid concentrations in the identification of portosystemic shunting in dogs". J Vet Intern Med 20 (1): 13–9. doi:10.1892/0891-6640(2006)20[13:DVOFPA]2.0.CO;2. PMID 16496918.
^ Frankel D, Seim H, MacPhail C, Monnet E (2006). "Evaluation of cellophane banding with and without intraoperative attenuation for treatment of congenital extrahepatic portosystemic shunts in dogs". J Am Vet Med Assoc 228 (9): 1355–60. doi:10.2460/javma.228.9.1355. PMID 16649938.
^ Adin C, Sereda C, Thompson M, Wheeler J, Archer L (2006). "Outcome associated with use of a percutaneously controlled hydraulic occluder for treatment of dogs with intrahepatic portosystemic shunts". J Am Vet Med Assoc 229 (11): 1749–55. doi:10.2460/javma.229.11.1749. PMID 17144820.
^ Rothuizen, Jan (2002). "Molecular Genetics-Diseases of the Liver". Proceedings of the 27th WSAVA Conference. Retrieved on 2006-11-14.
[edit]External links
Portosystemic liver shunt article by Dr. Thomas K. Graves
Categories: Dog diseases | Cat diseases | Hepatology
#9 Update By Author
AUTHOR: Pomlover - Newburgh (U.S.A.)
SUBMITTED: Sunday, September 07, 2008
POSTED: Sunday, September 07, 2008
PORTOSYSTEMIC LIVER SHUNT
by: Thomas K. Graves, DVM
LIVER MALFUNCTION IS MORE COMMON THAN YOU THINK
The term portosystemic shunt has a scary sound it, and perhaps rightly so. A portosystemic shunt is a congenital malformation of the veins that bring blood to the liver. Unfortunately, it's not a malfunction you can see with your eyes or hear with a stethoscope or feel with your hands.
What makes it scary is that it's so incredibly vague. It usually affects puppies, but not always. It can be the bottom-line reason for that one that's doing poorly in the litter, but not always. It can be the explanation for unexplained death but not always. It can be the reason the puppy just can't seem to be housebroken, but there can be a million and one other reasons for that. One thing is for sure: It's more common than we think. In a normal dog, blood travels from the intestines through the portal vein to the liver. There it is detoxified and travels to the heart by way of the vena cava. (See above photo.)
In health, the liver's job (among many) is to process the blood. After a meal, blood bathes the intestines, soaking up proteins and their by-products ammonia, for instance) minerals and various other molecules. It collects at a central point in the abdomen and pours into the portal vein. The portal vein then sends this blood which is laden with the by-products of digestion (many are toxic), to the liver.
In the liver, the blood is detoxified before being sent to the vena cava, the large vein that carries blood to the heart. Thanks to this circulatory scheme, the blood arrives in the heart to oxygenated and then to the hungry cells of the brain, muscles and other organs is free of toxic by-products of digestion.
In patients with portosystemic shunt, circulation through the liver is abnormal. There are many different specific malformations that can occur. Most commonly, blood flows from the portal vein directly to the vena cava, bypassing the liver. This is called a portocaval shunt, and can happen with the majority or only a small part of the portal blood, depending on the severity of the defect.
When this happens, the blood that is sent to the lungs, brain, cardiac muscles and every other body tissue has not been detoxified. The result is a poisoning of many of the body's cells. Clinically, that can mean just about anything, from poor weight gain to excessive sleepiness and mental dullness to vomiting to blindness to seizures. The longer the shunt goes undetected, the worse the prognosis.
I have seen portosystemic shunts in many breeds of dogs. In my opinion, it occurs commonly in Maltese, Toy Poodles and Shetland Sheepdogs. I've seen it in Labrador Retrievers, Cocker Spaniels, Springer Spaniels, Pugs, Shih Tzu and once in a Corgi. I wouldn't rule it out in any breed, and the fact that it occurs far more commonly in pure-bred dogs than in mixed breeds points to a genetic cause.
THE CLASSIC CASE
The classic picture of a portosystemic shunt patient is that of a puppy. It's smaller than its littermates and has never done well. It sleeps more than usual. It may have a poor appetite and may vomit occasionally and have a little diarrhea from time to time. It may have periods of normalcy, but the pup is at its worst just after eating (that's when toxins in the blood are at their peak). As time goes by the signs of disease become worse. It may progress to periods of poor coordination and blindness. Seizures are common, especially after a meal.
Neurological dysfunction caused by liver insufficiency is referred to as hepatoencepholopathy. This can cause any degree of neurological problems including lethargy, dullness, decreased learning ability, weakness, stumbling, blindness, circling, seizure, coma and death.
The last portosystemic shunt patient was not at all like that classical case. It was a two-year old Shih Tzu, a beautiful, typy little bitch with an outgoing personality, a nice topline, four good legs, a very cute face and a ton of coat. The dog was brought to me because of a urinary tract infection. As I discovered the urinary tract infection had been caused by stones in the urinary bladder. The stones were composed of urates, crystalline compounds that build up in the blood when the liver does not function properly. Urate stones form when the levels of urates in the urine are so high as to cause crystals to clump. (See Bladder Stones in Dogs, in September 1992 GAZETTE).
This is the same type of stone commonly found in Dalmatians, but with a different cause. The stones in my patient were due to inadequate liver function. And the inadequate liver function was due to a portosystemic shunt. Thankfully, the shunt was surgically treatable.
If you or your veterinarian have any suspicion of a portosystemic shunt, the dog should have a full diagnostic workup. The longer it is left untreated, the worse the prognosis. The liver needs the blood
supply from portal circulation in order to grow and regenerate. In dogs with severe long standing shunts, the liver is often shrunken and almost completely non-functional. In such cases, treatment is often impossible.
The diagnostic starting point (once a thorough history and physical examination have been evaluated) is a chemistry profile, a complete blood count and a urine analysis.
Urine is often overlooked as a diagnostic fluid in veterinary medicine. The reason is the difficulty of obtaining a clean sample. We can't just ask our patients to go into a bathroom and collect a sample as aseptically as possible in a little plastic cup. In fact, voided urine samples in dogs are not very useful. Usually, by the time the urine has traveled through the vagina or prepuce and through the dog's hair, it is useless as a diagnostic specimen. And if the urine is collected from the floor forget it.
I routinely collect urine by cystocentesis; sticking a needle through the skin on the abdomen and into the bladder. This seems drastic to most human patients, but is a routine procedure in veterinary medicine and is safe, almost painless and allows us to get uncontaminated urine samples from our patients. If I had not collected urine, I would not have made the correct diagnosis in the Shih Tzu. All of the other tests on the dog's chemistry profile and blood count were normal.
Changes can be seen in levels of liver enzymes, cholesterol, glucose and many other factors, but the results of screening blood and urine tests can only suggest a portosystemic shunt; they can never offer a definitive diagnosis. To more adequately assess liver function, we do a serum bile acids test. This test involves taking a blood sample after the patient has fasted for 12 hours. The dog is then fed and the blood is retested after two hours.
This tests the liver's ability to clear bile acids (which are secreted by the liver in response to feeding) from the blood. Any abnormality suggests liver dysfunction. If post-feeding serum bile acid levels are normal, this excludes the diagnosis of portosystemic shunt.
DIAGNOSTIC X-RAYS
The next step in diagnosis is a trip to the radiology department, where a variety of tests can be done. I usually start with a set of x-rays of the abdomen. I'm looking for changes in liver size (the liver can be smaller than normal in patients with portosystemic shunts). I can also look for bladder stones or kidney stones.
The next step is usually ultrasound of the liver. This test is advantageous because it is non-invasive, perfectly safe and can help rule out other types of liver disease. if it is large enough and if the ultrasonographer is skilled enough, a portosystemic shunt can sometimes be seen with ultrasound.
Another test I use commonly when ultrasound has been inconclusive is rectal portal scintigraphy. It sounds really awful, but it's very safe and usually quite definitive. There is no discomfort or danger for the patient, and the information gathered can be vital. To perform the test, a radioactive substance (with a very low level of radiation) is placed in the dog's rectum via an enema tube. The radiation is taken up by the intestinal circulation and a gamma camera is used to watch the flow of blood by detecting areas of radioactivity in the dog.
In a normal dog, the radiation travels from the intestine to the liver to the heart to the kidneys and beyond. In a dog with a shunt, the radiation travels from the intestine directly to the heart, bypassing the liver. The liver lights up sometime later, and the diagnosis is made. Unfortunately, nuclear medicine facilities are not always available for veterinary patients. However, most university-based veterinary teaching hospitals are equipped to perform rectal scintigraphy.
SURGERY
The last, and most invasive test is saved for the surgery department. The patient is placed under general anesthesia and a look of gut is isolated through an abdominal incision. A radiographic contrast agent is injected into an intestinal blood vessel and x-rays are taken. The contrast agent allows us to see the path of portal circulation and abnormal vessels can be seen quite easily. Often this test is done at the same time surgical correction of the problem is planned.
There is only one way to cure a portosystemic shunt--surgery. Most veterinarians refer patients with portosystemic shunts to soft tissue surgery specialists. Surgical treatment of the disease involves identifying the abnormal blood vessel (shunt) and closing it. Of course, it's not that simple. It all depends on the degree of normal circulation left and the condition of the liver.
Sometimes, especially in long-standing cases, once the shunt is tied off, there is nowhere else for the blood from the intestines to go. Because there are not enough normal vessels, the blood cannot circulate through the liver and pressure builds up in the intestinal circulation. If this pressure is too high, the patient will die. In such cases, partial closure is attempted.
In some cases, no closure is possible and medical management is the only option. Medical management can help ease the symptoms, but it is only temporarily effective. It should only be used with patients in which surgery is impossible.
Medical therapy is also valuable before surgery. Depending on the degree of illness, various treatments re used to help decrease toxin production in the gastrointestinal tract and toxin levels in the blood. Low protein diets are an essential part of medical management. Various antibiotics are used to decrease how much ammonia is produced by bacteria in the gut. Lactulose is used to trap ammonia within the intestine and keep it from diffusing into the bloodstream. In severe cases of hepatoencepholopathy, repeated enemas may be needed to reduce blood ammonia levels. Obviously, long-term intensive medical management is difficult, expensive, impractical and, arguably inhumane.
LONG-TERM PROGNOSIS
If a patient survives the first few weeks after surgery, the long-term prognosis is usually excellent. Occasionally seizures that can be extremely severe, develop following shunt closure. The reason for this post-surgical complication is not understood, and the prognosis is very poor. The majority of patients, however, do well following surgery, and they go on to live normal lives.
Like so many diseases of pure-bred dogs, the key to success is early recognition of the problem, aggressive diagnosis and expert care in treatment. The key to prevention is awareness and responsible breeding.
Thomas Graves breeds and exhibits Pekinese, is an instructor/resident in small anima l medicine at Michigan State University and is a frequent contributor to the GAZETTE.
This article was printed from the January 1995 Gazette with permission from the American Kennel Club.
#10 Update By Author
AUTHOR: Pomlover - Newburgh (U.S.A.)
SUBMITTED: Sunday, September 07, 2008
POSTED: Sunday, September 07, 2008
AGAIN, refer to treatment options, which INCLUDE Metronidazole.
PORTO SYSTEMIC SHUNTS IN THE DOG AND CAT
Clinical signs are similar to those seen with hepatic encephalopathy.
The most common clinical signs are: chronically ill, exhibiting ill-thrift, reduced growth rates, and poor hair coats.
Neurologic abnormalities: impaired vision, circling, ataxia, gate abnormalities, behaviour changes, seizures, and head pressing. Signs may wax and wane.
Gastrointestinal signs: vomiting, diarrhoea, and anorexia. Are intermittent.
A frequent clinical sign in cats is pytalism.
Some animals are also reported to be PU/PD, and have intermittent fever.
Because the signs are often mild and come and go, some animals may not be diagnosed until they are anaesthetized for spay or neuter operations, whereupon they will have prolonged recovery from anaesthesia.
Portosystemic shunts (PSS) are vascular communications between the portal and systemic venous systems that allow portal blood to reach the systemic circulation without first passing through the liver. PSS can be either congenital or acquired. Congenital PSS are usually single shunts that can be either intrahepatic or extrahepatic. In most cases, congenital PSS represent retained fetal vascular anastomoses, but can also occur when compensation for portal vein atresia results in formation or retention of collateral connections to adjacent veins. Examples of congenital PSS include persistent sinus venosus and direct portal vein connection(s) to the caudal vena cava or azygous vein. Acquired PSS are secondary to portal hypertension and are typically multiple extrahepatic shunts that connect the portal system to the caudal vena cava.
Congenital PSS are most frequently diagnosed in purebred dogs (Yorkshire Terriers, Miniature Schnauzers, Irish Wolfhounds, Old English Sheepdogs and Cairn Terriers) and mixed breed cats. Some diagnostic features include central nervous system (CNS) signs (disorientation, ataxia, blindness, seizures), poor growth, non-specific gastrointestinal signs, cryptorchidism in dogs and cats, polydipsia and polyuria in dogs, and heart murmurs, seizures, ptyalism, and copper iris color in cats. Large breed dogs usually have intrahepatic shunts whereas small breed dogs more often have extrahepatic shunts.
Laboratory findings include a mild nonregenerative anemia with microcytosis and poikilocytosis, mildly elevated ALT and ALP, low BUN, hypocholesterolemia, hypoglycemia, hypoalbuminemia, and hypoglobulinemia. Ammonium biuratecrystalluria and urate calculi may be seen in up to 50% of the PSS cases.
Diagnostic tests can be used to determine liver function. These include sulfobromophthalein (BSP) retention testing, fasting ammonia concentrations and ammonia tolerance testing (ATT), and serum bile acids (SBA). BSP is difficult to obtain and, due to many inadequacies associated with the use of organic anions for estimation of liver function, BSP is not commonly utilized. A normal fasting ammonia concentration does not rule out PSS since dogs and cats with PSS may have normal values. If the concentrations are above normal reference values an ATT is unwarranted. An ATT is a reliable test to detect hepatic insufficiency. One drawback of the ATT is that it is a labile test which requires immediate assay samples for diagnostic accuracy which is not feasible in all veterinary practices. ATT is contraindicated in patients with hepatic encephalopathy. High resting and postprandial SBA concentrations are good indicators of portosystemic shunting. The postprandial SBA concentration is the most dependable diagnostic test for detection of PSS in routine practice.
Abdominal survey radiographs may reveal microhepatica and renomegaly. Abdominal ultrasound, especially with Doppler capabilities, may reveal a small hypovascular liver and a shunt. Renal calculi may also be detected. Portography is the gold standard for documentation and anatomical location of the shunt.
A liver biopsy should be collected to ascertain the presence or absence of hepatic fibrosis and acquired hepatobiliary disease. When portal blood circumvents the liver, the liver fails to develop normally. Hepatic hypoplasia is recognized histologically as atrophy of hepatic lobules, compressed hepatic cords with dilated sinusoids, close proximity of portal triads, portal vein hypovascularity, hepatocellular degeneration (vacuolization, lipidosis) and proliferation of the small vessels, arterioles, and lymphatics. If the animal had hepatic encephalopathy (HE), on necropsy, brain lesions would include bilateral symmetric polymicro-cavitation of the brain stem and diffuse neuronal necrosis throughout the cerebrum and cerebellar cortex.
Diagnosis of PSS should be made based on historical and physical findings, laboratory findings, and diagnostic tests.
Treatment of PSS includes medical management (lactulose, neomycin, metronidazole), dietary therapy (high carbohydrate, low protein) and surgical intervention (amaroid ring constrictor, suture attenuation). Complete surgical ligation of the shunt has an excellent prognosis. Partial occlusion of the shunt usually results in improvement, but has a more guarded long-term prognosis. Exclusive medical management results in continuation of signs, but the patient may still survive for years. In some cases, a combination of surgical, medical, and dietary management may be necessary.
By Grace Steenburgen, Class of 2001
- edited by Evan Janovitz, DVM, PhD, ADDL Pathologist
#11 Update By Author
AUTHOR: Pomlover - Newburgh (U.S.A.)
SUBMITTED: Sunday, September 07, 2008
POSTED: Sunday, September 07, 2008
The last two articles I posted were found at:
http://lowchensaustralia.com/health/pshunts.htm
AND
http://stfsc.bizland.com/health5.htm
#12 Update By Author
AUTHOR: Pomlover - Newburgh (U.S.A.)
SUBMITTED: Sunday, September 07, 2008
POSTED: Sunday, September 07, 2008
NOTICE HOW THIS ARTICLE ALSO STATES METRONIDAZOLE AS A TREATMENT COURSE FOR LIVER SHUNT PATIENTS, AND STATES SYMPTOMS RESEMBLE THOSE OF HYPOGLYCEMIA.
Website: http://www.dog-health-guide.org/caninelivershunt.html
Canine Liver Shunt
"A canine liver shunt is a problem where the liver is bypassed by the blood stream. Since the liver cleans the blood, a shunt needs to be corrected to remove toxins that may accumulate. Treatment options include medications and surgery."
A canine liver shunt (portosystemic shunt or PSS) is a blood vessel that bypasses the liver, carrying blood from the stomach, intestines, pancreas, and spleen to the heart before it has a chance to be filtered by the liver. The liver cleanses blood of things like protein, sugar, bacteria, and toxins. When a liver shunt is present, the liver doesn't get to do its job.
Shunts can be present at birth (congenital) or develop after birth (acquired).
Liver shunts are particularly common in certain breeds such as:
* Yorkshire Terriers
* Irish Wolfhounds
* Maltese
* Australian Shepherds
* Labrador Retrievers
* Toy Breeds
The true cause of this condition is not known.
Canine Liver Shunt Symptoms
Symptoms of liver shunts in dogs usually show up at an early age and usually impact the central nervous system or the gastrointestinal system. Symptoms include:
* depression
* failure to grow at a normal rate
* behavioral changes (things like staring into space, circling, and disorientation)
* weakness or lethargy
* seizures
* inability to gain weight
* too much weight gain
* vomiting
* diarrhea
In some cases, signs of a canine liver shunt don't show up until a dog is older, when kidney and bladder problems such as stones develop.
Canine Liver Shunt Diagnosis
Symptoms of a liver shunt in dogs are similar to symptoms of some other illnesses, such as hypoglycemia (low blood sugar) and hydrocephalus (water on the brain). Tests must be done to rule these out.
Blood tests will then be done to check liver function. There are a number of blood tests that can be done to check for the possible presence of a shunt, including tests that check for protein, albumin, blood urea nitrogen, ammonia, and bile acid concentrations.
Abdominal x-rays will probably be taken to look at the liver. It will usually appear under-developed. A special x-ray with contrast called a portogram will show the actual shunt.
The shunt will also be visible by ultrasound, or by a nuclear scan called scintigraphy.
Canine Liver Shunt Treatment
Liver shunts in dogs can be treated medically or surgically. Most often they are treated medically until the dog is well enough to undergo surgery.
The dog is fed a diet low in protein, and medications such as lactulose and metronidazole or neomycin are given to prevent the manufacture and absorption of toxins such as ammonia. Some dogs do just fine with medical treatment only, but the majority do not. The liver continues to shrink and eventually fails.
In most cases, surgery is needed. Since the liver has not developed normally, the shunt cannot always be completely closed. Instead, the vet partially closes the shunt. In many cases, this is sufficient to relieve the symptoms of the disorder and the dog no longer needs the special diet and medications following the surgery. Success rates for surgical treatment are greater than 80%.
There is also a device called an ameroid constrictor. This device is a ring that is placed around the shunt. It slowly constricts over a period of four to five weeks, giving the liver time to adjust to the new blood supply.
Herbal remedies also show some promise in supporting liver function. A good source to research is PetAlive Liver-Aid Formula which is made specifically for this purpose. Discuss this and other options with your veterinarian.
Sources
Portosystemic Shunts
Karen Tobias, DVM
Pet Place
Diagnosis of Portosystemic Shunts
Daniel J Brockman, BVSc Cert VR, Cert SAO, Dipl. ACVS, Dipl ECVS ILTM MRCVS
Senior Lecturer, Department of Veterinary Clinical Sciences
Royal Veterinary College. University of London, United Kingdom
#13 Update By Author
AUTHOR: Pomlover - Newburgh (U.S.A.)
SUBMITTED: Sunday, September 07, 2008
POSTED: Sunday, September 07, 2008
And finally, anyone wanting to accuse me of libel or slander needs to do a little research. Libel and slander both constitute of something FALSE/UNTRUE being said/written/spread about an individual and/or business.
However, if the TRUTH is spread, and the individual and/or business's reputation suffers from this- it does not constitute as slander or libel.
As I have said many times, everything I have said in any of my posts is nothing but the truth. I have plenty of people (witnesses, DVM's, resources, veterinary reports, research, etc) to back up every statement I have made.
Thank you :)
#14 Consumer Comment
AUTHOR: Ripoff Reporter - Sacramento (U.S.A.)
SUBMITTED: Saturday, January 17, 2009
POSTED: Saturday, January 17, 2009
Pomlover, its funny that I came across this. I searched under Heavenly Terriers and this report came up. Heavenly terriers sold Yorkie pups WITH PARASITES to my California breeder.....hmmmmm. Makes all those people who defended her and mentioned the word "slander" are being proven that they are incorrect. I also read all the comments on here and think that all the people "defending" her actually make her look worse in my eyes. You never made comments about her character, just your experience. As a bystander, that is clear. If someone were TRULY innocent they or any of her "friends and colleagues" wouldnt see the need to post on here and argue with you. The fact that they take offense is prrof enough that the TRUTH about Tammy hurts!! Im very sorry for what happened to you and will spread the word so people dont have to go through what you did. Terry sold Yorkies to Kim Hinkle, from what Kim says that all had parasites and in turn Kim's whole line at My Elegant Paws had parasites. Kim also sold her pups KNOWING THEY HAD PROBLEMS to people and walked off with their money....are all backyard breeders alike? I sure wish there was some type of authority to investigate these people....and do you think they pay a bit of taxes on all these pups worth $800 and up????? Im glad you post your story and know others will read this and think you were nothing but honest, never nasty like the rebuttals were.
#15 Consumer Comment
AUTHOR: Devilsadvocate4education*just My Opinions* - Las Vegas (U.S.A.)
SUBMITTED: Saturday, January 17, 2009
POSTED: Saturday, January 17, 2009
Well, I knew early on in this story that that puppy was very likely going to show up with a liver shunt. It has become my habit to ask everyone with a new super tiny puppy to have their vets run the test. I knew when someone who appeared experienced with caring for hypo animals could not keep him 'up'. This has always been a major sign to me. Also, did he not start to turn yellow (eyes, gums, ect.)? If the two happen in conjunction, DEFINANTLY a liver shunt to me. While sometimes it is simply the puppy whom goes 'hypo' often, and no problems exist, it most definantly signals a need for testing to me. And sometimes just because the animal is so much smaller than is typical for it's breed can signify a need for the test for liver shunt, even when they are showing little to no signs like would be apparent in the tiny breeds who appear to go 'hypo' in alot of cases(seen this in bulldogs and such). I would like to address the issue of the Metronidazole, AKA Flagyl. I do not believe (though can not know) she was aware of the problem based on that. While I have never seen it used for a liver shunt, I have seen it used thousands and thousands of times to treat and prevent parasites. If you walk into your local pet shop and ask to see the records, you are likely to see it on alot of them, if not all, given either preventativly or as treatment. It is used to prevent and treat giardia most of the time, things like that. We are talking about one of the most commonly prescribed medications for diarreah. So it makes sense. I also use it on my fish for certain things. So, I am sorry for your heartbreak. I have been through it, and I know how much it hurts. Good luck to you. *just my opinions*
#16 Consumer Comment
AUTHOR: Thomas Craven - Summerville (U.S.A.)
SUBMITTED: Friday, June 12, 2009
POSTED: Friday, June 12, 2009
You stated that you are getting a full refund, you were not RIPOFF.
#17 Consumer Comment
AUTHOR: GLM - Crown Point (USA)
SUBMITTED: Tuesday, October 13, 2009
POSTED: Tuesday, October 13, 2009
Well this is really odd. I never expected to read a report on this site and have it convince me TO buy from a particular business. But reading about the kennel's clean, happy, groomed & handled puppies & dogs with individual medical records, it was pretty easy to differentiate this business from a "backyard breeder".
Obviously the person writing this article (“Pomlover”) has NO idea of the conditions & poor quality animals used in a backyard breeder or hoarder situation. AKC certainly won't certify a place that isn't clean, well organized, with happy dogs that it takes excellent care of.
I am MORE than happy with the puppy I bought from Tammy, and very impressed with the care she takes of her animals and her business - AS IS my vet. He was very impressed with how well my puppy had been raised - he'd obviously been handled and groomed a lot and all of his needs taken care of.
And the best part of all of that is how confident he is in new situations (we've been to a couple of horse shows & a horse wellness clinic, and of course the park & Petsmart!) - he's been given the right upbringing and handling to trust "his people" & not be fearful of new people (even kids!) meeting & petting him, crowds, other dogs, noise - anything.
That isn't the type of personality that comes out of a bad kennel situation at all. I think the person writing the article needs to worry more about those voices in their head they were talking about than any non-existent problems with this breeder or their program & premises.
On 8/17/08 the writer "Pomlover" posted a rebuttal to his/her own “ripoff report” article saying: I just want to say again, I am in no way trying to bad mouth Tammy Price, she was a nice lady. I just want people to be aware of things like this so they don't experience the same thing!
And on 8/19/08 you posted ANOTHER rebuttal to your own report, saying: want to say AGAIN I am not saying Tammy sold us the puppy knowing it had all of these problems, or that she gave the Metronidazole knowing he had liver problems.
But in your report you OBVIOUSLY imply that Tammy knew he had a liver shunt with your extremely snide comment about “Tell me if thats not just to coincidental?”
And you also spew all that junk about the voices in your head telling you to “get away”, and comment on one of Tammy’s personal pets that has hair loss (which was apparently explained in yet another rebuttal on here and isn't even from Tammy's breeding). How exactly is it horrible that she keeps Poms as pets after retiring them from breeding, or if they're not breeding candidates? Were you trying to imply she was breeding animals with hair loss problems? Or had some disease causing hair loss? You say yourself that you are NOT, but I don't see the point of bringing up all of the points in your story if you weren't. It's pretty obvious you are trying to imply any bad thing you can possibly think of. So someone else has to come on and explain that that dog was a pet, and spayed or neutered, and doesn't have a disease.
Your protests that you aren’t trying to "slam" this breeder are COMPLETELY contradicted throughout your story.
I see that when you took the puppy to the emergency vet, he suggested it was a liver shunt, but you never did a thing about that – and if you had, you could have had him operated on instead of letting him die with his body filling with toxic waste as he struggled for breath. You waited until the day before he died to get him back to the vet, even after DAYS of him being "depressed, dizzy, lethargic, vomitting, wheezing, stumbling, and finally couldn't even get up". The more I read this “report”, the more disgusted I am with the way YOU/"Pomlover" handled the whole thing, including reporting the breeder. Next time wear some head phones to drown out those voices in your head. I'm really sorry for that puppy and what he went through, and your reaction was completely inappropriate.
A VERY HAPPY PUPPY OWNER
#18 Consumer Comment
AUTHOR: bouvierlover - Hanford (United States of America)
SUBMITTED: Sunday, February 27, 2011
POSTED: Sunday, February 27, 2011
As a breeder with more then 10 years experience as a Veterinary Technician, I just have to say WOW. First, I do not know any of the party's involved and I am sorry to hear the puppy was lost. But you really should be complaining about the Veterinarians.
You say the puppy was 10 weeks old when you got it, he seemed healthy for the first week, making the first episode happend at 11 weeks of age. Hypoglycemic puppies generally out grow it BY 12 weeks of age, that should have been the first big red flag. Even if hypoglycemia was the first thought, blood work still should have been done just to have a guideline of what his blood values are. Had the Vet done this, you (and the puppy) may have been spared a lot of pain.
To blame the breeder is out of line, you, yourself, state the puppy was / seemed to be healthy for the first week, how was the breeder to know that there was going to be a problem. You also state that the puppy's records show he was on Metronidazole. Did you know that metronidazole is used for MANY reasons. I use it on my dogs to treat various bowel disorders, such as Giardia.
It is impossible for a breeder to prevent parasites 100%, we do what we can. But unless you keep every puppy CAGED by itself and are able to clean the fecal matter the second it comes out, they will cross contaminate!!!
I too, keep my dogs kenneled, this is for their protection and to ensure the integrity of my breedings, if all my dogs were loose, I would not be able to control who each bitch was bred to.
About the hairless pom, did you ask what the story was?? As an adult, you should be asking questions, when you have reservations. Myself, as many other breeders, take in rescues. Is it possible that could have been the case???
I also have to ask, what more did you expect of the breeder?? She offered a replacement, but you did not want one, so she gave you a refund. Did you want her to clone the puppy for you???
#19 Consumer Comment
AUTHOR: pomlover - (United States of America)
SUBMITTED: Friday, December 09, 2011
POSTED: Friday, December 09, 2011
And although it has been years and I have since moved on from this horrid situation, it still haunts me. What my poor little baby went through, what I went through... I will never forget the pain of the whole situation. I am only here to make something clear, because apparently some people have the wrong idea.. to be clear I was NEVER given nor offered a refund by Tammy Price. I was ignored. I was out $800 plus vet bills which was the least of it... The worst part was the suffering my poor puppy had to endure, and then to be treated the way I was by a “loving“ breeder who sold me a puppy with a liver condition. All in all heartbreaking. I did EVERYTHING I could to help save this puppy, as soon as the issues arised. Just now years later I am finally in a place where I can even consider getting a new puppy, and I'm still scared because of this nightmare.
#20 Consumer Comment
AUTHOR: Belen - Dallas (United States of America)
SUBMITTED: Saturday, May 05, 2012
POSTED: Saturday, May 05, 2012
I would like to comment on my experience with tammy price i have bought a pom from her and i paid 1000.00 for her she is just like in the picture that i have received from tammy, she is so beautiful and i am so so happy with her i would by more pom from her if i needed too. maybe you had you dogs round your puppies that were sice or just like the one i had bought from another person in Colorado i kept it inside with us, but when i let her go outside i did not know that when a dog is sick and a puppy steps where there were they will also get sick because there system is not strong like a adult dog in a few days later i took her to the vet and she had gotten provo and 2 days later she died.
we had to bleach everything and not bring any pets to our house till after 1 year to make sure the parvo is gone.
believe me it hurted us because we loved her so mush she was just like part of our family.
1 year and 1 /2 later that is when i found Tammy Price i fell in love with a pom she had but it was already sold to someone in alaska, she said she didn't have anymore like that but if she does she will call me well she keep her promes.
she called me that she had a pom just like the one i wanted i was so suppressed that she calle me back after a total of 2 years and thats when i got the pom from her..
all i am saying is that its like people we look and feel ok but then all of the sudden thing change i am sorry to read what happened to you but you honestly can not blame her in my oppion i now for a fact that all her pom are beautiful and in great health. but like i said you can not really blame her for that..i know if she did give you a puppy that was sick she would not even take the risk to sell a pom like that thats her reppuation.
and i'm pretty sure that if that was the case you could have talk to her and returned the puppy back after you had the puppy checked out within the 72 hours you received it she would had given you another puppy but you had to prove that it was.
i am very very happy with her services.
i am speaking an customer .
what would have happen if the shoes was on the other foot what would you have done if you knew the puppy was in great health and this happen to someone else and they reported you what will you do.???
i am just saying fom the experience that i had with her and the other persons that i also recommend to buy a pom from her..
we are very happy.
that is just to say i speak for her as a coustomer i would continue to buy pom from her and everyone else that asked me where i got my pom i would tell them
..
