Why is little Lili so different from all the other puppies?

Meet little Lili, a 6 month old Maltese Shitsu cross. We first met Lili when she was referred to us by her normal vet. They were concerned that Lili was small for her age and unusually inactive - strange behaviour for a 6 month old puppy! Lili had some blood tests done which showed that there was a problem with her liver, but which needed an ultrasound to confirm it.

It was thought that Lili had an extra blood vessel, called a Portosystemic Shunt, which takes blood from her intestines straight back up to the large blood vessel that goes to the heart. Normally blood from the intestines goes through the liver first, where nutrients are metabolized, and toxins detoxified.

Lili was very well behaved and didn't need any sedation to do the abdominal ultrasound. And sure enough, the extra blood vessel was found, sitting just in front of her left kidney. It was about 6mm in diameter - a decent size for a blood vessel that isn't supposed to be there!

Since Lili had an anatomical problem that she was born with, the only way to fix it would be to do surgery. We could control her symptoms with medication and special diets however her prognosis would have been better if we went ahead with surgery.

A few weeks later we admitted Lili to do surgery. The extraneous blood vessel was found in the abdomen (we knew where to look because it had been seen on ultrasound) and tied a stitch around it to decrease it's diameter to 2.5mm! This would decrease the blood flow through the shunt immediately, and ultimately, over the next few weeks, Lili would form a blood clot inside the blood vessel, completely occluding it. This means that blood would be forced to go through her liver, like it is meant to.

Lili recovered quite well from surgery, she was on a lot of pain relief and is still on some medications to help her liver function better, but we hope she will be able to stop these soon. We look forward to following Lili's recovery closely, and believe she has regained her puppy playfulness already!

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