Pom Health

Treatment Options for Liver Shunts In Puppy Pomeranians

Pomeranian Headquarters

Sharing is caring!

Last Updated on 07/09/2023 by Dochlaggie. Post first published on March 10, 2022.

N.B. This article regarding the Pomeranian puppy liver shunts has been written in consultation with our resident Veterinary Doctor, Dr. M. Mushtaq DVM. MSc. (Hons.)

While the puppy develops inside his mother, there is an extremely small chance of a liver shunt in puppy occurring. While a dog is a foetus, he needs assistance from the mother’s liver to help detoxify his systems.

Embryos don’t have a functioning liver until near the end of the gestational period. At the start of gestation, a naturally existing liver shunt pushes the blood into his liver and then out again where it heads straight for his heart.

So the mother’s body needs to handle the detoxifying process for both herself and her foetus. Ductus venosus is the name of the liver shunt that works while a puppy is still developing inside his mother.

Just before puppy is born, this shunt must close so the puppy’s liver will start to work properly on its own. If the shunt doesn’t close off prior to birth, leaving an open shunt, this is known as a patent ductus venosus and the puppy is born with this intra-hepatic liver shunt.

Portosystemic shunts occur if there’s a genetic anomaly, meaning that the blood flow gets routed around the liver when it should flow through it. The extra shunt also happens when the pup is growing in utero. Acquired shunts can occur as well in large breed dogs and small breeds.

Liver Shunt in Dogs Symptoms

There are various signs and clinical symptoms that a liver shunt may exist and stops the liver from performing its two main functions:

  •  Distribution of protein to help the pup grow better and possess functional nutritional response.
  •  Proper detoxification of the body.

There are two types of clinical symptoms to watch for:

  1.  Toxicosis. This can depress the puppy’s central nervous system and cause diarrhea, vomiting, stupor, and lethargy. In the most extreme cases where the detoxification process isn’t occurring, and toxins cross the brain-blood barrier, your puppy may experience seizures and various nervous system side effects.
  2.  Stunted growth. If this problem happens, your puppy may not grow properly. Poor muscle development, his muscle tone can be poor; he may remain tiny in size; he’ll sleep much more than usual, and he won’t develop as well as other puppies in his litter.

Dog Breeds Prone to Liver Shunts in Dogs

  1. Large breed dogs prone to having an intrahepatic shunt include: Labradors, Samoyeds, Australian Cattle Dogs, Old English Sheepdogs, and Australian Shepherds.
  2. Small and toy breeds more commonly have extra hepatic shunts and these breeds include: Jack Russell, Lhasa Apso, Poodles, Shih Tzu, Cairn Terrier, Maltese, and Yorkshire Terriers.
Liver Shunt In Puppy Pomeranians
Liver Shunts In Puppy Pomeranians

Using Blood Tests to Detect a Liver Shunt in Puppies

To diagnosis congenital liver shunts in puppies is extremely hard to do. If he’s born very small, doesn’t put on weight or thrive, and has visible issues with his central nervous system, they’re definite indicators to check.

However, in mild cases it may be hard to correctly identify if the shunt isn’t very significant. Certain blood tests can help identify the presence of a congenital portosystemic shunt.

The puppy’s liver function is monitored. Blood-Urea-Nitrogen (BUN) level may be low (this is a kidney measurement), as can albumin levels (a circulating protein). AST and ALT (liver enzymes) may be higher than normal and they indicate that the liver has been damaged and a portosystemic shunt exists.

The main test to determine whether dog liver shunts exist is a test for bile acids. The liver creates these acids and they’re stored inside the gallbladder which then secretes them to enable your pet to properly absorb fat. They’re then absorbed by the small intestine and the back to the liver for recycling.

If your Pomeranian’s liver doesn’t have sufficient blood flow to recycle the acids, their value can become very high when blood works are done. Most labs find that the values of the bile acid is lower than 20. You may be able to identify a liver shunt is present in your pet because her bile acids are more than 100.

It’s essential that your vet does pre-anaesthetic bloodwork and checks your puppy’s internal organs is because puppies are usually neutered or spayed when they’re six months of age and checking that his organs work properly isn’t necessary for a puppy that young.

If your puppy takes twice or three times as long to recover from an anaesthetic, the vet may be surprised, or even shocked, to discover the puppy does have a liver shunt. If his blood isn’t flowing properly, the anaesthetic can’t be dispersed properly because it’s the liver that processes anaesthesia. It’s the worst way to learn of the existent of a shunt.

Your Veterinarian should always be proactive and check blood work and organ functions prior to having anaesthesia for the very first time. Your dog’s liver function must be sufficient to cope with anaesthetic at any time.

Liver Shunt In Puppy Pomeranians
Liver Shunts In Puppy Pomeranians

Extra Diagnostic Tests Detect a Liver Shunt in Puppies

Other diagnostic tests are the only way to learn if the puppy has a liver shunt and whether it’s intra (in the liver) or extra-hepatic (outside the liver).

These include:

  • CT scan.
  • MRI.
  • Ultrasound.
  • Testing liver blood flow.
  • Surgical exploration.

If you know your puppy’s quality of life is poor, then it’s time to carry out these tests as they can be costly. If your puppy isn’t growing as well as he should, or has signs of central nervous system issues, it’s time to consider what tests and medical treatment to carry out.

If his health is deteriorating to the point where he may have to be euthanised, that’s certainly a time to run these tests. Once the vet has got the results of all these tests and knows what the exact problem is, he can evaluate whether surgical intervention is appropriate because this is the best method for treating most liver shunt scenarios.

Liver Shunt In Puppy Pomeranians
Liver Shunts In Puppy Pomeranians

Treating a Liver Shunt Pomeranian Puppy

If your Pom does have a liver shunt but there are no visible symptoms and it’s only because of blood work that you learn that your Pomeranian has a problem, there are various forms of treatment that can be used (other than surgery).

Treating a liver shunt puppy via surgery to repair any blockage or abnormal blood vessels with specially designed tools or vessel closure with suture materials is another option.

However, if it’s an intra hepatic shunt, it’s harder to fix with surgical correction. The prognosis isn’t very good and there the risk of other complications occurring after the surgery has been carried out. On the other hand, extra hepatic shunts can be fixed quite easily through surgery. This can prevent further complications and ensure your pet has good quality of life.

When surgery is not in favour of a dog, then medical management and diet management can reduce the symptoms and prolong the dog’s life.

Soy protein is the best option for protein addition in feed (there will be fewer chances of hepatic encephalopathy when using soy as a protein source), and this protein will increase liver antioxidant capacity.

There are a number of herbal compounds that can help your pet’s body detoxify itself. These include: dandelion, milk thistle, acetyl methionine and SAM-e.

You can also use various Chinese herbal remedies and other homeopathic concoctions to help his body become detoxified. Look at the food you give your dog and how much nutrients are contained in each different type of food.

Liver Shunts In Puppy Pomeranians
Liver Shunts In Puppy Pomeranians

Dietary Management- Low Protein Diet for Dogs with Liver Shunt Issues

As carnivores, dogs must be fed protein to live a healthy life. His liver processes protein so if there’s a shunt, he can’t deal with the protein he’s given and his diet needs to be modified so he eats less protein. He can’t be on a NO-protein diet or he may suffer from hypoproteinemia.

Because you feed him less protein, the type and quality of protein you do feed him MUST be top quality protein such as human-grade meats. In an ideal world, choose organic, raw meat as the base for his meals. It’s critical that you learn more about what constitutes high and low quality protein and your vet can offer advice in this matter.

Many of the commercially available diets for dogs with liver shunts contain a low grade of protein. While it IS rendered, the dog will still have difficulty processing the protein. The perfect diet, if your beloved dog has a liver shunt, is a homemade diet. Then you know exactly what you’re feeding your dog.

Talk to a pet nutritionist or other veterinary professionals for expert dietary management advice so you’ll know what dietary changes to make. While food needs to be low in protein, it also has to satisfy his nutritional requirements with regards to vitamins, minerals, fatty acids and antioxidants.

Pomeranian dogs with shunts are more prone to bladder stones due to a reduction in minerals in their diet. If you can give him sufficient nutrition, you’ll hopefully avoid that problem, as well as any additional stress on his kidneys.

Liver Shunt In Puppy Pomeranians
Liver Shunt In Puppy Pomeranians

Final Thoughts on Liver Shunt In Puppy Pomeranians

Your pet nutritionist will work with you to design a well-rounded diet that has less protein but more of the healthier foods to ensure he lives a long, healthy, happy dog, despite the existence of a liver shunt that prevents his liver from performing at 100% efficiency.

Copyright Pomeranian.org. All Rights Reserved.

Disclaimer: The Content is not intended to be a substitute for professional veterinarian advice, diagnosis, or treatment. Always seek the advice of your veterinarian with any questions you may have regarding the medical condition of your dog. Never disregard professional advice or delay in seeking it because of something you have read on ANY website.

N.B. This article regarding Pomeranian health issues was written in consultation with our resident veterinarian.

Dr. Muqeet Mushtaq
DVM, University of Animal and Veterinary Sciences, 2019
MSc. (Hons.) (Animal Breeding & Genetics), University of Agriculture Faisalabad, 2021

References and Further Reading:
Official Standard of the Pomeranian (AKC). American Kennel Club, 2011.
Official English Kennel Club Pomeranian Breed Standard , 2017.
Denise Leo, The Pomeranian Handbook.

The Pomeranian Handbook


Denise Leo

Pomeranians are my passion, and I have shared my life with these darling little dogs for many decades. The creator and face behind this website is published author and Pomeranian breed authority Denise Leo of Dochlaggie Pomeranians.

Denise Leo
Denise Leo