Crystals on bladder, kidney.  Kidneys big, not unusual with this situation.  Spleen (not S-P-L-I-N-E !) OK.  Liver is small.  Gallbladder big - could be normal.  Blood vessel to liver - turbulence in vein.  Lots of blood outside the liver.  Not getting to the liver.  One vessel is 4x bigger than usual.

All in all, it's positive.  The main plus is that the shunt is outside of the liver so it's operable.  Because much of Bobby's blood does not pass through his liver, it took much longer for the anesthesia to exit his body.  The vet stated that Bobby might be very sleepy for two days.  He's pretty much back to normal today (and he greatly improved last night once he returned home and ate) although he's not as bouncy as usual.

On other subjects, today was the first day in ages when I a) didn't HAVE to be somewhere for the entire day and b) don't have any major items that MUST be done TODAY.  I did have the LA/SS newsletter hanging over my head and finished it last night.  However, I wanted to Alexa to read through it first as I haven't actually taught the units which I wrote about.  She made a few tweaks and I finished that newsletter once we returned from Clearwater Bay (James' tennis & Claire's piano lesson).

On the way home, we stopped at Metro City, Po Lam.  We went to Toys R Us as Claire received a gift certificate from piano.  (She actually wanted the cash so I said James could use the gift certificate towards a Wii game.  Tom's sister, Ann, sent Christmas money for both kids and James also has three weeks of pocket money saved. ) James ended up buying a Wii game from the store next to Toys R Us.  It wasn't an expensive game so he still has some money left over.  Claire bought another Zhou Zhou pet along with a "bed" for it.  It was so nice just to be able to be spontaneous and to NOT rush to the next place where we were due.

I finished the newsletter earlier and sent it out.  Another colleague emailed and stated that she could not open the file.  Not sure why so I've sent it again (in Pages) and also exported it to Word.  (Couldn't keep all of the formatting, though.)  Also sent the pdf so she could view it.  Hopefully one of those does the trick.

Read some more of Flyte, napped a little on Claire's very comfortable bed (LOVE her room) and just finished playing Wii with James.  I'm planning on walking down to the beach and hanging out there. 

Tom's in Macau today.  He returns tonight.

His coat is much silkier.  It felt coarse and dry when he arrived due to his liver issues.  Bobby is quite energetic and occasionally jumps quite high, nearly to James' shoulders on one occasion.

Next step is an ultrasound on Friday.  Tom will take Bobby to Mongkok.  Bobby will be NPO which will be a challenge - his appointment isn't until 2:00.  He is SO hungry now.

A few more pictures:

Bobby attacking his pillow.  You can see his shaved belly (from the previous ultrasounds).

The Wonder Dog pouncing on his tennis ball.  I love the fact that his hind legs are in the air.

His "boneless chicken" impersonation.

I also found this article very helpful:  Liver Shunts In Dogs – Why My Dog Went Undiagnosed For 3.5 years, and how to Spot It!

From the above article: 

Symptoms Bobby has displayed are in bold.

Here are the symptoms of liver shunts:

1. Poor Doer: A puppy / dog that is always always sick. Since shunts cause liver toxicity in the blood because the dog have not filtered the blood from the liver. This leads to various diseases, which occur frequently.

2. UTI: AWill puppy / dog that has frequent urinary tract infections or it looks like a urinary tract infection due to the many accidents in the house who is not able to be housebroken or urinating small amounts.

3. Bad smell: A puppy / dog bad breath, and / or urine has bad odor. Often, the urine is a darker color yellow instead of the "little" Yellow healthy urine. (Note: Puppies and young dogs should have good breath. Bad breath is a red flag that somethingis not correct)

4. Leader Presses: Dogs with liver shunts do not filter their blood, which results in ammonia buildup in the blood. Feel ammonia toxicity causes the head, funny – so they rub their heads a lot.

5. Crystals in the urine: This is the surplus of ammonia in their system. Every dog with crystals in the urine should test a bile acid.

6. Complete blood count (CBC): This test is simply given in the practice of veterinary medicine. Liver shunt dogs often have a lower thannormal urea and creatine count.

7. Depression: liver shunt dogs are not very active, or they can use for a very short time. You are a "silent" puppy or "silent" dog known. A "silent" Puppies usually not completely normal and all "quiet" Puppies should test a bile acid, to ensure that they are okay.

8. Lightweight: puppy with liver shunt looks normal with a milk content abdomen, etc. Since they are dogs, it is obvious they are growing thin. Their ribs showing, herBones are prominent and they do not develop muscle mass. Not all liver shunt dogs do have low weight, but many do. They tend to be light weight, because their liver does not record and process for these nutrients liver shunt dogs have to bring their normal weight.

9. Small: Dogs with liver shunts often do not grow as much as their brothers and sisters. They are smaller than normal, liver, and sometimes less than the normal functions. Wendy never developed the strong leg muscles that all greyhoundBreeds show.

10. Anorexia eating non Many liver shunt puppy / dog is usually not. They eat very little dog food. You can chow on a newly introduced canned food or people food – but almost always resort back to not eating much. Eating food makes them not feel well because of the higher toxicity, they have after a meal – so they tend to avoid food.

11. Race: Any race can have liver shunt, but Yorkshire Terriers are known for having them.

Tuesday night Bobby fell ill and was increasingly lethargic.  He vomited several times throughout the night and was not himself on Wednesday morning.  He deteriorated during the day and when I arrived home early at 1:30, he did not even open his eyes when I walked into the kitchen. 

We were at the Eastern Animal Hospital by 2:30 where Bobby was examined.  I asked if Bobby might have a kidney infection because he kept peeing on our floor.  He wasn't able to hold his urine for more than two hours which is unusual for a 9 month old dog.  The vet thought his kidneys felt enlarged so she pulled blood and took x-rays.  His kidneys were clean but he had two elevated levels in his blood test indicating liver problems.  At this point, the vet gave the differential diagnosis as either tick fever or liver shunt. 

Bobby stayed at the hospital (and is currently still there).  He's on an IV and has been switched to a low protein diet which is customary for dogs with liver shunt.  His weight was shocking.  He only weighs 13 lbs at the moment. 

The vet is pretty sure now that Bobby does have portosystemic shunt.  She will ultrasound again tomorrow to try and confirm where the open blood vessels are located.  Outside the liver is operable, inside is not.  In small dogs, the open vessels are much more likely to be outside the liver.

Too tired to explain liver shunt.  Will do so tomorrow.

Our family met Bobby's family in Ma O Shan.  The entire family was lovely and it made me very sad to watch them say good-bye to their wonderful boy.  (Dogs are not allowed where they live.) 

Claire is absolutely THRILLED and James is as well.  (According to James, he's Bobby's father and Claire is Bobby's mother.  Tom and I are the grandparents.)

Bobby is settling in but he must be confused.  He's a very smart and calm dog, wonderful on a lead. He enjoyed walking around Stanley waterfront, especially when he was able to "say hello" to other dogs.

You are cordially invited to our simply MAD production of Alice in Wonderland.

How mad and wonderful is this show? We have fabulous costumes from Australia, original music from America, a pretty set designed in Hong Kong and a talented cast of performers waiting to entertain you on stage.

Find out more about our production at the Facebook event page. We have photos of some of our delicious costumes, fun articles from Time Out, Parents Journal and local papers as well as a Morning Brew chat with Phil Whelan on RTHK radio 3 online.

Its a big show and we need a big audience to come see it. We're only on one week - Thursday Jan 21st - Jan 24th only.

Suitable for all ages, even the big ones.

Best Regards
The Production Team of Alice in Wonderland

If you are still interested in booking some more tickets, please call 2111 5999 or buy online www.Urbtix.hk.