Portosystemic Shunt (Liver Shunt) in Malteses
Hepatic condition — Maltese — Small breed
Moderate RiskWhat is Portosystemic Shunt (Liver Shunt)?
A portosystemic shunt (PSS) is an abnormal blood vessel that bypasses the liver, allowing toxins normally filtered by the liver to circulate in the bloodstream and reach the brain. Congenital liver shunts have a heritable basis in several small breeds. Signs often appear in puppyhood or young adulthood.
Symptoms of Portosystemic Shunt (Liver Shunt)
- Poor growth and small stature compared to littermates
- Disorientation, confusion, or apparent dementia after meals
- Circling, pressing head against walls
- Seizures
- Excessive drooling and nausea
- Increased urination and thirst
- Urinary crystals or stones (ammonium biurate)
How Is Portosystemic Shunt (Liver Shunt) Diagnosed?
Blood tests show low BUN, low albumin, elevated liver enzymes, and elevated bile acids (pre- and post-prandial bile acid test is the primary screening tool). Ultrasound can identify extra-hepatic shunt vessels. CT angiography or scintigraphy provides detailed vascular mapping for surgical planning.
Treatment & Cost
Surgical attenuation of the shunt using an ameroid constrictor or cellophane band is the treatment of choice and is curative in many cases. Medical management (low-protein diet, lactulose, antibiotics) is used pre-surgery and for dogs not surgical candidates. Surgical outcomes are excellent for extra-hepatic shunts.
Most pet insurance plans cover portosystemic shunt (liver shunt) treatment in full when the policy is active before diagnosis. Compare plans below.