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Maltese Health Issues

Letter from the University of Sydney  NSW Australia  for Dr Geraldine Hunt - re Liver Shunt               click on to read letter     -     Uni of Sydney - G Hunt

 

CONGENITAL PORTOSYSTEMIC SHUNTS IN MALTESE

 

Maltese have an increased prevalence of Congenital Portosystemic Shunts or CPS. The Maltese breed predisposition has been noted not only in Australia but also in North American Maltese.  In this condition an abnormal blood vessel allows blood to bypass the liver.  The signs seen in this condition are variable and may include depression, lethargy, weight loss, vomiting, diarrhoea and drooling.  Because the signs are non-specific and may be mild the condition may never be diagnosed or diagnosis may be considerably delayed.

 

One of the first tests that can be suggested is measuring the Bile Acids in the blood.  This is a simple test which measures the level of bile acids in the blood taken two hours after feeding.  Maltese that return abnormal values need a follow up test to determine whether blood shunting is present.

 

Gameford Maltese (Australia) arranged for over 100 Maltese which were clinically well, and have found that many have returned abnormal results on initial testing.  Follow up tests did not show any Shunts in any of these Maltese. It is suspected that bile acids are broken down by the body differently in the Maltese breed.  This was an important finding as Bile Acids are a commonly used test of Liver function in the Veterinary practice in Australia and it is needed to establish accurate normal ranges for the Maltese breed.

 

Some of the Maltese tested readings.

 

Tattoo No       Name Bile Acids Ammonia Tolerance         (2)Pre                  Post

 

GFD068          GAMEFORD CANDA MAGIC  -         47.37     -      30.0 -     20.0

 

GFD061          GAMEFORD JINNIVAH   -                   25.89     -     46.78  -   29.3

 

GFD042          CHERMERA CANDA MAGIC  -          75.00      -      67.0   -  55.0

 

GFD014          JAMEBECO SIR ERICH    -                   98.79    -      48.78  -  78.51

 

GFD019          CH COSYVISTA PAGE BOY         -      50.72     -      56.96  -  95.56

 

GFD018          PATRICIAN PRAEGO AMEE        -     63.32      -     34.00   - 65.00

 

GFD017          WHITESILK LITTLE EGRET      -      24.48      -     58.00  - 110.00

 

GFD601          CH SNOWDANCE THE COWBOY  - 71.00        -     52.0   -  89.00

 

GFD066          MARBLANC TAILOR MAID       -      75.00        -     44.93 -  54.68

 

GFD047          NADIFOME SWEET SUCCESS (Sister)  - 125.0   -   62.0  -   52.00

 

GFD046          NADIFOME PROUD ONE   (Litter sister)  - 65.42  - 39.03 -  72.38

 

 Ammonia Tolerance tests involve the following procedures:-

 

Enema (Microlax) to empty the rectum of faeces which could interfere with absorption of ammonia.

Pre-ammonia blood sample

Rectal administration of 2ml/kg of a 5% solution of ammonium chloride.

Post-ammonia blood sample 30 minutes later.

Ammonia is absorbed through the wall of the colon and into the portal vein (the vein that takes all the blood from the gastrointestinal tract in the liver).  In normal dogs most of this ammonia is removed in the liver before the blood returns to the heart.  It is expected therefore that the pre and post blood samples will have similar levels.  This level is up to 50 umol/1 according to the laboratory normal range, but in practice as long as the increase is not large, value around 70 can be considered normal.  In animals with portosystemic shunts, portal blood is able to bypass the liver so the ammonia is not broken down and it can be expected larger increases in post-ammonia levels.


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