Liver issues?

Question
QUESTION: Hello,
this is a strange story but try to bear with it, its important to me. for a couple of weeks my pekingese was trying to get out of the house, whining, and just trying to leave. he is not neutered and so we think a female from our neighborhood must have been in heat. over these past couple of weeks, he refused to really eat anything, but was still drinking just fine. we even had to try to just force him. so then off to the vet, who took a regular blood test, fecal test for parasites and such, and an xray. the xray revealed his liver was a little small. according to the vet, the blood work didnt show any problems and he figured i should get an ultrasound to see what the issue was by an internist which costs too much money. i told him about the female in heat issue and he didnt think the lack of appetite was related to it. but a few days after he stopped trying to get out of the house (i guess the female was no longer in heat) he started eating again. he would even bark and demand to get food. he would eat a lot. but for the past couple of days hes been eating but a lot less of an appetite. doesnt bark and sometimes have to try and motivate him to eat something. sometimes he circles around the plate and tries to head butt it and then not eat. but sometimes he will eat a little after head butting it.

my vet initially thought he might have a liver shunt but i guess the normal blood test revealed that "nothing was wrong." we didnt take him to the internist for an ultrasound not only because it was too darn expensive, but also because he started eating normally again, but sometimes not as well. my main concern really is that i read somewhere that headbutting can be a liver issue or liver shunt. also, just the fact that he said that the liver was a little bit small really concerns me whether or not the blood test came back normal. should i be right to worry even though he doesnt show any real extreme liver disease symptoms except for the lack of appetite at times, and head pressing the food?

im sorry but i have had bad experiences with vets and am extremely skeptical of their judgment. i feel like even if i pay them a million dollars, they still wont come to any real conclusions and help me, and ill just end up with a sick dog and penniless in the end. i dont know what to do so please help me, tell me if im worrying over nothing?

thanks,
karmen

ANSWER: While dogs with PSS (portosystemic shunts) can have some head pressing going on, it is by far not one of the main signalments of this disease.
More commonly you are going to find a weak, undersized dog with vomiting, circling, and other symptoms of toxicity from the liver not clearing out the toxins in the body.

You do not mention your dog's age but this disease is most commonly found in dogs under one year of age. Acquired portosystemic shunts are seen in older dogs.

I think that this dog is unhappy with his food and is not happy being an intact dog that is frustrated from the scent of a bitch in heat. Dogs can smell a bitch for 3 miles which is the main reasons male dogs roam and get hit by cars.

I would think about getting this dog neutered and getting him on a different diet. He is doesn't sound like he has all the symptoms of having a PSS and if his blood work is normal (which it would not be with a PSS) then you need to consider the easy things first.

Some dogs have smaller livers by birth so without some other hard evidence I wouldn't be jumping on this bandwagon so fast.

Here is an article about PSS that you can read. The symptoms do not match what your dog is doing and the Merck Veterinary Manual also does not match what you are saying.

http://www.malteseonly.com/shunt2.html

the Merck:
http://www.merckvetmanual.com/mvm/index.jsp?cfile=htm/bc/23602.htm&word=portosys

So read up and those and then let me know what kind of diet this dog is on.



---------- FOLLOW-UP ----------

QUESTION: I really do appreciate the response. thank you. my dog is 4 years old now and i do agree he needs to be neutered soon. we change his diet  A LOT. i mean for the past 2 years now he also gets homecooked chicken on a DAILY BASIS. if he gets sick of that, he also gets homecooked beef especially for him. he gets fresh fruits and vegetables everyday. the dog food we give him is not what i would refer to as "crap in a bag" basically iams, purina, pedigree or any of those TERRIBLE dog foods that contain nothing short of garbage ingredients for a dog. so far, we are feeding him nature's variety instinct alongside his homecooked meats. and he's shunning away his homecooked meats!! if thats not an indication that something is wrong, then i dont know what is. but if this issue continues i guess i just need to go with an ultrasound and something else. but u are saying that older dogs acquire liver shunts? in what way and could this be the case for him considering he is only 4? thanks again!!

Answer
Older dogs usually means older than 8 yrs old. Home cooked diets are very unbalanced as is any dog food that isn't trial fed and tested.
You are correct about all those other foods but your food is just as bad if there is no proof that it works with years of testing and feeding.