neurological issue....liver shunt

[Yorkieluv]

She's having hepatic encephalopathy symptoms...I know it's hard to see her like this, but I'll do my best to help you.

Liver compromised dogs refuse food when the toxins have built up. Has she had a BM today?? This is extremely important. When was the last time she ate and how much?

Not only is adding water important, but it is important that you begin her on a feeding schedule so you can regulate the amount of protein that she gets at each meal.
Before I learned all of these things, I also free fed RC Hepatic but once I learned about the water and importance of several small meals, it made a huge difference.

[scrappymomma]

I forgot to mention that her breath is really bad too.... not just stinky dog breath but a funky bad breath that I havent smelled before.

[Yorkieluv]

Yep, the stinky breath is a sign that ammonia/toxins are built up big time. Has she had a bowel movement today?? If she has not had a bowel movement, then it is very, very important that she does this. If it were Miko, I would give a dose of lactulose per hour until he had one...I have had to do this before. The only side effect to lactulose is diarrhea, and it sounds like she needs to be cleaned out anyway because of all the toxin build-up.
If not, then you may need to take him into the vet's office for an enema to make her poop...Do not let them give her valium or anything like that as it can send her into a worse state because it is very hard on the liver.

[Ladymom]

Originally Posted by Yorkieluv

She's having hepatic encephalopathy symptoms...I know it's hard to see her like this, but I'll do my best to help you.

Liver compromised dogs refuse food when the toxins have built up. Has she had a BM today?? This is extremely important. When was the last time she ate and how much?

Not only is adding water important, but it is important that you begin her on a feeding schedule so you can regulate the amount of protein that she gets at each meal.
Before I learned all of these things, I also free fed RC Hepatic but once I learned about the water and importance of several small meals, it made a huge difference.

That was my first thought, but I hesitated to post it.

Here is some information from Dr. Tobias/University of Tennessee:

http://www.vet.utk.edu/clinical/sacs....shtml#hepatic

[scrappymomma]

This is gonna sound terrible but here it goes. I dont know if she has had a bm or not, with 4 of them I dont know if she did or not. I will definitely watch from now on. She hasnt eaten today. I gave her denosyl this morning on a empty stomach and she hasnt eaten since. Shes been like this almost all day. Should I give her more lactulose to make sure she goes? I know she hasnt pooped since 1pm but not sure about before. She hasnt been out of my sight since 1pm.

[scrappymomma]

Thanks again .... I type so slow, you already posted about the lactulose by the time I finished typing. Im gonna give her more lactulose right now.

[Yorkieluv]

If she's acting like this, then honestly, she probably did not have a bowel movement, but if she did, it must not have been much...Many times, liver compromised dogs have a problem storing glucose, so it is necessary to never let them go long periods of time without food because this can cause problems in itself. If there is any way that you can get her some PediaSure or DogSure until you can get her back to eating, this would be a good thing.

You mentioned that she hadn't peed in 5 hours....Has she tried to urinate at all?? The last time she peed, what color was her urine? Is it typically dark? Her urine should not be dark. I would recommend having a urine sample and culture taken. Have them check for crystals...This is also very important. Liver compromised dogs typically get ammonium urate crystals and stones because their livers are not functioning properly and this can also cause problems. This is another important reason to add at least equal parts water to each of her meals. You need to keep the urine dilute so that the crystals/stones do not have a chance to form.

[Yorkieluv]

Push fluids however you can...If you have to syringe water into her mouth little by little, then do that. If you have watermelon, give her some of that. The moisture should be good for her. If you have apples, give her some pieces; the fiber will help bulk up her stool.

[Yorkieluv]

Originally Posted by Ladymom

That was my first thought, but I hesitated to post it.

Here is some information from Dr. Tobias/University of Tennessee:

http://www.vet.utk.edu/clinical/sacs....shtml#hepatic

Excellent link!!

Scrappymomma, read that as soon as you get a chance so you can understand hepatic encephalopathy...

[scrappymomma]

Is the pediasure sold at Petsmart or the vets? I will definitely try to get some in the morning.

Her urine is darker than the others but not much darker. She just urinated now and I checked it, it looks like it usually does. Should I give her fluids every hour? How much would you suggest?

I usually try to make sure she eats a few times a day but today she wanted no part of it.

[scrappymomma]

That is a great explanation. I am frustrated that my vet doesnt suggest anything for her. Thank God for the internet, I dont know what I'd do otherwise. I am gonna stay up until she has a bm tonight. I am thrileed she actually stood up on her own to urinate. It scares me to see her this way, I am dreading falling asleep. Its pretty amazing how the other 3 Yorkies know something is wrong with her, they are completely leaving her alone. Her sister did smell her once but just walked away. Their dimeaner is so different today than usual.

[Yorkieluv]

Darker urine and crystals/stones are some of the "symptoms" of liver problems, so that's why I asked about her pee If she's dehydrated, I would try to give some fluids every hour until she starts looking better. How much lactulose does she typically get in one day and does she usually have 2 BMs per day? If not, then you need to work with your vet to increase the dosage. When I have encountered this problem before, I usually increased by a dosage of .5 ml per day until his poop was the right consistency. It takes some tweaking, but once you get it right, you will notice a positive difference.

If you have any other questions, let me know...Also, the liver shunt/mvd group is a great place to post things like this as you will get several answers as well. If you post on the liver shunt group, I will be sure to see it because I am always on there. I am going to bed unless you have any questions right now.

Feel free to pm me as well...

[scrappymomma]

One last question before yo go to bed..... should I try to get her to eat or is she okay? I will watch her carefully tonight. Thank you so much, I will let you know how she is in the am. Have a good night sleep

[scrappymomma]

Oh she gets 2cc of lactulose daily but I think I'll increase it.

[Yorkieluv]

Originally Posted by scrappymomma

That is a great explanation. I am frustrated that my vet doesnt suggest anything for her. Thank God for the internet, I dont know what I'd do otherwise. I am gonna stay up until she has a bm tonight. I am thrileed she actually stood up on her own to urinate. It scares me to see her this way, I am dreading falling asleep. Its pretty amazing how the other 3 Yorkies know something is wrong with her, they are completely leaving her alone. Her sister did smell her once but just walked away. Their dimeaner is so different today than usual.

If you go on the liver shunt group, I can direct you to certain documents in our Files section that you can take to your vet. Many of our members have had to take information in to their vets regarding diet, supplements, lactulose dosage, etc.
Most vets are not experts on liver disease. You are your pet's best advocate, and that's why it's so great that you are asking lots of questions....Arm yourself with the knowledge so that you can get your baby the best care possible. Read through the Files section.
I can't tell you how many times vets have practically given up on Miko, but I will tell you something...I researched until I was blue in the face and have been able to nurse him back to health. He has been seizure free and stone free since around July '07
We get down to the tiniest little detail...