neurological issue....liver shunt
 

I have a little girl with an irrepairable shunt. She is 15 months old and today at the vets weighed in at 4lbs 1 oz. She has been diagnosed for about 6 months now and is on RC 14 food, lactulose, marin and denosyl. For the past few months she has been doing great. Today she is not doing so good and I am very worried. She had a seizure earlier and is pretty lathargic and weak. Her head kinda shakes and now that is is walking again she is walking kinda sidewards. Earlier she couldnt even stand without collapsing. The vet did put fluids under her skin because she was dehydratedwhich I dont understand, she hasnt been vomiting or diarrhea. The vet said to syringe her pedialyte and try to get her to eat. Gosh I am just so worried about this baby. Is there anything I can do to help her or something that Im doing wrong? She hasnt urinated in almost 5 hours also. Please help with any advise.

also how much pedialyte should I be giving her? Ive been giving her 2 cc's per hr.

I am so sorry to hear that your little girl is not doing well. Hopefully, this is just a temporary thing and she will be better soon. You are both in our thoughts and prayers. I know you are worried about her. It is always so scary when things do not go well for our little ones. Alyssa and Emmy send your little girl yorkie hugs and kisses. We all wish her the best in days to come. Hopefully, she will get everything under control and not be in constant pain. Prayers being sent from us to you.

Are you sure she didn't get a piece of something she shouldn't have?
I would be so worried but if it is just one bad day, then maybe it is okay. If it were to go on I would definately change her diet. I know RC 14 is one of the best for this but sometimes it just doesn't cut it.
I have no idea why the fluids if she wasn't dehydrated.
Have you tried some of the techniques like giving part of a juiced zuccini to clease the liver?

Poor girl...I'm sorry.:(

aww sorry to hear about your little girl sending prayers her way

OMG Kelly i am so sorry for you and your little girl, i know how much you love her, wish i could help you...hope she feels better tomorro, will try to call you. Sending you hugs
Call me if you want to talk !

thanks everyone Im trying my best to stay positive.

Ellie May... the vet said she was dehydrated and gave her the fluids. I just dont understand how she did get dehydrated without vomiting and/or diarrhea. Do you think I can syringe the juices zucchini? She will not drink on her own unfortunately. She just wants to lay and either stare or sleep. It kills me to see her this way.

I don't have any advice, but I can pray:hands: I hope it's not serious:(

Hugs!!

Yorkieluv gives Miko juiced zuccini or celery quite often. You could talk to her about that. If she isn't drinking though, she needs water before zuccini... PediaSure is usually recommended above PediaLyte because it has more vitamins in it.

Are you a member of the yahoo liver shunt group?
How much does she weigh?

Since she hasnt eaten today should and could I give her nutri drops or should I give her nutrical? Sissy is 4 lbs. We are on the LS group, Im going there next. Thanks again!!

I just want to let you know that I'm typing some info that will help you, but it will take me a few minutes...

Hi scrappymomma, I'm so sorry that your little girl is so sick...She's dehydrated because RC Hepatic LS 14 is a dry food, and liver compromised dogs *need* water added to their food. That food is excellent for them, but dry foods do not provide nearly enough moisture even if they drink lots of water on the side.

I'm not sure if you free feed or have her on a schedule, but liver compromised dogs should eat on a schedule because they are only allowed to take in certain amounts of protein at a time. She should be fed, at the very least, 4 small meals of RC Hepatic per day with equal parts added to the water. The several small meals help lighten the load on the liver so that it's not processing too much at one time.

How much food would you say she eats in one day? At 4 lbs and the fact that she is symptomatic means that she should be taking in around 3.6 to 4 grams of protein per day until you get her symptoms under control. 1/4 cup of RC Hepatic contains 4 grams of protein, so this would be the max. amt. of protein that she could take for now, but you can add cooked carrots and/or green beans specifically to add some substance to it if you want and if she's hungry for it. A couple of other options include adding seedless watermelon or peeled pieces of apple. Do not add oats, rice, beans, or anything like that. Oats and beans are high in purines and rice is high in manganese.

How many times a day do you give her lactulose? If her dose is 6 ml per day, then it needs to be split up into 2 ml 3x per day instead of 1 or 2 larger doses. This is very important so that she doesn't get stopped up and then have diarrhea and then get stopped up and then get diarrhea again.

Is she having at least 2 bowel movements per day? What is the consistency of her stool? Is it soft or firm?? Her stool should be soft and difficult to pick up , but not diarrhea and not firm. The dosage of lactulose should be adjusted to make the stool this consistency.

Although many people have success with Marin, I do not like to recommend this to dogs who have a history of seizures and hepatic encephalopathy because it does contain liver and yeast which are two high purine foods that should not be given to very sensitive liver compromised dogs, in my opinion. You may find that plain dried herb milk thistle or Hepatosupport are better options for her.

PediaSure or DogSure is recommended for dogs who won't willingly eat so that they get some nutrients and caloric requirements. You might try this.

I have found that when Miko has seizures, it is helpful to hold an ice pack on his mid to lower back area. For some reason this seems to help him a great deal and slow down the seizures to a stop. Some people think it works, some people don't. It has worked for us.

I am not a vet, and I am only providing information that has successfully worked for my yorkie and several other dogs that I have helped.

If you have any questions, please ask.

So sorry for the long post!!

Thank you soooooooooooo much for posting! I do give her apples, and various fruits and veggies usually as a treat. Today has just been a awful day here, she hasnt eaten anything and I wanted to give her something for tonight. All I have right now is Nutrical and nutridrops. I can go in the a.m and get something else. She is just so lifeless that I dont think I can go to sleep without giving her something. I have been free feeding her and didnt realize she needed more water. I tried cooking for her Dr. Tobias recipe and she wouldnt touch it. I would love to feed her better than RC but dont know what. Her gums are pink now but very tacky so I know she is still dehydrates, what should I do about that? Thanks again for your help.... I feel like my mind is in a fog.

Oh I have dyne also.

I just thought of this....her eyes are just staring when shes awake. I try to get her to follow my hand but she doesnt. Do you know what that is about?

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.

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.

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.

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

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.

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.

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.

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.

Excellent link!! :thumbup:

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

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.

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.

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...

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 ;)

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

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...