Epilepsy, Shunt, Hyploglycemic...
 

Jaxon, a three pound, seven month old teacup yorkie, has had a few seizures over the past month. At first, I thought it was his temperment, however, after looking into it further I am worried that he may have epilepsy, or a portosystemic shunt, or possible hypoglycemia. His seizures seem to be grand mal, afterwards he is very lethargic, as if he has been drugged. I believe that he may also have had, or continue to have Psychomotor seizures, he will run around in circles, really hyper and upbeat, almost as if he is chasing an invisible squirrel or something of that nature. He then becomes lethargic after many minutes of this running. He is having bloodwork done, and am expecting the results back next week. I was wondering what the best and worst case scenerios would be. I know that with the shunt he can have surgery, but if its not a shunt, what else might it be. I don't think it is hypoglycemia, as he has had a seizure shortly after eating. I am waiting for the bloodwork to come back, but am worried in the meantime... Anyone been in a similar situation? Also, if it is not a shunt, or hypoglycemia, could it be his diet? He eats organic store bought dog food, however it is premium and not mass produced as some other brands. I've been reading for days and days, and everything seems to be saying the same thing, wait and see, test and see, eliminate possibilities and see. The results can't come soon enough...

did you have pre and post bile acids done? sounds like a shunt as puppy is young and after eating. What is protein amount on dog food? Tough as puppies have to have higher protein but if liver baby needs to be low protein. Once you have bile acids back that will give you a better idea --if post is over 100 then could be a shunt - i am leaning more towards shunt or mvd than epilepsy :( when will blood work be back --- Shunts are fixable but the best person is dr tobias at ut and i would only have her do this surgery if it is a shunt. Liver_Shunt_And_MVD_Support@yahoogroups.com is a group you want to join if it is liver shunt to learn everything you can before further testing. My dee dee is mild mvd and i learned alot about this while trying to figure out what to do with her but she has never showed symptoms of liver disease - just showed up on her blood work. Make sure no rosemary in dog food as that can trigger seizures in dogs as well - hang in there

Having a bile acid test and full blood panel is the best way to help rule out liver problems. Seizures are usually *caused* by something, not usually idiopathic at this age, so there's probably an underlying issue here.
Hypoglycemia ties in with liver problems. Most liver compromised dogs have hypoglycemic issues. The liver is a powerhouse, so it has a lot of functions including maintaining blood glucose levels...
Do you feed several small meals per day?

It is unlikely that he is epileptic at his age. Seizures in puppies are usually a symptom of something else. In Yorkies, the first concern is a liver shunt. He needs to get a bile acids test asap.

Here is some information for you:

Portosystemic Shunts FAQ

Hepatic Vascular Disorders - WSAVA 2006 Congress

the blood tests came back, and the vet said that they didnt indicate any problems with the liver, however, she did not test his bile levels. She wants to wait and see if he has another one before running anymore tests, as he has not had a seizure in over a week now. she did mention that it might be a problem with his brain? if he possible had trauma before my friend baught him. we are hoping that this is not the case. he seems to be doing a lot better, he gets fed every five hours, can dog food with some yogurt. he used to have dry dog food added to this as well as a pinch of metamucil to help with the diariahh that he had had in the past. however, he only gets dry dog food in it occasionally (no more than twice a day), and no metamucil. could these have been the problems? also, i would give him football shaped dog treats, but realized they contained bha, so those were thrown away promptly. is it likely that is what caused his seizures?? thanks for all the help and information.

This is an excellent website to visit and learn all about canine epilepsy and seizures. Food ingredients, household chemicals and other things can trigger seizures. I did learn there that the ingredient Rosemary can trigger seizures and most people don't realize that...it's in a lot of foods too.

Canine epilepsy and diseases that cause seizures in dogs

I hope Jaxon is feeling better and won't have anymore seizures.

I'd have the bile acid tests run.

As for your pup. Was a contract signed that contained a health guarantee? So sad......

I would have to strongly disagree with the vet on this.
Any Yorkie who has had seizures needs to be bile acids tested.
Liver enzymes in a blood panel don't have to go up until the liver is considerably damaged (liver cell death...).

It is not normal for a dog to seize and if it is liver shunt, it is best to catch it before it early... I would most definately have the bile acids tested.

In fact, it is a good idea for every Yorkie over 20 weeks old to have a bile acids test anyway just to make sure there is nothing wrong because LS is so common in the breed. This is according to Dr. Center, developer of the bile acids test.

I'm sorry about your pup.:(
By the way, my Yorkie didn't show many symptoms of an issue and her bile acids are very high (with no diagnosis).

Another clue to a "possible" liver issue is, he is quite small.
Is he a picky eater?

:goodpost:

I couldn't agree more. All Yorkie puppies should have a bile acids test after five months old regardless of whether or not they are having any symptoms according to Dr. Center. The incidence of liver shunts in Yorkies is just too high.

Unfortunately, most regular vets don't know much about diagnosing and treating liver disease. They just don't see enough cases. There has been a lot of research done in the past few years and the protocol has changed dramatically. Are you anywhere near a vet school?

There is simply no reason not to do a BAT test. It's just a simple blood draw and the test in very inexpensive, under $100.

Yes, I agree with everyone above. He needs to have his Bile Acids Tested. The amount of pups with Liver Disease (LS and MVD) is so unbelievable these days, that I am kinda shocked that this Vet is not pressing about it.

Please do not wait for another seizure. Honestly, if this were my pup I would be finding a Vet in the area that has a better handle on the small breeds and one who know more about Liver Shunts.

What food are you feeding him? What treats? Does he have any odd behaviors?

... :eek: :eek: :eek: I just went back and read your first post, IMO this has to do with his liver and I would be getting him into a Vet for a BAT ASAP :(

Hi my name is LoraJ my 6 month yorkie is now awaiting a liver biospy they feel it is MVD is it a form of liver shunt, but with many vessels as opposed to the main aartery in the liver.Mine does the same running, has loose stool, I was told the bile liver count was high, she cant have any protein in her diet except for her kibble, this is a hereditary disease. I am now haveing many problems with the breeder I have her just 4 months she just turned 6 months. The vets tell me its good I caught it early. She went from giardia straight to this. Any one have similar?

I also agree that you should have the bile acid tests done. Some of the symptoms your baby is having sound just like what my baby was experiencing. Her bile acid level was 325. You should definately not wait. we took our baby to UT for her shunt surgery. wonderful, caring staff unfortunately our baby could not come out of the anesthesia and we lost her over a month ago. Don't wait better to have shunt ruled out

Why has the vet decided to do a biopsy?
It is good to do if she is being spayed at the same time but if she isn't being opened up anyway, I wouldn't jump to this to quickly.
Was a Protein C test done?

Hi, my dog Beckham is also exhibiting some of the same symptoms but does not have seizures yet. I am praying that he doesn't have a liver shunt, but I think that I
May be fooling myself. My puppy also hasn't gained that much weight. My puppy three up on Sunday 5x, had diarrhea on Monday and has not been eating well since Sunday or very much at all. His bile acids are high after the bile challenge test. I tried to milk some info from my vet about the costs to ensue. I was told that the imaging with contrast dye is $400.00 and if the shunt is operable, then it would cost $3000-5000.00. We can not afford this!! Has anyone gone through this and had a dog that survived and now is thriving?!

Many dogs do well after LS surgery.
It could also be MVD which can't be surgically corrected.
Some people who get these really high estimates find it cheaper to fly to University of Tennessee to have the surgery done. It is much cheaper (under $2000) and the best place to have it done.

What are the bile acid numbers?
With these symptoms and high bile acids, this is very likely the problem... :(

Liver shunt
 

I don't know the exact levels of the bile acids. I should've asked...I'm a nurse. I was just in a state of utter shock. The vet did say that the levels weren't just borderline. They were definitely high and he didn't think that it could be anything else. What is MVD? Do I need to get the x-rays here and them forward them to Dr. Tobias? I've been doing some research and TN seems to be the Mecca for this type of surgery. What are the steps that I need to take and what type of food & supplements do I give him in the meantime? Will it be really costly? Everything seems to be adding up so fast!!!
J

I am so sorry you are going through this with your puppy. The first time I came here to YT was because I was experiencing the same thing you are with a then 7 week old puppy that I had for 10 days (I know now that was my first mistake). By the time she started having the grand mal seizures she was 8 weeks old and had been eating fine while she was with me. I took her to the vet and she stayed overnight, while she was there she had another seizure. She was checked for everything and everything came back normal range. Because it was a young puppy my vet told us that it was not epilepsy that there was an underlying condition. They also asked me if the puppy had any brain trauma but she was in a crate and we didn't have small children in the house, so that was ruled out. Long story short I contacted the breeder and she said that I was not feeding the puppy correctly ( I have 3 other Yorkies and the test gave no indication that she was not eating correctly). After many tests it was determined that it was a brain mass. I returned the puppy to the breeder she did give me the money back (she was not pleasant about it) and she never gave me the astronomical amount of money that I spent on vet bills and not to mention the heartache. Send me a PM and I can give you more details. Hang in there, I know this can be very difficult.

I'm sorry...what is a PM? We never gave Beckham table food, but ever since he became sick, we have been trying to get the puppy to eat anything. Today, my husband kept feeding him pieces of Hawaiian roll, pancake, a few grapes. He seems more like my puppy before he got sick on Saturday. Did you say that your puppy had the liver shunt surgery too?

Please, please don't give the puppy grapes. Grapes and raisins can be toxic to dogs!

they will cause renal failure fast in a dog - read below - NEVER GIVE YOUR DOG GRAPES OR RAISINS

snopes.com: Raisins and Grapes Harmful to Dogs

Not real costly as surgery is not too bad at $1600 i believe and i would only have dr tobias do this surgery as i have seen others go to other surgeons and dogs have died :( my dog has mvd. I would get your dog on natural balance vegetarian as that is a low protein diet and low protein is important -- you need to join the two liver shunt groups dogliverdisease and Liver_Shunt_And_MVD_Support at yahoogroups.com as you will learn alot but you need to provide the pre and post bile acid numbers and the full blood panel numbers so they can help you see what is going on

you live by me and the place they are going to do the scan is either in tustin or los angeles

AVMI - Scintigraphy

it is dr broome -- i was suppose to have this done with dee dee but due to he having no symptoms of liver shunt meaning she was not a picky eater, no head pressing, no seizures, etc and her post biles less than 100 I opted to not put her threw this test - now had she shown signs and had her numbers been over 100 I would have had test done by dr broome or i would have just went to uoft to dr tobias to have everything done there as much cheaper and she is the best. There was a girl who brought her dog down from washington to los angeles as she did not want to fly to tennessee and she had liver scan done by dr broome and it was confirmed and then she had a surgeon in los angeles do the surgery -- could not recall his name but the dog did not make it after surgery and i know this may sound funny but in looking for a surgeon in a small dog the size of hands are important to me as that many times determines the size of incision so for this reason i have vowed to only go to dr tobias for this type of surgery if it were my dog

MVD or microvascular dysplasia is small shunting throughout the liver instead of one big shunt.

I would do a Protein C test next most likely (blood test sent to Cornell). It helps determine if it is LS or MVD. Then I would go to scintography. If the Protein C test points to LS, you might want to do scintography at UT. I'm not sure how that works with sending them test results. Some vets will try to talk you into an ultrasound. They are great if you want to see the size of the liver and if there are bladder stones secondary to liver issues but as for diagnosing shunts, they are only 60-80% accurate.

Dogs with liver disease who have neurological symptoms/hepatic encephalopathy should be on a low protein diet. Vegetarian protein is preferred. I would not give red meat, pork or exotics at all. Natural Balance vegetarian is okay but if he is having neurologic symptoms, you might want to go with a prescription food. The ones to consider are L/D canned and Royal Canin LS 14 kibble (makes some Yorkies itchy).

Since he is symptomatic, he should probably be on lactulose, denosyl or vetri dmg, milk thistle, vitamin e and fish oil.

Please do NOT feed Grapes or Raisins, they CAN KILL :(

First you need to get the Bile Acid Test results and post them here for us. Second, I would wait on the Ultrasound. The U/S is only about 60% accurate. To spend $400 on that with no guarantee, I'd want to spend it on a test that's better. But we need to know the BAT results.

Also, for more support on Liver Disease please join:
DogLiverDisease : Dog Liver Disease

Imaging with contrast dye was mentioned.
I think the vet is thinking scintography? :)

We have stopped the grapes!! After doing further research, I found a thread on the types of foods that are harmful for Beckham. Just called the vet and asked about getting a faxed copy of all of his lab- I will post them as soon as I get them. My vet doesn't see many liver shunt patients. He just keeps on pushing the scintigraphy for confirmation. Does Dr. Tobias include the scan in her cost? The vet just said to put the puppy on Hill's L/D or K/D. Is the kibble or canned better? I also asked him about the lactulose and he said that it was a good idea. My puppy is 3 lbs, how much should he be on? He didn't mention any other supplements, but there are several mentioned. What are they and what do they exactly do?

K/D is low in protein, so vets tend to grab it for liver disease but it is the wrong kind of protein. L/D canned is the best in the science diet line for this.

I'm not sure if the scintography is included in the cost at UT.

Fish oil is an anti-inflammatory.
Denosyl or Vetri DMG helps repair the liver and helps prevent further damage.
Not sure of the lactulose dose but if you search on YT, you might find it.

Is this the Vet that is going to do the Scintigraphy? If he isn't familair with shunt dogs, then I would be a little concerned about the scintigraphy, I would tend to think he would be doing a U/S - So please confirm this with him before you proceed...unless he is sending you to a Specialist?

Dr. Tobias in TN and Dr. Center in NY at Cornell *could* do all of this as well, so if you plan to come to the East coast for this...maybe you should try to get it all worked out here :confused:

i agree 100% we need to see pre and post bile acids and i agree the add on for protein c will be good as well - due to dog having seizures i am thinking post will be over 100 but fingers crossed. The only one who does scinitography in california is Dr Broome so i am sure her vet is referring her to him as we live close by and my vet recommended him as well. I think the ultrasound is a waste of money as they did several when dex had pancreatitis and cost me a fortune and they said yep it is inflamed duh - which i knew from cpli and tli -- the true tests are pre and post bile acid, protein C, and scinitagraphy - dr broome is excellent at it and i believe the cost is $340 but for surgery i would only have dr tobias due it - lower in cost and she does a ton of them and she is very good at this - I would not take my chances with anyone else if it were my dog especially here as a woman drove to LA with her dog from washington as she did not want to go to uoft and her dog died so that confirmed it for me that dr T is only place i would go