neurologic 6 year old yorkie
 

Something is going on with my 6 year old yorkie, Chauncey. Up until now.. he has been pretty health with no health issues. I hvae noticed over the past couple weeks a series of events.. First I thought it was leg trouble but it has turned into more.

He has been experiencing neurologic symptoms prety much 24-7. He has a hard time keeping up with his legs, stares into space, has no pep.. cant support himself when going to the bathroom.

We tried prenasone for a possible pinch nerve which didnt work out. A full blood panel yeilds high Lipase (almost double the rate) and slightly low Amylase. He also has a higher white blood count.

Getting frustrated and scared.

thanks

I don't have any advice but hope you can find out what is causing his problems and get him better.

Hi,

Did your vet run a full blood panel? Could it be possible that he has liver issues? Often, neurological problems can be a sign of a liver problem. Our dog Enzo is four and was vomiting with wobbly legs and shaking. Upon full blood panel and a bile acid test, we found his liver enzymes to be high - sometimes that can indicate a liver shunt (repairable) or MVD (not repairable - treated with lower protein food and supplements) - He had an MRI and that did not reveal a shunt. He is now on Hill's L/D and denamarin - he has no real symptoms (except for his sensitive stomach - he has still been vomiting once every 4 or 5 days) but in otherwise good health. Just something to check - these things usually come up before they are a year old but can show later - even at your dog's age.

You can do a little research online and there are great forums. I hope he feels better!

we did run a full blood panel. Everything was pretty much in the normal range with the exception of high White Blood Count, High Lipase and Low Amalayse.

I started him on 3 meds for liver shunt yesterday. How long did it take your dog to respond to the meds?? I gave them to him late yesterday afternoon... but as soon as he ate he was in la la land again for a few hours. He pepped up a bit and was a little better this morning. I noticed a tad of a difference just in his walk. BUT... again after breakfast he went into a neurologic state where he stumbles and is in space. Even 4 hours later he isnt normal. Did it take a few days for the dog to stablize or did you notice right away??

I am so scared.. it has been almost a week now that he has been like this. I'm afraid one day he isnt going to wake up!!!

We are scheduled to do the acid bile test on monday...

What food are you feeding him?

well for most all of his life.. he was on an all natural no animal by-product food made by Flint River Ranch. Then oh maybe 6 months ago I switched to a different food.. Innova. Its the same deal..all natural human grade ingredients. I had to mail order the Flint River Ranch and

I am aware that a food change may be in order if the problem is liver related...

I think you need to get him off the Innova ASAP (too rich for liver issues). Flint too. These are good foods for normal healthy pets. If you baby has liver issues these foods are like poison to him, and when you say he goes into the symptoms after he eats, it really screams that this food is hurting him. If he has liver issues, his liver cannot filter the ammonias from the meats and organ meats in the food you are giving him. These toxins are poison and since the liver cannot filter them properly, these toxins are allowed into his blood stream and are going straight to his brain (and other organs), causing him to feel very, very, very sick - drunk like - headaches, etc. hence the stumbling, can't stand up, blank staring, etc...

You should head to your Vet asap and get Hills l/d (wet food) and or Royal Canin HP14 (dry food).

I went to the vet and got the Hills L/D. I gave him some.. and he did have a reaction. I am not sure if its as bad as with the other normal food.. but I am hoping he is just adjusting to the medication and that it will take a couple days for his body to catch up and detoxify as much as it can.

He did bark today a couple times which he hasnt done in days.

Ugh I wish there was something more definitive here. I hate waiting.

What kind of reaction? Did the Vet put him on Lactulose and antibiotics?

oh, he just goes into a deeper state of being neurologic after he eats. He is on Denamarin, Lactulose and Metronidazole all which I started yesterday. The change in food was this afternoon.

this may be a dumb question but the lactalose is given orally correct??

Yes. It may take a little time to get the dosage correct. He should poop at least 3x daily and it should be like soft ice cream. He should be eating 4 to 6 small meals a day/night. Spread apart and small so that his liver dosen't get over worked.

Keep us updated and ask any all questions you need to. We are here for you.

thank you so much for all your suggestions and help. I really appreciate your input. The smaller meals make sense.. my vet should have told me that too along with insisting on a food change immediately.

So far two poops today but they werent too soft. He has a hard time pooping b.c his legs are so wobbly from the neurological problems. He dances around.

I will keep you posted.

I think I mentioned but we are doing the bile teset monday.. hopefully that confirms the problem.

heather

Was a bile acids test done? A Protein C test? Both need to be done if liver disease is suspected. You don't want to assume it's liver disease and misdiagnose something else.

PSVA and MVD Research Summary

Comparative Coagulation -- NYS Animal Health Diagnostic Center

we are going monday for the bile acid test. By then hopefully there will be some sort of idea as to what is going on.

I hope so too! In the meantime, you are doing a very good job. Lots of us here have Liver Shunt and/or MVD experience and we have some tricks and tips that we have learned and shared along the way.

Try to get some rest this weekend and hopefully next week, you'll get some answers and more direction for your baby :)

thank you so much. One more thing.. do you know if it takes a while for the neurologic symptoms to cease after medication and diet change are implimented?? The dogs legs are all over the map... he keeps slipping and trying to keep up with his legs.

thanks

It will depend on what the diagnosis is. Often liver shunts need to be surgically corrected.

Portosystemic Shunts FAQ

But that is putting the cart before the horse. You need to get a diagnosis before you can think about treatment options.

The Meds he is on is helping to rid the body of toxins, if his poop is still really hard, you may have to give a little more lactulose.

As Ladymom said, first you need the dx and then you can proceed more with helping him get better.

To me, this sounds liver related, but I am just so surprised he didn't show any other symptoms for his first 6 years of like. (Although, my friend at work has a 9 y/o Shihtuz (sp?) whom most likely has MVD, and he just started to have seizures), so I guess it can show up later in life.

How much does he weigh?

thoughts and prayers for u and ur baby, keep us posted

Chauncey weighs about 4.5 lbs. Perhaps he could have shown symptoms earlier but never enough to be concerned. For as long as I can remember he has been a shaker.... in the car and at home he would have episodes but I honestly thought they were from being nervous.

He has had some periods of time where he has throw up... but with two small children he is always getting into more food than he should be eating... so to vomit once and a while was no concern.

I am in a bind b/c I want an answer and want it (yesterday) LOL. If we go for the bile acid test monday.. the vet told me today that the results wont be available until later in the week... they send out the samples. I am not sure I can wait that long since he hasnt really had any great reaction to the meds he is on for liver shunt. So.............. do I take him to emergency care to have them do it and perhaps get an ultrasound..or try to schedule an appt at a more advanced pet hospital on monday where he may be able to have the tests done and more treatment... I wish it werent the weekend.

He is doing "ok" so far today except his legs are giving out when he walks on the hardwood and tile. He seems to be ok on carpet and outside on the cement and grass. He has not had great poops either... i will give him another dose of lactulose. It calls for one to two droppers once to twice a day. perhaps he is scared to go since he cant support himself all that well.

ok thanks for listening...

They BAT results will take a day or two no matter where you go, so you can't get around that. The u/s is only about 60% accurate is seeing a shunt, however, if the BAT is sky high it may be worth it to do the u/s as a shunt may be seen. A u/s is good to see the size and shape of the liver and if he has any bladder stones, which can go hand in hand with liver issues.

There is no harm in giving a little more lactulose, so you can do that. It does take some time to get that dosage right. You'll know when you are getting it right bc it will be like soft ice cream, and you want him to go at least 2-3 times a day.

My concern right now is that you say he is unstable on his legs at all times???

The shaking, is it like shivers? They say when they shake and shiver (and it is not cold) they are in pain.

Did the Vet say anything about possible Spine issues?

How far are you from Cornell University?

LOL my husband and I were literally just having the discussion about taking him to Cornell. We arent that far.. about 1 hour. Do you think it is best to bring him in as emergency or is it something we would need a referal for?? I would seriouly consider taking him there...

The first vet I saw thought he may have a pinched nerve (note at this time I didnt notice him to be all that neurologic).. so she treated him with a shot of Metcam, and I gave him an oral dose the next day. He really had no reaction to the meds. I almost think he got worse neurologically. The day after that we tried a steroid for possible inflamation.. I forget which one.. but that didnt do much either. It was then I took him back, met with another vet at the practice and had full blood work done. He had a high level of White Blood Count, high Lipase and low amylase... really nothing conclusive. We gave him antibiotics.. but nothing. As he became more neurologic all week.. we started giving him the liver meds on thursday maybe... I think today is day 3...

The legs are really at their worse. He can walk around on his own but often slips on the hardwood or tile. I usually pick him up, but he can eventually get himself up. The shakes are exactly that.. shivers... which he has a lot of throughout his life... lots of times on car rides, sometimes when outside when it is cold, and other times just "whenever".

let me know if you have any experience with Cornell and taking a pet there.

thanks

I absolutely would take him to Cornell if I were you.

Should it turn out to be liver disease, Dr. Sharon Center is at Cornell. She is one of the leading experts on liver shunts in the country. She developed the bile acid test. All Protein C tests must be sent to Cornell. Dr. Center is currently working on finding a genetic marker for liver shunts with a grant from the AKC. Did you read the links I posted earlier? They are from Dr. Center.

You will need a referral from your vet, but I would ask for it right away.

I have to agree with Ladymom. Being that you are only 1 hour away from Cornell, that's where I would go. Skip the ER or Speciality hospitals and if possible get into Cornell. Now as for whether this is an emergency or not, I can't answer that, you need to figure out if his condition is extreme and getting worse as time goes on....

...and if this is liver related, Metcamp and the Steroid shots really must be doing a number on his little body, as both are no good for liver babies.

I would up the Lactulose a little to help his body rid those toxins....

yes, thank you very much for the llinks. I did read them and they were helpful. I showed them to my husband who doesnt quite get how the neurological issues may be liver related.

my vet isnt open until monday.. which when we are supposed to take him for the acid bile test. At that point I think I will have them give me a referral. My vet is nice but now that my dog is really sick i wish I had someone who knew more about this and put me on the right track sooner. This has been kind of ongoing for a week now and I still dont have a definitive diagnosis. My concern is that he passes before we can get him the help he needs.

"Neurological dysfunction caused by liver insufficiency is referred to as hepato-encepholopathy (HE). This can cause any degree of neurological problems including lethargy, dullness, decreased learning ability, weakness, stumbling, blindness, circling, seizure, coma and death." http://stfsc.bizland.com/health5.htm

Maybe you should call Cornell Vet Hospital and discuss the situation and see what they say.

Hepatic Encephalopathy
Hepatic Encephalopathy - Portosystemic Liver Shunt

TLC

That could be why he got worse after the shot of metcam and then the oral dose... it makes sense b/c he was really not all that neurologic when I took him to the ver the first time. He was cautious with his back legs when walking... that was my complaint to the vet. Never in a million years would I have thought it would turn out to be liver related. (assuming it is).

so frustrating.

still no change with Chauncey. He went for a bile acid test today and we have an appointment at Cornell tomorrow. I feel so bad for this little yorkie. He is so disoriented.

wish us luck

thanks