this one is tough i keep thinking neurological :( and that vestibular really looks more the issue than liver shunt as i have seen alot of videos on liver shunt and have never seen this :( the good thing is she is acting normal other than head tilt and balance issue- I am going to post this rabbit video with vestibular -- i really think you need to have a neurologist see her asap :( but first i need to see those bile acids

here is a schnauzer with vestibular and i know the vet said no but i keep going back to this as it looks like your dog :( more than the liver shunt videos and she is not affected by eating. My guess is she has mild liver disease like mvd and her bile acids were slightly high but we will see as my vet said my dd had liver shunt and to have scintigraphy etc and everything and her bile acids were below 100 with no symptoms so sometimes they are trying to find answers so badly the throw it out there and keep running tests to figure it out. If those biles are not over 100 this is not liver related it is neurological - also i think someone posted that 2 days on lactulose if it is liver shunt related the symptoms should subside. Have you seen any of it subside at all since giving the lactulose?

i keep going back and looking at those videos over and over ok if this was my dog and those bats are not over 100 i would skip the whole liver shunt and i would go straight to neurologist and have them review everything. If bats are over 100 then I would call dr centers and discuss this case.

darn i wish we had those bats :( that is really going to determine which way you go with this

My husband and I both agree that Bella's just like Sammy in the video. I've read that liver shunt behavior is associated with food and Bella is fine before and after eating (no addition symptoms).

She's been the same today and I started her meds yesterday at 4pm when I got them from the vet. I would say she's a tiny bit more active. She actually picked up her squeaky toy today but other than that, she's the same as other days. Where did you say Dr. centers was located?

she is at cornell university but you can fax her info and do a phone consult

Cornell University Hospital for Animals

Ithaca, New York - Cornell University
Dr. Susan Center
Phone: 607-255-2000

yeah she may have mvd as well and why bile acids were elevated as that runs pretty heavily in the breed and my dd has it and not a big deal just low protein diet. I am just real curious as to those bats. My friends dog had liver shunt surgery and his bats were 501 so way over 100 and he had no symptoms pretty wild and alt was not high either - he is a 7 year survivor of liver shunt surgery and doing awesome

here are the internal medicine specialists and neurologists in your area you can search this site

ACVIM

Name Univ/Hospital Specialty City State
Dr. Wayne Lester Berry Southern California Vet. Specialty Hosp. Neurology Irvine CA
Dr. Melanie Campbell Animal Care Center Sonoma Cnty. Neurology Rohnert Park CA
Dr. Stephen M. Hanson Veterinary Neurology Center Neurology Tustin CA
Dr. Lisa S. Klopp The Sams Clinic Neurology Mill Valley CA
Dr. Marguerite F. Knipe University of California, Davis Neurology Davis CA
Dr. James A. Lavely Animal Care Center of Sonoma County Neurology Rohnert Park CA
Dr. Robin E. Levitski-Osgood Veterinary Specialty Hosp. of San Diego Neurology San Diego CA
Dr. David Lipsitz Veterinary Specialty Hospital Neurology San Diego CA
Dr. Michelle Murray Veterinary Neurology Center Neurology Tustin CA
Dr. Veronique Sammut Neurology Woodland Hills CA
Dr. Tammy L. Stevenson Veterinary Surgical Specialists Neurology San Diego CA
Dr. Beverly K. Sturges University of California, Davis Neurology Davis CA
Dr. Stacey A. Sullivan Animal Specialty Group Neurology Los Angeles CA
Dr. Karen M. Vernau University of California, Davis Neurology Davis CA
Dr. Diccon Westworth University of California, Davis Neurology Davis CA

<< First | < Previous Next > | Last >>

there are 5 pages of internal medicine in california so cannot post but only one page of neurology - what i found interesting is dr centers is not on the list in new york :( I thought she was a board certified internal medicine specialist ??? I know she knows alot on this and is running a study on it as well as dr tobias who is the surgeon for liver shunt i would go to

So Bella's been having really runny poo and had an accident in the house since she's been on lactulose and clavamox. I was suppose to be giving her 3 cc of the lactulose, do you think 2 cc is too much of a decrease or should I go with 2.5cc? (vet is closed)

can you call er to ask them sorry i have never given lactulose maybe tlc can help - the runny poo can be from either as antibiotics can cause diarrhea so make sure to give 1/2 food antibiotic then other 1/2 food that is how i give antibiotics so it is mixed in real good with food. The lactulose not sure how to do that one:( maybe ask on yahoogroup as well they will know

Runny poop, I would say cut back on Lactulose.

I belong to a Dog Liver Disease on Yahoo Group (different than the other one posted).

Please join. Olga is the owner of the group and she has done soooooooo much research and has really good advice and experience, she follows Dr. Center. She also runs a Small Breed Resuce, and she really gets her fair share of Yorkies with LS and MVD and also other diseases, so I KNOW she can help and advise you.

DogLiverDisease : Dog Liver Disease

Also, show them the videos, as Olga could really say if she thinks that is HE symptoms or not...

And she could very well have MVD too, that would be why high BATs, but we'll have to see what those #s are...

agree i like olga too she does a ton of research and my friend rescued an LS surgery survivor from her so join that group too the more info the better

Thank you, I just joined the group.

Finally, I got a copy of Bella's records from the vet.

If I'm reading this correctly it says:

bile acids results: 15.5
reference range: 0.0-6.9 umol/L
flag: H

bile acids post pranidial results: 42.9
reference range: 0.0-14.9 umol/L
flag: H

(I have no idea what this all means)

I'm also looking at her bloodwork she had done the day before that and noticed there were some highs/lows. They were:

Bun:28- high
B/C ratio: 35- high
MCV: 79-high
MCH: 26.1-high
neutrophil seg: 49-low
lymphocytes: 48-high
monocytes:2-low
eosinophil: 1-low
absolute eosinphil: 94-low

(I'm not sure if all these matters or not since when vet called, she said Bella's blood work came in normal)

I'll also have to go to two specialist since the one in Santa Rosa, CA does internal med and neuro but their MRI price is way expensive and the one place in Roseville, ca only does neuro.

I was thinking I'll go to the place in Santa Rosa for Bella's liver shunt and the one in Roseville for Bella's neuro tests.

With her BAT results, do you think she'll have to continue eating prescription food forever or can I just feed her low protein food?

If anyone can please explain her BAT results to me since the vet was with a client when I picked up her records.

Thanks!

with those bats I would skip internal medicine and just go right to neurologist as those bats are not bad at all which is what i thought :( she is pre 15 and post 42.9 and this is what i was afraid of - go to neurologist you want to see they know about liver shunt too as it affects brain but my gut all along is this is neurological and not liver shunt. She probably has MVD not LIVER SHUNT - my dd was post 73 then 54 and then 26 on low protein and she never did this and she is on steroids and soloxine two drugs that affect liver so get her to the NEUROLOGIST he will get to the bottom of this - save your money see the one specialist that knows about both

Thanks, the thing is...I called both places and the one in Santa Rosa stated that I'll have to do an office call for both internal med ($125) and an office call for the neuro ($150). They deal with both the liver shunt and anything neuro but their MRI is $3500-$3700. I wanted to see the neuro in Roseville because their MRI is only $1800-$2700 but they don't deal with liver shunt.

Would you say, since she only has MVD, should I continue her on the prescription diet l/d or can I feed her anything low protein? Does this also mean I can discontinue the lactalous?

Also, I had the vet call in to Costco for Bella's refill on lactalous and I cannot believe how much cheaper it is!!

IMO I don't think she has a liver shunt. Those results are really really quite low. She may have MVD or no liver issues at all. Did she get any shots or pain meds recently, or heartworm pills or flea tick meds, as they can skew the BAT results.

Her head tilt, etc really seems neurological.

The l/d and lactulose can't hurt, but if she is having HE symptoms, the clavamox and lactulose and diet should be diminishing it very soon. Do you notice any difference in her? Is she getting better?

She hasn't had anything results shots or anything so there's nothing that would screw up the BAT results. I've had her on the diet and meds since Friday afternoon she's been the same or maybe a little worst. She's sort of limping now and normally she's able to walk up and down the stairs but she can't do that now. She'll fall to the right side and I'll just have to pick her up. I've noticed, she doesn't turn clockwise anymore either and if you were standing to her right, she wouldn't be able to see you (unless you call for her and she turns around counter clockwise until she see's you there).

I've also noticed, her hair is getting really thin on her head and does not know if this as anything to do with it.

I'm actually just waiting for the vet to refer us to the neuro place in roseville tomorrow until I can actually make an appt with them.

i agree 100% and questioned the lactulose and clavamox :( as really wanted those numbers - I would do a phone consult with dr centers about the lactulose and clavamox as i personally do not think your dog needs it and have a feeling your dog will be on steroids for this issue but neurologist will go over all this - I would get her in asap to neurologist and tomorrow call dr centers and discuss. I think the low protein diet of 18%-22% would be good for her but these symptoms are not from liver shunt and since your dog has not had any issues food related I really did not think these bats would be high. When you talk to dr centers ask her if she thinks your dog should be on lactulose and clavamox as i think the low protein diet right now yes but the other not so sure it is going to help

Also, I noticed that she hasn't touched her water bowl in 2 days. Is there a way I can make her drink water?

call the place they may take you without referral - we do not need referrals here get her in asap if she is getting worse she needs to get it now - the lactulose, food and clavamox would not be making her worse

when did all this head tilting start happening?

Good I am glad you are getting a referral. That is best and I am sure They will be able to give you more answers. I know how frustrating this all is. You and Bella are in my prayers. Keep us posted and we will be here for you.

The wet l/d has more moisture than dry food.

You can feed her little pieces of watermelon and apple (no skin)

do you use spring bottled water? change the water 3-4 times a day - she is getting moisture in food but if she does not drink with bottled water changes then put a little low sodium organic broth from whole foods in there to entice drinking but do not let it sit out all day

I agree with the others, she needs to see a neurologist and soon. An MRI of the brain and spine, especially C-spine/neck. Good luck, don't hesitate...there is something wrong and she needs help quick.
P.S. Don't even let her jump off furniture, no rough housing with her, keep her as calm and quiet as possible, I really think she is in a very fragile state right now. Good luck, my thoughts and prayers are with you...

I've actually called them several times and they wouldn't let me make an appt until I get a referral.

The head tilting started 2 Fridays ago.

Should I still be worried about her water intake even though the wet l/d has more moisture in it. She doesn't like fruits or veggies either.

sounds to me like she needs steroids to get inflamation down so hopefully you can get her in soon :(

get some low sodium broth and freeze it in ice cubes and then let her lick it and the sodium will make her thirsty hopefully so she gets more water in her

Dwerten, when you asked about UCDavis, were you talking about the teaching school there? My vet mentioned them today to me and I'm actually going to take Bella there instead of Roseville or Santa Rosa. Have you heard if they're good? We have an appt on Monday the 8th and I'm so relieved that we might have an answer soon.

Off topic but how would get you something out of your yorkie's eye? Bella gets hair in her eye sometimes and I can only imagine how much that would bug.