Wobbly Dog--High Liver Levels
 

A few weeks ago my 1 yr old yorkie Carl started wobbling around and holding up his paw, it only lasted for about 1-2 minutes and then he was back to normal and running around.

Then about 8 days later it happend for the 2nd time and lasted about the same length then he was back to normal. We thought maybe his foot had fallen asleep because he always acted like nothing happened a few minutes later.

Thursday night he was extremely wobbly and the symptoms didn't really go away, then Friday morning when I got up he had thrown up twice in the middle of the night and was still wobbly that morning. He went outside potty and when he was coming back in had fallen on the step.

I took him to the vet right away and by the time we got there his symptoms had then gone away, they checked his temp, gums, ears, eyes, felt around his belly and said everything was normal. Then they did blood work and a tick test and everything was negative except his liver levels were high. They wanted to do a bile acid test to see if he has a liver shunt but he couldn't have eaten for 12 hours prior to that and I didn't know if he did. The only other thing they could do was an ultra sound, but they felt as if the bile test would show more and scheduled it for Monday.

They gave him lactulose 1ml every 8 hours and low protein canned food every 2...I gave him the lactulose as soon as I got home and it seemed like his wobbliness got ALOT worse, almost to the point where he could not stand. I gave him 2 tbsp of the food with a little water and 1/2 hour later he puked 4-5 times. I called the vet back and told them and they said to hold off on all food for 3-4 hours but still give him the medication. I didn't want to give him the medication because it had made him so much worse the first time so I held off on everything and gave him more food a little later. He kept everything down since Friday around 4pm until today, Sunday at about 6am he threw up once and then once in the car as well. He is still peeing/pooping like normal and eating, just isn't really drinking alot of water.

I'm taking him in for a 2nd opinion tomorrow instead of doing the bile acid/ultrasounds right away to see what they think, the shunt (if thats what he has) is 3-5,000 so trying to rule out everything else first.

Has anyone had anything like this happen? :(

I would do bile acids as a first step.

I would do the bile acid test first, too. Ruling things out is as every bit as important as ruling them in at this point. The symptoms you described do seem to suggest LS, and I would expect that a specialist would want to do the blood test, too. The ultrasound may or may not show if there is a liver shunt depending on the degree of the shunt and the skill of the tech.

Sorry to hear about Carl. I agree the Bile Acid test would be the best next step. The cost isn't too bad. I think Cali's ran about 100.00 at a specialist. The bile acid can be a help in determining if he has a shunt and if it is internal or external. I hope everything checks out ok. Please keep us posted.

Because the enzymes are high and he is wobbly, liver shunt or microvascular dysplasia are top on the list. You will likely save money if you do the bile acids test before a bunch of other things (wobbling is a neuro issue - if you don't rule out liver issues and start someplace else, that place will be with a neurologist which is far from cheap).

This sounds like a good vet. They are on the right track and I would stick with them for now.

I agree with the other posts.

I am going through something similar with my Lucy, she doesn't have the wobbly thing going on but she has thrown up a few times, she isn't eating regularly, and she trembles a lot. We are going in for the bile test in the morning.

Please update us?!

Sorry it took a few days to reply, and thank you everyone for the responces, it's been a crazy few days. They did the bile acid test on Monday, The vet didn't think the levels came back too abnormal and doesn't think that he has a shunt. He said normally in dogs with shunts they are typically smaller(Carl is 9lbs) and they have low energy, yellowish eyes(in the white part) and do a "face pressing" against the wall...Carl doesn't have any of those symptoms. The levels were only mildly high which he didn't think showed a shunt. Also, his bilirubin levels were a little high, but otherwise everything else was normal.

He was put on a antibiotic for 7 days and a liver supplement (Denamarin) for 30 days. It doesn't seem like the medications have really helped anything so far, so I have a call back into the vet to see what they think. He said the next step would probably be doing an ultrasound with a liver biopsy.

I did some research online and I'm going to ask if they checked him for hypoglycemia, I'm sure that glucose shows up in blood work but going to double check. I just can't imagine what is going on, the vet kept asking if he maybe ate something bad but he does not get any people food and I have nothing laying around or even anything toxic in my home. He is still playing, eating, going potty, doing EVERYTHING he normally does, it's just his lack of stability and wobbliness that is scary. :(

Does it mostly happen before or after eating?
When it happens and you give a sugar supplement (i.e. Nutrical), does he return to normal within a few minutes?

If it is not hypoglycemia and not his liver, then he needs to see a neurologist.

What were the numbers from the bile acids test?
Microvascular dysplasia tends to cause more mild elevations. The two disease present with the same symptoms (MVD pups can have milder symptoms and are sometimes asymptomatic). With these symptoms and an elevated bilirubin, it's probably best to just go to a specialty hospital. If the liver checks out, then he would go to neuro. As long as it's not his sugar, that's probably where he needs to be. Using a supplement for a month is usually fine if a liver problem is suspected, but if he continues to be wobbly, it is not okay to wait. That has to be brought under control asap.

Thanks again for the information, all of this help and concerns make me feel so much better, I just feel so helpless.

I haven't noticed any significant changes after eating, the vet asked me that as well. He really has never been a big eater, only really eating a few kernals, and its hard to judge because sometimes he'll have the symptoms worse after he's been sleeping for awhile and gets up and other times he's almost completely normal. I really haven't noticed anything just after he eats.

I do have a call in to the vet to ask if they checked for hypoglycemia or not so still waiting to hear on that and what the bile acid levels were and I will post here as soon as I get that information. I'm also going to write down the MVD and ask about that as well as do some more research about that online. He has NO symptoms except the wobbliness. He still does everything else exactly how he did them before, still eats bones, plays with toys, chases the cat around, everything all normal. The vet said if he wasn't doing all of those things he would be more concerned but wanted to try this medication first.

It's interesting, one of my friends just sent me a list of poisoness things around your home that you may not think are harmful, one of them is "rhubarb leaves" and i do have a rhubarb bush so I'm going to check the second I get home to see if he's eaten any of them. As far as I know, he's never gone by it but going to double check.

Can you tell us what his Bile Acid results are?

Anything above 25 for the post "would" indicate a liver issue, and if you Vet says it's not too high, based on his wobbles and vomit, and poor eating, he could very well have MVD (microvascular dysplasia)

Looks like the vet is treating it as a liver problem (Denamarin onboard).
So the bile acids were very likely up enough to clue the vet into something.

My only other thought if it's not liver (I think it may be) and not neuro would be gallbladder problems. This is a pup, right? What are you feeding?

When the first vet on last friday checked his bilirubin it was 28, 2nd vet checked it Monday it was only 0.2 which is below normal, and they said 28 is highly unlikely and was probably an error... bile acid test was pre 2.3, after eating was 49 and normal is 25, So was a little high but with shunts is usually in the 100's, his first test for glucose was 123 and 2nd vets was 102 which are both normal, his liver levels were 51.

Both vets seem to be stumped and referred us to fox valley referral center in appleton wi for additional testing.

I didn't think he was eating much, but he's actually eating right now as I type! Yahoo! Still normal otherwisae as well. He wants me to continue on the anti biotic and liver supplement as well until he's seen again.

Heidi & Carl

That is definitely enough elevation to be concerned. Most likely not a shunt, but still possible. Very possibly microvascular dysplasia. Could be another liver issue altogether.

It would be best to go ahead and make an appt. with the specialist.

That's what I've got to do. He suggested having either an ultra sound or xray of his head to check for an inner ear infection too.

I just wish I had the answers now.