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.

Thanks for sharing the results. I hope the Specialist can get to the bottom of this.

Roxy's IMS said they don't worry about the post until it's over 40

My vet mentioned that a shunt would normally have bile acid results from 150-400s and that 49 while a little high might not be his problem. I did mention the mvd and he said that would be normally found with the ultrasound. Unfortunately the specialists are only available on monday, nice.... He actually seems to be doing REALLY well since I've been home(4 hrs now) so I'm praying maybe the medication just took a few days and is starting to work... Poor sweetie. He seems to be shaking a lot (like how they dry off after a bath) and using his back leg to scratch by his head so I'm wondering if he has an inner ear infection, and if he does if his current antibiotics will fix that?

Yes a single liver shunt usually will throw very high BATs (waaaayyyy over 100).

MVD will NEVER be seen on an Ultrasound though, and a U/S is only about 60% accurate in seeing a single shunt as well (Like Kerri said about Quinn's shunt). A U/S is good to see the size and shape of the Liver and to see if there are bladder stones present.

MVD is tiny microscopic shunting throughout the liver, and can even be in only part of the liver. MVD can be loosely dx through BATs and other testing, but can only be confirmed through a liver biopsy. The end result is always the same though, low protein diet, sometimes lactulose and antib's (depending on the symptoms) and liver aiding supplements. So, one has to decide if it's worth it to put their dog through a liver biopsy just to confirm MVD. I choose not too, bc Roxy had already been spayed and I felt why put her through that invasive surgery when the end result would still be the same: diet and supplements.

Keep us posted!

Did the vet swab the ear and look at it under the microscope?

MVD can't be seen on ultrasound (unless the vet meant doing an ultrasound guided biopsy, but a lot of times those samples are too small).

The Denamarin could make it a bit easier for his liver to work, but the major goal to to help prevent further damage. Lactulose could stop the wobbly thing if its his liver.

I'd honestly be hoping that's what it is right now. If the vet doesn't think it's his liver or hypoglycemia, then it may be harder to deal with. If the vet feels that strongly that it's an inner ear problem, then why are they waiting to take a look?

Ask them to check his calcium and albumin levels.

Hi,

I am praying that you figure out what is going on with your baby, I am new to all of this so I don't have any advice as I am waiting on Bile acids tests for my little one too. I am hoping and praying you find out what is going on soon!! Hang in there!!

Hi Everyone! WONDERFUL news to give you!!!! :)) I got home Friday from work and he didn't seem to have ANY wobbliness, which was good news because when I talked to the vet(the 2nd one I had gone to), he told me that he thought if he did have the liver/gallbladder infection that he suspected he had that the anti biotics would have probably started working by now. He has shown NO signs of ANY wobbliness ALL weekend! I was so happy! Even though he was acting normally throughout that whole time, he seemed to have a little more spark in his running around the house this weekend. He still has 2 more antibiotic pills, will get one tonight and one tomorrow morning and then that will be finished but will still be on the liver supplement until thats gone. (I got a 30 day supply) I'm so excited to call and tell his doctor today how he's doing. Since the medication worked they think he just had an infection considering his blood work was all pretty good.

I am however going to switch his food to an all natural puppy food, just because I've read so many bad things about feeding them different dog foods that don't suite them well. Currently he eats Purina Puppy Chow(has been on this since I got him last July), what does everyone recommend? There is a store by my home that sells all natural foods, including dog food, so I was going to go there. Otherwise I've heard Royal Canine is good too... what do you guys suggest? Also, are treats ok? He likes to eat rawhide bones, bacon treats, things like that. He doesn't get any people food but does like his bones.

I am SO SO SO thankful to God for saving my little sweet man, he means the world to me, thank you everyone for your sweet messages and prayers. I am so thankful for a wonderful site like this .... I can't wait to post more pictures once I figure it out. :)

Heidi & Carl

Yay!!
So happy to hear that he is doing better. I switched my Lucy to Fromm (a suggestion from someone on yorkietalk) and Lucy seems to really like it and you should be able to find it at the specialty pet stores.

Congratulations on your baby being better and I hope it continues that way!!

I'm not sure what happened to my longer post on here that I made Monday morning.....but anyway, Carl has been doing FABULOUS! He hasn't had any wobblies, has been even more spunkier than normal and I think has been cured! :) His last anti biotic was yesterday morning but I'm still continuing him on the liver supplements for another month.

I also changed his food to Royal Canine for Yorkies, he loves its! I couldn't believe how much he was eating, I used to give him Purina Puppy Chow and so I mixed it 1/2 & 1/2 so that he would not get sick and he picked all the purina pieces out and would not eat them ... so this morning I gave him just the Royal Canine. It seems like he has an easier time pooping with this food too as before it always seemed like he had a hard time going. Also he no longer gets tap water, only bottled! :) I am so thankful for my little man... and thank you all for the wonderful help! :)

Heidi & Carl

Sounds just like my boy "Shelby" right now. He has done this almost a year ago. Today he woke up wobbly and swinging head. Very much same details. We did all these test last spring and showed nothing. But now we are back today seeing same symptoms but less. So I am kinda waiting to see if he gets better. It took about three days. I am so lost. Would love to hear about anything you all try please. Thanks! It is just pitful!

I am going thru same thing. But Jupiter looks like her hind legs just give out then her front legs. Excitement brings it on and a couple of times just the excitement of getting a bite of human food like steak and peanut butter made her even go into like a dreamlike state. After a few seconds she snaps out of it. I live in KNOXVILLE TN so her vet is referring us to them tomorrow. Not sure if I get appt tomorrow but hoping so. This has been going on for 1 week today. It was last Sunday we noticed all this. But looking back while playing with her she seemed like she was clumsy when jumping and playing get the toy! I understand what your going thru. I hope all works out for both of us.

I meant to say she being referred to university of Tennessee.