Please Help- Seizure and/or Liver disease!
 

Hi everyone! I just found this forum while researching some health issues my Morkie has been having. I am really hoping some of you can offer some advice and/or information. My nightmare began about 3 months ago.

First, Just a little about my Pup:
He's a 3yr old Morkie, named CRUZ- He's very much ALL yorkie. Hyper & Sweet and smiles too! Thinks he's the boss of the neighborhood! He loves to cuddle, play, his mommy, and treats. He's very well behaved, with the occasional sock hiding game under my bed. He was completely trained in 2 months -smart boy! Never bites, but loves to bark and act tough!

Health: Up until about 3 months ago he was in perfect health! Never an issue, never an unplanned trip to the vet. Takes heartworm and gets his frontline monthly! July my little man experienced his first seizure. Did not last more then 2 mins, soiled the bed. Post seizure: very larthargic, confused, loss of vision (only a couple seconds- he bumped into the wall). I immediately brought him to the vet. By this time, he was starting to act like himself. The vet ran some blood test to make sure everything was normal so they could make sure nothing was causeing the seizure. Unfortunately, blood test came back abnormal with liver enzymes. A couple days later they administered a Bile Acid Test. His scores were Pre:3 & Post:29. Not too bad on the post result, I guess they should be <25. Out vet didnt seem too worried and said we could test again in 8 weeks. On 10/18, Cruz had another seizure. Between 2-2.5 mins. Last week they did another bile acid test and this time his scores were Pre:29 and Post:58. Out vet has now recommended we see a specialist to get an ultrasound for a possible liver shunt.

I've been doing way too much research (keeping me up all hours of the night) and for what I am seeing his levels would be much higher if he had a Liver Shunt but could possible be have HMD. I don't really know too much about this disease or any! Anyone out there with a similar experience? We see the specialist Thursday for an ultrasound! However, my wiggly guy might not be the best patient for that.

Please help! My morkie is my baby! (Sorry for the novel)

I can't be of any help other than to pray for you and your little guy, which I am doing God bless. Hopefully someone with knowledge will see this soon and be of some help to you. Welcome to YT.

Thank you so much! Some of the post have already helped so much, at least by keeping me calm and positive! :)

Best wishes for you and Cruz. I hope the ultrasound helps your Vet figure out what is happening with your sweet boy.
I found this site which has a lot of information about seizures. Dog Seizures Symptoms
Hugs to you both.

I just wanted to say you and Cruz will be in my prayers. Please keep us posted on the ultrasound.

I don't know much about liver shunts, but thought they were in puppies only? Something about a vein not sealing itself off so the liver can't do it's job in cleaning the blood. If that's the case, he would have been showing symptoms much much younger. Again, I don't know much about shunts, but just my initial thoughts.

Seizures are so scary. Scrappy started getting seizures and he ended up passing the same day they started. They were only about 30 secs long each. I would suggest get every test done that the specialist recommends, and if they can't find anything, please get him on meds that will keep the seizures under control. If he does have another seizure you have to hold him until it's over so he won't fall over and hurt himself. I'm so sorry you are going through this. It's such a helpless feeling and you want to help them but don't know how you can. :(

Thank you all so much for your prayers I will keep everyone updated after we meet with internal Medicine specialist Thursday.

I too thought it was more common for shunts too show up when their puppies but then read about where there is type called acquired liver shunts, which result later in life. But then I also read a lot about HMD and some other liver diseases. The only symptoms he has is the 2 previous seizures and high bile acids, current he is running mad through the house with his toys ;)

I agree watching him have a seizure I never felt so helpless!

I'm so sorry you are going through this. My Yorkie has been having some health issues lately so I understand how scary it can be. I'm so glad you found this site. There are some very knowledgable members on here that will be able to give you some very good advice. Whenever I am feeling helpless and scared I always turn to YT. Welcome..........and I will be sending lots of prayers out for your precious baby. Please keep us posted.

Sorry to hear of Cruz's health issues. My Cali has a very mild case of MVD. Her Bile Acids were something like 0/45 and 0/78. After an ultrasound showed no external shunt I had a liver biopsy done when she was spayed. The biopsy showed a very mild case of MVD that required no treatment other than I keep her on a low protein diet. Cali was 8 months old when she was diagnosed. She's now 7 years old. Her vet does yearly blood work which has been good and treats her as liver compromised for any surgeries or medicines she has. As a puppy Cali was a terrible eater and had several episodes of hypoglycemia so they tested her for a liver shunt. She never had any seizures. I hope you can get some answers from the ultrasound. I would have the specialist test for seizure disorders too. Good luck and keep us posted. I will keep Cruz in my prayers.

Seizures can be a secondary symptom of another issue.

Its most important to rule out those innitial causes before the issues is A) deemed neurological B) then determined to be a neurological issue causing them secondary or epilepsy.

My Elvis went through so mich testing everythong negative and nornal...he has cluster seizures and is epileptic.

Foremost be seizure prepared. You need yo create a safe for seizures enviroment, if the cet did not send you with meds keep some karo handy yo gice after seizure-seizures drop blood sugar quickly this is life threatening especially in yorkies.

Many dogs want to eat immediately after a seizure or drink excessively.
Many say to wrao them in a towel-DONT. Give them a soft place wrapping can cause over heating.
Never restrain just protect from injury.
Ensuring the 'come out' is critical or you need to rush to the vet or ceterinary emergency center.

This is all in the meantime advice untim the cause can be determined.
Check all possible environmental culprits new foods plants treats etc
Rosemary and other substances can trigger seizures in epileptics, also many dogs dont have symptoms of epilepsy until 2-4 years old...

However it seems seizures may ve a secondary symptom of another health issue your baby is having.

I hope you get answers quickly.

Oh if the vet gave you meds choking while seizuring is a risk crush them and drop them in the mouth with a liquid ask vet for this option.

Wow thank you all for your support and prayers!

Patti- I am so glad to hear that your Cali is doing so well with MVD, gives me hope. It just concerns me that I can't find any connection between MVD & Seizures. But also my Cruz doesn't fit any other symptoms of liver shunt. Hopefully answers Thursday!

Shan- My vet did not give me medicine for Cruz. In July at the time of his first seizure he wasn't too worried. He said before we make any decisions about medicine he wanted to see what his pattern would be, if he would even have a pattern. Until his bile acids went up he was pretty sure Cruz was just going to be labeled as a idiopathic epileptic. Now with his Bile Acid's rising I guess we are back at square one.

Thanks again everyone, I updated as soon as we meet with the specialist Thursday.

Also- can anyone give me any info about an ultrasound? I am guessing they will call before the apt to tell me know if he has to fast or what not. I hope they have a special way to get them to lay still, because I am 100% Cruz will not be the best patient for that!

I had the same with Elvis...no meds until pattern established and that was even after a neurology consult.
I hate how that is the route, leaves us and them in limbo.
Elvis had 4the ER trips getting Valium injections in the limbo time it was awful.

So so so sorrt someone else abd their furbaby has to experience this.

When Cali and my Pom had ultrasounds they had a technician hold them in place. It seems most dogs will sit still for a vet. I don't reall either of them having to fast but I would call and make sure. WHen my Pom, Maya had one of her ultrasounds (she had Cushing's disease and then liver failure so she had several) they called me in the back to show me while they were doing it what her liver looked like. She remained calm and she was a very hyper dog usually. I hope Cruz doesn't get to stressed and everything goes smoothly.

Thanks Patti!

Awww poor baby. I have one with seizures and another with MVD. Both scenarios can be managed. Best wishes for you!

Sorry to hear about your dog. I had a similar problem with my Bella. She is only 5 months old. 4 months when it happened. She had a first time seizure lasted only a minute or so and then with in 48 hrs had a total of 5 small lasting 30 sec to 1 min. All bile acid test were negative or the enzyme was within the normal limits. All her labs were normal. I was scared because the internal medicine vet stated the same things. US after to see if in fact they could see lack of or re-routed blood flow from the liver. Because everything was negative they went the other route of either a brain abnormality, inflammation, or viral. Because she is so young they didn't want to label her as being an idiopathic epileptic, but they did. She is a "toy" breed weighting only 3.5lbs now and the thought of anesthesia at that low weight could be worse than finding a real diagnosis. So no CT, MRI. For US they just do a moderate sedation not general sedation. Mainly IV with medications to help them relax. If your US tech is good they can do it quick. I have been giving her Phenobarbital for any re-current seizures but she hasn't had any in a month now. Your vet should at least offer a little valium to make the next seizures not as severe. I'm hoping this was a fluke and will never happen again. She did get her immunizations 3 days prior and she got a full adult dose of rabies at the same time. But the vet will not agree nor deny that it could be the reason. In fact he even stated that this case is rare for Bella and has no answer, accept for what he does know. Idiopathic epilepsy at a young age. I feel your pain. Good luck.

Today is the big day! We meet with the internal medicine specialist and get Cruz's ultrasound. Hopefully we get answers and leave with a plan, no more waiting and guessing! Thanks everyone!

I think he's on to me that we're going somewhere not so fun!

Hope you get some answers.

Rooting for Cruz today.

Rooting for Cruz too! My thoughts and prayers are with you all!

i got back from the internal medicine specialist a couple hours ago and I am not really sure how to take how it went. Honestly, I couldn't wait to get home and share my experience/ results with everyone on here to see anyone could relate more.

So Cruz had his ultrasound today and i didn't really find the answers I was hoping for. They said they didn't see any external liver shunts but he didn't suspect one seeing that Cruz did not have any symptoms other then seizures. So before I could even smile, he adds "BUT that doesn't mean their not hidden". Then he tells me that Cruz's liver is small which could suspect a shunt or Microvascular Dysplasia. He said the only way to be 100% would be a liver biopsy. He said there is another type of ultrasound that can be done to detect MVD but sometimes it doesn't provide enough to examine. If my head wasn't spinning enough, he goes to say or Cruz could have epilepsy and mvd or just epilepsy.

He recommended that we sort of do a little trial for a month and see how Cruz does on a special diet and medicine. I told him I was worried about him being on medicine and he assured me there were no side effects because the Medicine for MVD doesn't leave the GI tract and just helps break everything down.

So I guess Cruz is going to do that for a month and then we check his bile acids again to see if they have gone down. Assuming Cruz doesn't have another seizure, then we have then found the problem. If he does, he could still have MVD and Epilepsy.

I asked him if he thought it was weird that if Cruz did have MVD, his only symptom is seizures. His answer "no". I said is there a chance Cruz doesn't even have MVD and just has epilepsy? He said. "That could be possible, their have been studies that suggest normal Maltese's have high bile acids". (Remember Cruz is a Morkie). Now I'm just speechless. I don't know what to do. I feel like the only conclusion we got out of today was that Cruz has a small liver.

The vet did write up a prescription for Neomycin and Lactulose along with special diet ex:Hills prescription id. I am supposed to call my regular vet tomorrow to get more info.

Am I doing the right thing? Should I do this trial for 2 months or just pay for the $3000-4000 liver biopsy and know for sure?? If it was just food as trial I wouldn't mind but medicine always worries me.

Sorry if I babbled. I guess I was hoping for different results. My poor little guy can sense i am upset and I think I am making him worried now!

Wishing you good luck today . My Alfie has epilepsy and is on phenobarbitone for the seizures but this has not eliminated them . I hope you get some answers it is so frustrating until you get the right diagnosisim must have been writing when you posted your results.
I don't know what to tell you to do but your regular vet might help you with your decision.

I have no good advice.

Its all personal choice in a way.

I spent a ton of money with Elvis' test...in the end he takes pheno exactly what our first vet wanted to do off the bat before I spent several many thousands.

All I can say is if you can afford it I would, but if its a pointless test ask the vet how can we stream line this to get an end all answer.

:thumbup: I agree if you can afford it then I would do the liver biopsy as well. I am sorry you feel you still have questions and not enough answers. I don't have experience with liver issues but I feel like from reading your post the biopsy would bring a lot more clarity. It's definitely a personal choice and you have to do what works for you and sweet Cruz. Keep us posted!

I feel the same way about the biopsy (money well spent in my eyes) but then I just keep thinking about how when I asked him if it was possible that Cruz didn't have MVD but just Epilepsy. And he said yes. I just wish their were more test to be done before the biopsy. The biopsy guided ultrasound he talked about (cant remember name) he said couldn't guarantee they would get enough to be sure. So I won't even bother with that. Looks like the liver biopsy is the only way. However he would have to go under anesthesia and if he has liver problems that concerns me too.

I personally would opt for a single test that is more relevent than muktiples even if more invasive-less stress on him.

Nicole-marie I can understand your feelings. I was set up for some pretty hard decisions too. But the things I had to ask were are the treatment options the same whether they find out if your dog has a problem or not? If the treatment is the same of diet,meds,and waiting then why put your dog through it? My internal med vet explained that if the treatment were the same then why go through it all, to find an answer? But then at what cost? I told him that the money wasn't the issue but the quality of life for my dog. Then he asked what is your view of "quality of life". "I put my dog through all these test and stress to find nothing or to find some diagnosis and the treatment is what we are doing now". He even went as far to say to postpone the test that were invasive, CT, MRI with anesthesia unless my dog had more seizures with the treatment option given, which are medications. Are the bile acid tests just a rich diet? If you just changed a few things like diet and gave him medications and just waited to see how things go, would it be enough? I was left with this option also. Its a hard one. My dog is much younger than yours but it is still hard to absorb. I went for the option of not doing the tests and anesthesia and just spoiling her with play and treats and just medication. I hope that the seizures won't return. But if they do then I will cross that road but at least I have options. I cant tell you what you should do, but hopefully to see it with different eyes.

Thanks everyone! I spent most of the night tossing and turning and trying to come up with the best plan for Cruz. It is just very hard for me to say yes do the liver biopsy when I don't look see a sick dog. He's had 2 seizures in 5 months -no other symptoms! One thing that stuck out in my mind and that I forgot to mention was how the specialist mentioned there were studies indicating that healthy Maltese's have higher bile acids concentrations. This is where he kept mentioning how he could just have epilepsy! (BAT!s were 29/58).

Winkerbean~ everything you said made perfect sense! The treatment plan would be exactly the same if he was officially diagnosed. I kept saying this to my husband last night. I think that's when I initially made up my mind. I am going to change his diet and retest the bile acids in a month or two. If we see good results then I know we are on the right track. If we don't, then maybe address the medicine and see if that makes a difference. (Considering Cruz doesn't develop new symptoms)

Thanks everyone for all the input and helping me clear my head! Even just reading other stories has provided me with so much information on every topic. In fact I just ordered a buddy belt for Cruz! :) :animal-pa