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DrLucy
DrLucy, Dog Veterinarian
Category: Dog
Satisfied Customers: 618
Experience:  Almost 30 yr as a practicing small animal vet.; experience in gen.medicine, surgery, emerg/crit.care
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MY DOG HAS NOT BEEN SLEEPING SHE KEEPS WALKING AROUND THE HOUSE

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MY DOG HAS NOT BEEN SLEEPING SHE KEEPS WALKING AROUND THE HOUSE HER TAIL BETWEEN HER LEGS. BACK IN 2001 WHEN SHE WAS 10 WEEKS OLD SHE WAS OPERATED ON FOR A LIVER SHUNT. SHE IS SOMETIMES AGRESSIVE TOWARDS US, BUT NOT ALWAYS, SHE JUMPS ON THE COUCH THEN ONE MINUTE LATER SHE GETS DOWN AND WALKS AROUND THEN COMES BACK FOR A FEW MINUTES SHE WILL DO THIS MOST OF THE DAY. IT IS LIKE SHE CAN NOT STAY STILL. YESTERDAY WE TOOK HER TO HER VET AND SHE HAD A TEMP OF 103 HE PUT HER ON SOME MEDS ZENIQUIN 25MG INCASE SHE HAS AN INFECTION. AND TO TRY HILL'S DIET L/D. ON HER BLOOD COUNT HER LIVER COUNT WAS A LITTLE HIGH. HE THINKS SHE MAY NEED TO SEE A NEUROLOGIST. DO YOU HAVE ANY SUGGESTIONS?? WE WANT TO DO ALL WE CAN FOR HER. WE CAN TELL SHE IS NOT HAPPY
Submitted: 6 years ago.
Category: Dog
Expert:  DrLucy replied 6 years ago.
Her ammonia level may be too high, if her liver is not processing protein properly. Most times, even after surgical correction of a shunt, the liver does not function normally. A bile acids test will help determine if the previous shunt is still affecting her liver. Some vets have the ammonia test, which is most accurate when it is run immediately after the blood sample is drawn. There are some ways to decrease ammonia somewhat, including oral or rectal lactulose, which would have to be obtained through your vet. If you have access to an internal medicine specialist, they will be able to give you the most information on how to handle her current problems. Good luck.
Customer: replied 6 years ago.
So would the L/D diet help her? She has been on the L/D diet for 1 1/2 days now and she has started to sleep a little. Still not herself though. Would she need more meds from specialist who did the shunting? I hope you are saying there is hope for her.
Expert:  DrLucy replied 6 years ago.

I think you will be able to tell a lot by having the bile acids test done. It should be done as a pair of blood tests: fasting and post-feeding (post-prandial). The ammonia test is helpful, but not essential. The L/D diet helps to control the protein level she is eating, so it usually helps, since one of the by-products of protein digestion is ammonia, and it is ammonia that is most likely the substance that is causing her unusual behavior. Smaller meals, frequently, instead of larger, less frequent meals, should help prevent an "ammonia rush" that could occur after eating a lot of protein. The "catch 22" of protein restriction, however, is that the liver supplies the body with albumin, the most important protein component in the body. It transports many import chemicals in the body and is the main substance that regulates the fluid component of blood. Restricting protein intake too much can cause albumin to drop. Therefore, the protein that she does take in should be of the "highest quality" possible, in terms of amino acid (protein components) composition. Milk protein (casein) and egg protein are very high quality proteins, and I believe that L/D is high in the percentages of these. Do you remember whether the albumin level in her blood was lower than normal? Was her blood glucose normal?

 

I do think that there is hope for her. The fact that she is already 7 years old is in her favor. If the surgery had not helped a lot, she would have had many more problems early in life. If you can take her to an internal medicine specialist, who can help you tailor a maintenance program for her, that would be ideal. There are some supplements available, like Marin, and Denosyl, that sometimes help support liver function. The internist will probably do an ultrasound of the liver. I doubt that a visit to the surgeon would be all that helpful at this point, because you are probably not dealing with something that can be treated surgically.

 

Just one additional thought: It would still be wise to see a neurologist. One shouldn't just assume, since she has had this major liver problem in her life, that all subsequent problems will be caused by it. It is possible that her odd behavior could be caused by something else.

 

I have some other obligations today, but I will check back in this afternoon.

Customer: replied 6 years ago.
The doctors who did the shunt are internal medicine specialist. And they do but don't specialize in neurology. Maybe we should see the Neurologist specialist first then the internal medicine specialist. To make sure there is nothing going on in her head first. What do you think?

Thank you for all your help :)
Expert:  DrLucy replied 6 years ago.
If I had my choice, I would see the internist(s) first, to have the bile acids test (+/- the ammonia test) done. While you wait for those results, you can start her on medication to reduce ammonia in her blood stream (which won't hurt her is it is not a problem), and then go see the neurologist. Something in her head is low on the list of possibilities, whereas something related to her shunt is high. However, if you can get an appointment quickly with the neurologist, by all means, go.
DrLucy, Dog Veterinarian
Category: Dog
Satisfied Customers: 618
Experience: Almost 30 yr as a practicing small animal vet.; experience in gen.medicine, surgery, emerg/crit.care
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