# When it rains, it pours (tears)



## tamizami (May 1, 2007)

I am totally beside myself with worry about my little puppies. Shiva is very lethargic and seems to be in an intoxicated state (ataxia), one of the symptoms of toxins in her system.

Today I got Stewie's results and his ALT is sky high and his postmeal bile acid is higher than Shiva. His fasting bile acid was normal. Everything else was good on his report, including albumin, cholesterol, etc. except for some of his blood counts: LYMPHOCYTES and Platelet Count (both were high, 5842 and 488 while normal range is 690-4500 and 170-400 respectively). I was so concerned about Shiva's lethargy and wobbley walk that I forgot to talk to my vet about Stewie's blood counts. But we did postpone his neuter until we have more answers.

I've been reading up on medical treatment, have bought a bunch of low-protein food WITHOUT any copper in it. My vet has lactulose coming tomorrow for me and I picked up Milk Thistle at the health food store, so I have some while I wait for Marin to arrive.

My big question is: How much should I give her? She is 3 lbs, 5 oz. 

The only thing she will eat today is "fake" vanilla yogurt and hazelnut butter (with tons of sugar in it). She will not eat her meat, which I am fine with that, but she has been constipated since Tuesday morning (the lactulose will help with that).

Please help? I just want to get their diets realigned and the supplements going before I subject them to the scintography (radioactive scan). Sorry for the rambling, my head is throbbing from thinking and researching and worrying. :smilie_tischkante:


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## Lil Boo Boo (Jul 22, 2006)

I have no advice for you but I sure hope things get better for your babies, I know someone on here will have some good answers for you. Keep up the good work, your doing everything you can. Big hugs to you and yours :grouphug: :grouphug:


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## Malteseluv (Feb 6, 2007)

I'm so sorry that Stewie's BAT came back high...The best piece of advice I can give you is to join the liver shunt/mvd group: http://pets.groups.yahoo.com/group/Liver_S...nd_MVD_Support/
The FILES section has an incredible amount of awesome information, and the members are extremely knowledgable.
I have a yorkie whose BATs were over 300 and we have been dealing with his condition for over 3 years. There are several foods that you can feed your Stewie that are safe and nutritious. You want to avoid anything with red meat because it produces the highest amount of toxins. Has he ever had UTIs or stones/crystals? If he has, stay away from anything with fish or fish meal because it's very high in purines which is bad for liver compromised dogs. 
Milk thistle (marin) is very beneficial for their livers...Also, denosyl (sam-e) helps the liver...This supplement must be given whole, NOT crushed and on an empty stomach(usually mornings), otherwise, it's as good as not giving the pill at all. Lactulose is really important also as it helps absorb the toxins and push them out.
Lactulose should be given either on the food or directly after each meal if at all possible. I can usually get my yorkie to take it if I mix it in nonfat organic plain yogurt(good b/c of probiotics) or nonfat cottage cheese. 3-4 small meals per day is optimal so that it lightens the load on the liver.
Please join the group that I suggested. 
I'll be praying for your little guy. Please let us know the results of the scintigraphy.

Oh, I forgot to mention...Usually liver compromised dogs have a lack of appetite because most foods make them feel sick because of the toxins produced. Once you get your baby eating the right foods (vegetarian/low purine), he will start eating better.


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## Ladysmom (Oct 19, 2004)

Good heavens! Are they related by any chance or did you just get really unlucky? :grouphug:


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## elly (Sep 11, 2006)

I am so sorry, I Will keep your babies in my prayers.

Cathy


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## msmagnolia (Sep 8, 2004)

I'm so sorry that you are having problems with your babies. I hope you can get some answers very soon....


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## Andrea&Luci (Jul 30, 2006)

Omigod I am so sorry... I hope your babies get better soon...stay strong. :grouphug: :grouphug: :grouphug: :grouphug:


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## coco (Sep 20, 2006)

I know nothing about all of this, but I want to tell you that I will be keeping your babies in my thoughts and prayers. :grouphug: :grouphug:


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## Cathy (Mar 19, 2006)

Oh geez, I couldn't believe what I was reading. I'm so sorry that you're having such health problems with your babies. What a worry this is for you. Please know that we are here to support you. Keep us updated.

Cathy A


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## bellaratamaltese (May 24, 2006)

Oh no Tammi, not your precious babies!!! I'm so sorry to hear this. I wish I had some advice for you but I don't even want to attempt to answer because I just don't know! *hugs you*


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## tamizami (May 1, 2007)

Thank you all for the kind words, I'm feeling a lot better because I made a trip to the emergency vet. I was perusing the Liver Shunt/MVD yahoo club and started to get completely panicked about Shiva's lethargy. So off we went to the vet, who did some motor tests on her and xray'd her tummy and she is backed up, but seems to be improving in mobility, etc. I am quite relieved about that.

Her advice is to repeat the blood tests. Both dogs appear very healthy and normal, and all of the other values are normal/good range....in the meantime, I will switch them off the high protein red meat diet (hormone & antibiotic free though) and into 15-20% animal protein....might try some quinoa or amaranth for protein substitutes. And I have Marin on order and will get lactulose tomorrow.

My dogs are not related at all. Maybe its the way the vet did the test? I mean you hear that this is prevalent in maltese, but this is ridiculous. Both dogs come from very healthy lines.....but they are both the runts of their litters, so maybe that is the commonality? I hope that Sharon Center gets a DNA test soon for this!

Thank you all again for the kind words and support, this is the best forum with the best members.


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## carrie (Aug 24, 2004)

gosh...i'm so sorry. poor little souls. i sure hope you get their ailment under control.... you'll be in my thoughts. :grouphug:


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## Malteseluv (Feb 6, 2007)

Lethargy is one of the symptoms of hepatic encephalopathy. When Miko gets backed up because he hasn't gotten enough lactulose, the toxins build-up and cause symptoms...


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## Maidto2Maltese (Oct 19, 2004)

Have no words of advise but certainly am saying lots of prayers for your precious babies!


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## k/c mom (Oct 9, 2004)

Oh, my thoughts and prayers are with you and your babies, Tami. :grouphug: :grouphug: :grouphug:


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## I found nemo (Feb 23, 2006)

:grouphug: My prayers are with all of you, I hope things get better and soon
Good Luck,
ANDREA :grouphug:


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## Missy&Maggie (Jun 17, 2007)

:grouphug: :grouphug: I am so sorry to hear about this!!!! :smcry: I really hope that things get better for you and our babies. When we discovered Maggie's heart murmur and tiny hole in her heart, my mom reminded me that it did not make me love her any less and that I need to try not be upset because she did not know what is going on. My mom also reminded me that I should be happy because if Maggie had gone to another home, she would not be getting the great care that I give her. Try to be strong for Stewie and Shiva!!! I know that it is hard!!! I pray that you get some good news!!! rayer: rayer: rayer: Please keep us updated with latest news on your precious babies!!!


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## Scoobydoo (May 26, 2005)

Omg, I am so sorry you are going through this with both your babies, I know how you must be feeling, my thoughts and prayers go out to you and both Stewie and Shiva :grouphug: :grouphug: :grouphug:


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## Tanner's Mom (May 27, 2005)

Oh Tami, I am so sorry to hear about your babies. When I was giving Tanner Milk Thistle, I initally gave him half a capsule, just sprinkled it on his food, then I moved up to sprinkeling the entire cap. I did try giving him Denosyl (which you can also order from Entirely Pets), but he kept spitting them out so I gave up. I am very pleased with the results from Marin as his ALT has come down almost 10% since I started in February. Tanner doesn't eat any red meat, as far as I'm concerned, he doesn't know what it is! I rotate his food between Candae Platinum, Ckn Soup for the Dog Lover's Soul Senior and Rocky Mountain something from Merrick, all canned. He will go thru bouts when he's not hungry and it scares me, but the next meal he is ravenous. We'll be thinking about y'all, keep us posted.


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## Malteseluv (Feb 6, 2007)

If your maltese won't take the denosyl pill or giving it to him on an empty stomach makes him nauseous or he spits it out, you can order Vetri-DMG from www.homevet.com...It does basically the same thing as denosyl/sam-e.


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## Ladysmom (Oct 19, 2004)

Here's a really good article on Milk Thistle including dosage by weight:

http://www.canine-epilepsy-guardian-angels...ilk_thistle.htm


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## Lacie's Mom (Oct 11, 2006)

Sending prayers and positive thoughts. :grouphug:


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## Malteseluv (Feb 6, 2007)

May I ask which foods you are considering feeding Stewie until you find out more info?


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## tamizami (May 1, 2007)

I've pulled them both off of any meat based proteins and am feeding them homemade of scrambled eggs mixed with pasta, butter & cheese; or organic yogurt and fresh fruit (watermelon); organic, no-salt peanut butter. My vet gave me Royal Canin Hepatic formula and Stewie ate a little today when I sprinkled cheese on it. I am feeding them both 4-5 times a day, small meals. Currently giving Shiva Lactulose, but it doesn't seem to be helping her constipation, lethargy and stumbling. I'm giving them both Milk Thistle. Stewie is asymptomatic at this point, but I am taking Shiva to an internal medicine specialist with Sharon Center's presentation from Nationals tomorrow morning.

I'm also concerned if the Dogswell Chicken and Duck glucosamine treats may be tainted? They are made in China and I saw something on the Liver Shunt yahoo group about Smokehouse treats that are made in China and tainted with mold. Both treats look exactly the same. Has anyone else had any adverse effects with these treats?


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## Malteseluv (Feb 6, 2007)

I did see that on the liver shunt group, but I don't give any meat-based treats...Maybe someone else knows? I really hope those treats weren't tainted...But at this point, nothing surprises me.

It looks like you've got everything together!! I hope Shiva starts feeling better soon. I know how scary this is. I was there 3 yrs ago. 

You might need to have the vet put her on antibiotics to help pull the toxins from her system...Have you increased her lactulose dosage? Sorry to get so graphic, but what you will probably see when she finally does have a BM is that part of the stool will be very, very firm and then the rest will be mush...Ideally, you will want the stool to be soft but not a pile of diarrhea, if it's firm, that's not good...but if she has diarrhea a couple of times while you are getting the dosage right, it's okay. It takes some tweaking to get it right.

As far as the peanut butter, be very careful with it. It's generally not recommended for liver-compromised dogs, and it's very high in fat and protein. The amount of protein in just one spoonful is probably more than a tiny liver compromised dog with HE symptoms should have in an entire day.


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## tamizami (May 1, 2007)

Thank you for the feedback, I've been combing the yahoo forum and researching every tidbit I can get my hands on. I'm happy to report that the lactulose finally did the trick and I think we had the perfect consistency too. I only give her a very tiny amount of peanut butter with the lactulose mixed in....I'll try to hide it in yogurt and see how that goes. 

She's definitely a lot perkier tonight, playing a little and just ate some pasta with scrambled egg, butter, cheese, peas and carrots. Lets hope we've turned the corner on any toxins in her system.


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## Malteseluv (Feb 6, 2007)

That's so wonderful!! It usually takes awhile to get them on just the right schedule, but it sounds like she's really coming around  Great news!


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## LynnToole (Jan 15, 2006)

Hi Tami, I am so sorry to read about all of the problems your fluffs are having. I don't know anything about this, but I'm wondering if the emergency vet was onto something when she said to repeat the blood work. Is this the first time that they've had abnormal liver results? Maybe the laboratory is having problems with this particular test. It's worth checking to see if all of the lab's liver values have been off, just in case. I sure hope that your fluffs are okay, and that you can get answers for everything, you must be going crazy over all of this.


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## coco (Sep 20, 2006)

I know absolutely NOTHING about this, but could it have anything to do with the food they are eating? This sounds very strange to me. I am so sorry, and I hope you get answers soon. Maybe more testing is in order. Good luck!!


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## tamizami (May 1, 2007)

I have both pups schedules for scintigraphy tomorrow (liver scans), which should tell us if they have a shunt or not. If not, likely suspect is MVD. If so, not sure what to do next but I am requesting my vet speak with Dr. Sharon Center of Cornell.

I mentioned this on another thread but think it is worth repeating again: a blood panel (even complete or "large" panel) may NOT tell you if you baby has a problem with their liver. Shiva's ALT has been normal for 2 years with 6 month checks. The ONLY test that will tell you if you have a healthy liver is the bile acid test. You need a pre-meal sample and a post meal sample (2 hours after feeding). You do not need to conduct a 12 hour fast for the pre-meal sample. This is based on the latest research from Dr. Center. 

The reason it is important to test your puppies early is so that you don't make the same mistake I did and put them on a high protein, "raw" diet. This diet can exacerbate the problem with the liver and poison your dog because the liver cannot effectively remove the toxins from the meat and you get ammonia build up. 

I will keep you posted on the tests when I get the results on Thursday.


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## bellaratamaltese (May 24, 2006)

> I have both pups schedules for scintigraphy tomorrow (liver scans), which should tell us if they have a shunt or not. If not, likely suspect is MVD. If so, not sure what to do next but I am requesting my vet speak with Dr. Sharon Center of Cornell.
> 
> I mentioned this on another thread but think it is worth repeating again: a blood panel (even complete or "large" panel) may NOT tell you if you baby has a problem with their liver. Shiva's ALT has been normal for 2 years with 6 month checks. The ONLY test that will tell you if you have a healthy liver is the bile acid test. You need a pre-meal sample and a post meal sample (2 hours after feeding). You do not need to conduct a 12 hour fast for the pre-meal sample. This is based on the latest research from Dr. Center.
> 
> ...


oh Tami, I am soo sorry!

At Nationals, they had a wonderful seminar on liver shunt and I learned so much. I'm jsut sorry that you are having to learn this the hard way. *hugs you*


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## msmagnolia (Sep 8, 2004)

Tami, I'm so sorry that your pups, and you, are going through all of this. I will be watching for news tomorrow about their tests. 

Last winter Sadie had few months with terrible stomach problems. Her ALT was high, but the other values were fine. I insisted on tests and the bile acids were fine, thankfully. After losing Sassy to NME, I just couldn't believe that Sadie was going through health problems too. She has a sensitive digestive system and maybe some irritable bowel and we have to be very careful. 

I just wanted you to know that I can appreciate how really upset and nervous that you must be. We'll all be pulling for you and the pups and we'll be hoping for the best...


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## Malteseluv (Feb 6, 2007)

That is so true, Tami...The liver must be 70% damaged before abnormalities will show in routine bloodwork...That's why bile acid testing is so important.


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## tamizami (May 1, 2007)

Well, the whole 'pack' went to pick up Shiva this evening from her scintigraphy. She doesn't seem any worse for the wear except for the mats on her behind, which I will get to when she is feeling a little more settled. Of course, I have been a wreck all day today. We won't get the results until tomorrow, I am hoping for the best but expecting the worst. Actually, I'm not sure what is worse - shunt or MVD? They can surgically correct the shunt, MVD is only manageable by diet. But because she has the signs of HE and her BATs were over 100, I'm pretty sure it will be the shunt.

Both puppies are getting offered the Royal Canin Hepatic formula (I think its better than Hills L/D, but also has drawbacks). Both are not eating it. But they are loving yogurt; rice with carrots, celery and peas; watermelon all the time instead of only as occassional treats; and vanilla flavored Kefir. I haven't gotten them to eat oatmeal yet, but that is supposed to be very good for them to help pull out the toxins and provide thiamine. 

I will let you know an update tomorrow once I've gotten the results. Thank you all again for the support, thoughts and guidance!


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## Cathy (Mar 19, 2006)

Tami,

My heart goes out to you and your kidz. I'll be watching for tomorrow's post from you.

Hugs,

Cathy A


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## msmagnolia (Sep 8, 2004)

> Tami,
> 
> My heart goes out to you and your kidz. I'll be watching for tomorrow's post from you.
> 
> ...



So will I........


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## beckybc03 (Jul 6, 2006)

I am praying that you get some promising news :grouphug:


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## tamizami (May 1, 2007)

I just got preliminary news from my vet that the scintigraphy does not show signs of a liver shunt. Good news, but the question remains, whats wrong with Shiva? From what I read, it didn't seem like dogs get HE from MVD? I'm going to the vet this afternoon to test for lepto and heartworm to rule those out since they can affect the liver.

Thanks again to everyone for all your support and positive thoughts!


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## bellaratamaltese (May 24, 2006)

> I just got preliminary news from my vet that the scintigraphy does not show signs of a liver shunt. Good news, but the question remains, whats wrong with Shiva? From what I read, it didn't seem like dogs get HE from MVD? I'm going to the vet this afternoon to test for lepto and heartworm to rule those out since they can affect the liver.
> 
> Thanks again to everyone for all your support and positive thoughts![/B]


I can't answer your question about what is wrong with Shiva, but thank you for updating us on the results. *hugs you* I'll be keeping you in my thoughts today.


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## msmagnolia (Sep 8, 2004)

Thanks for the update. We are standing by as info becomes available about Shiva!


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## Malteseluv (Feb 6, 2007)

Dogs *do* get HE from MVD...My yorkie has MVD and for awhile, it was quite challenging to stabilize his condition to get him better. Now he has been symptom free for months


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## tamizami (May 1, 2007)

> Dogs *do* get HE from MVD...My yorkie has MVD and for awhile, it was quite challenging to stabilize his condition to get him better. Now he has been symptom free for months [/B]



How long did it take before the HE symptoms went away? I've had Shiva off meat for a week now (low protein vegetarian diet with some dairy, eggs), Lactulose since Saturday, antibiotics since Monday. I hate to see her like this. She seems to be making very slow progress, but wants to sleep a lot. She wobbles when she walks and stumbled tonight when she was walking.


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## Malteseluv (Feb 6, 2007)

Is she on antibiotics? It sounds like she might need an antibiotic like amoxicillin to help clear the toxins...When my yorkie gets these HE symptoms, he is put on amox for 2-3 weeks...
It can take awhile to get the protocol right. Even though she's on low protein, you need to monitor exactly how many grams of protein she's taking in per day. I know you're feeding the right kind of protein, but the amount when they have HE symptoms is important also. For a dog having symptoms, it should be 1-1.5g per kg of body weight per day. Fat is hard on their livers also, so make sure the food isn't fatty.


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## tamizami (May 1, 2007)

Thanks so much for the info! Yes, she is on amoxicillin....internist gave me a 10 day supply. She must be eating less than 1g of protein per day, because she hardly eats. I worked out all the calculations yesterday for the 1-1.5g per kg....when she is HE, she gets 1.4-2g protein per day based on her weight (if not its 2.8g/day).

She won't eat anything in the morning except a little yogurt (1.5 teaspoons today with a dollop- like 1/8 teaspoon of praline with her lactulose). 

She also ate a little RC hepatic yesterday (1/8cup) and some watermelon. She always is hungrier in the afternoon/evening and in better spirits then too. Not shaking. 

How long do you think before the HE symptoms go away?

Our vet appointment is today at 2, taking hubby along with me.


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## LynnToole (Jan 15, 2006)

Tami, I hope you come home from the vet with encouraging news, and maybe everyone can have a restful weekend. My prayers to you and your fluffs.


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## tamizami (May 1, 2007)

We went to the vet yesterday and he went over the test results with me. We also did a lepto titer, heartworm and pancreas check and checked her glucose to make sure everything was ok. Her glucose is borderline low (at 3:00), I'll get the other results on Monday. 

He said that dogs with MVD don't get HE, which is contrary to what I've read from Dr. Center and heard from other owners with liver compromised dogs. I have to vent a little, I'm very disappointed with him and the fact that he was reading a *10 year old paper *from Dr. Center on MVD! I gave him the 15 or 16 page document from her presentation at Nationals 2 weeks ago. Oh, and now he said we can do a protein c test, which I had asked about LAST WEEK before the scintigraphy. And he told me to put her back on half of her old diet (RAW) and half RC Hepatic support, that she's probably not feeling well cause I changed her diet too much and she isn't eating. Never mind that she started not feeling well BEFORE I CHANGED HER DIET.

Unfortunately Shiva is still not herself. The morning is the worst, she is shaking and screams if you pick her up, like poor baby is in pain all over. I wonder if its low-blood-sugar and the fact that she is hardly eating. I give her goats milk with 1/8 or less teaspoon of praline spread (first ingredient is sugar, others are all natural) with her lactulose. And I have to admit, I boiled organic boneless, skinless chicken breast last night to use the broth to make rice and veggies for them and she gobbled up a teaspoon. So she is hungry, just doesn't like anything other than meat.  But she did seem really happy after eating and when we went for a walk (she rides), she wanted to get out and walk a little. She looks so cute waddling on the strand. No stumbling today, so that is a really good sign.

Anyway, if anyone has any ideas, feel free to throw them my way. Also, can anyone tell me more about NME? What are those symptoms? I don't know anything about it, want to find out a little more to rule that out.

Thanks and hope everyone is having a good weekend.


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## k/c mom (Oct 9, 2004)

> We went to the vet yesterday and he went over the test results with me. We also did a lepto titer, heartworm and pancreas check and checked her glucose to make sure everything was ok. Her glucose is borderline low (at 3:00), I'll get the other results on Monday.
> 
> He said that dogs with MVD don't get HE, which is contrary to what I've read from Dr. Center and heard from other owners with liver compromised dogs. I have to vent a little, I'm very disappointed with him and the fact that he was reading a *10 year old paper *from Dr. Center on MVD! I gave him the 15 or 16 page document from her presentation at Nationals 2 weeks ago. Oh, and now he said we can do a protein c test, which I had asked about LAST WEEK before the scintigraphy. And he told me to put her back on half of her old diet (RAW) and half RC Hepatic support, that she's probably not feeling well cause I changed her diet too much and she isn't eating. Never mind that she started not feeling well BEFORE I CHANGED HER DIET.
> 
> ...


I'm so sorry that things aren't going as well as we all had hoped. I'm just wondering if there is a vet school or specialist nearby that you could go to. It sounds like your vet may be lacking in the ability to do the best for her. I hope and pray that she gets well. :grouphug: rayer: :grouphug:


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## tamizami (May 1, 2007)

You'd think in LA I would be getting great care. I went to an internal medicine specialist earlier this week and got the amoxicillin for her. I just think we've all been focused on the high bile acids and thus on the liver.

If Dr. Jaime reads this, I'm curious if there is some way to look at the symptoms, like ataxia, and see all the possible reasons? I should note: her temperature is normal, her eyesight and hearing is normal, she doesn't seem to be having any seizures. Her main symptoms are the ataxia and listlessness and melancholy. Sometimes she seems like she wants to play but when she stumbles, she stops. She sleeps A LOT.

I have a book coming this week that I hope will help me get some answers.


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## k/c mom (Oct 9, 2004)

> You'd think in LA I would be getting great care. I went to an internal medicine specialist earlier this week and got the amoxicillin for her. I just think we've all been focused on the high bile acids and thus on the liver.
> 
> If Dr. Jaime reads this, I'm curious if there is some way to look at the symptoms, like ataxia, and see all the possible reasons? I should note: her temperature is normal, her eyesight and hearing is normal, she doesn't seem to be having any seizures. Her main symptoms are the ataxia and listlessness and melancholy. Sometimes she seems like she wants to play but when she stumbles, she stops. She sleeps A LOT.
> 
> I have a book coming this week that I hope will help me get some answers.[/B]


What does your vet say about the ataxia? I wonder if you should see a neurologist? :grouphug:


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## tamizami (May 1, 2007)

Shiva is better today! She woke up happy, no shakes or shivers. She walked (slowly) off leash today for a few blocks and ate well this morning and this afternoon. Its my first day feeling like she is really getting better...wish me luck on stabilizing her the rest of this week before we head to Hawaii on Saturday. Its so sad that I don't really want to go, but its our 10 year anniversary and hubby needs a vacation.


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## bellaratamaltese (May 24, 2006)

> Shiva is better today! She woke up happy, no shakes or shivers. She walked (slowly) off leash today for a few blocks and ate well this morning and this afternoon. Its my first day feeling like she is really getting better...wish me luck on stabilizing her the rest of this week before we head to Hawaii on Saturday. Its so sad that I don't really want to go, but its our 10 year anniversary and hubby needs a vacation. [/B]


I am sooo happy that Shiva is better today!! I will keep her in my thoughts this week that she continues to improve so you can go to Hawaii relatively worry free! *hugs you*


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## tamizami (May 1, 2007)

Thanks Stacey, I appreciate your support. Are you still coming down here next weekend for the Cypress show? Needless to say, I won't be able to come...if you are coming, GOOD LUCK!!!! Hope you and Caira take home 1st place and lots of points.


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## Gemma (Jan 19, 2006)

I'm so sorry you are having so many problem  I'm glad that Shiva is doing better today. I hope every one is much better by the time you have to go to vacation and I hope you have a good time :grouphug:


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## Maidto2Maltese (Oct 19, 2004)

Praying this is the beginning of her feeling much better!!!


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## Malteseluv (Feb 6, 2007)

Wow, I'm quite surprised that your vet said that HE symptoms cannot be seen in a dog with MVD...It sounds like he's not up to date with liver issues because if he was he would know that it is. I've been dealing with Miko's severe MVD for 3 yrs now. Seizures, ammonium urate stones, head pressing, etc. Here are a couple of links that you can follow and print out to give to your vet...
http://www.vet.utk.edu/clinical/sacs/shunt/diagnosis.shtml
http://neuro.vetmed.ufl.edu/neuro/Journal_...les/PSS_Art.htm

Here's a quote from the Merck Veterinary Manual: http://www.merckvetmanual.com/mvm/index.js...tm/bc/23603.htm

*Hepatoportal microvascular dysplasia *is often seen in animals predisposed to congenital PSS, including mixed-breed cats and small-breed dogs (particularly Yorkshire Terriers and Cairn Terriers). Affected animals may be asymptomatic or show clinical signs, which include anorexia, vomiting, diarrhea, *hepatic encephalopathy*, and dysuria due to ammonia biurate crystals.


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## Malteseluv (Feb 6, 2007)

I'm very happy to read that she's feeling better!!


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## msmagnolia (Sep 8, 2004)

Tami, I continue to watch this thread and hope that you will have some sort of diagnosis soon. Just curious but why are you trying to learn about NME? Has your vet mentioned this as a possibility?


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## 3Maltmom (May 23, 2005)

Tami ~

I have a very good "network" of vets, in So Cal. Daisy's vet is AWESOME. She will, most certainly, lead you in the right direction. I'm thinking you could fax her the vet's paperwork, she could look it over, and refer you to a specialist, in your area. Just a thought.


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## tamizami (May 1, 2007)

> Tami ~
> 
> I have a very good "network" of vets, in So Cal. Daisy's vet is AWESOME. She will, most certainly, lead you in the right direction. I'm thinking you could fax her the vet's paperwork, she could look it over, and refer you to a specialist, in your area. Just a thought.[/B]



I may want to take you up on that. I'm really hoping to find a vet and/or internal specialist that is very familiar with maltese and/or liver disease. It concerned me when my vet was quoting a 10 year old report that MVD dogs rarely get HE.......and suggested I put her back on her raw diet combined with the RC Hepatic formula. 

Can I give you a call sometime today to discuss?


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## Scoobydoo (May 26, 2005)

Tami I am so sorry that Shiva is having such a bad time, but also please to see some improvement :grouphug: 
I know what you are going through with the vet too, the same thing happened with Scooby when he became so sick with Fanconi, the so called specialist internist who diagnosed it was so far behind with his primitive care had we listened to him and not sought out other opinions and help I am sure Scooby's health would be a lot worse today.
Tami do get other opinions and also don't give up hope :grouphug:


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## elly (Sep 11, 2006)

I am so glad she is feeling better today. i have also learned that you have to take charge of your pets health. I think it so sad that we cannot always get the help we need from a trusted vet. 

Cathy


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## bellaratamaltese (May 24, 2006)

> Thanks Stacey, I appreciate your support. Are you still coming down here next weekend for the Cypress show? Needless to say, I won't be able to come...if you are coming, GOOD LUCK!!!! Hope you and Caira take home 1st place and lots of points. [/B]


No, I am not going to be able to go -- Caddy is due on the 30th and I just don't want to risk leaving her for the weekend. I still need to work on caira's coat anyway, she isn't likely to get many points unless she is close to a full coat! 

I'm so sorry you are having to deal with this! *hugs you tight*


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## gibbert (Jan 13, 2005)

I am so very sorry about the health issues Shiva is going through. I was very happy to read your most recent update stating that she's finally feeling a little better. I'm sure this ordeal has had you going crazy, trying to figure out what is wrong with your precious little girl! I pray that she is nealry out of the woods, and that her recovery is a swift one. Please keep us updated when you can. Big hugs, prayers, and positive vibes coming your way. :grouphug:


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## tamizami (May 1, 2007)

Hi everyone, I'm cautiously optimistic that we are turning the corner on this. I'm also starting to think that Shiva's strange behavior may in fact have been due to physical injury from playing with Stewie - she definitely tries to avoid him when walking around. She took a walk yesterday - she loves them off leash, hates to be on the leash - and ran a bit. Tonight she ran even more and no more stumbling. She also ate much better today, hooray!

We're done with her amoxicillin, so hopefully that is helping her appetite. I still have her on lactulose - she has always been prone to constipation so I don't think it will hurt her.

Finally, you probably will think I'm nuts, but I am trying to see an animal communicator tomorrow or Thursday. First thing I want to know is what is wrong with her - where does she feel bad? And what kind of food does she want? And I want the communicator to let her know we are leaving town for a few days and she & Stewie will be visiting the breeder and other dogs (& having lots of fun) and see how she feels about that. And lastly, I want to ask her if she wants her knees operated on. I figure I might as well go for broke if I'm going to be paying the money for this. 

Also, I spoke with Jan Rasmussen today (author of Scared Poopless) and she gave me a referral for a vet in Vermont that will do a complete analysis of Shiva's blood tests and make some recommendations on supplements, feeding, etc. for her. He did some of his post-DVM work at Cornell, so I'm hoping he is familiar with Dr. Sharon Center and her work there. 

Thank you all for your support, kind words, thoughts and prayers during all of this. You have really helped me get through this and I truly appreciate it!!


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## bellaratamaltese (May 24, 2006)

> Hi everyone, I'm cautiously optimistic that we are turning the corner on this. I'm also starting to think that Shiva's strange behavior may in fact have been due to physical injury from playing with Stewie - she definitely tries to avoid him when walking around. She took a walk yesterday - she loves them off leash, hates to be on the leash - and ran a bit. Tonight she ran even more and no more stumbling. She also ate much better today, hooray!
> 
> We're done with her amoxicillin, so hopefully that is helping her appetite. I still have her on lactulose - she has always been prone to constipation so I don't think it will hurt her.
> 
> ...


i don't think you're nuts, I think you're the most wonderful malt mom EVER! I am so happy to hear things are better with Shiva today and I wish you luck that everything stays better. I've been keeping an eye out for an update and I'm soo happy to see this one. *hugs you*


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## bbry (Feb 17, 2007)

Prayers for both you & Shiva


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## gibbert (Jan 13, 2005)

YAY! I am so happy to hear that Shiva is feeling better - I pray that you're right about her having turned a corner. And I don't think you're crazy at all about seeing a pet communicator. You're doing everything you can to get to the bottom of Shiva's issues, and I applaud that. Your babies are both very lucky to have you as their mommy.
Keep getting better Shiva - we're all praying for you! :wub:


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## wagirl98665 (Jan 5, 2006)

I'm so sorry and hope your babies are feeling better soon. :grouphug:


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## Malteseluv (Feb 6, 2007)

Prayers for you and Shiva!! You could try a holistic vet as well as the animal communicator... They will also help with supplements and helping her more naturally. I think it's important to stick with the lactulose.


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## tamizami (May 1, 2007)

I had a phone consultation today with the naturopathic vet that Jan Rasmussen recommended, Dr. Kruesi of Cold River Veterinary Center - it was great! He did a complete biomedical profile on Shiva and we went over diet changes and supplements for her. 

Then I packed Shiva off and we went to the animal communicator. She told me that Shiva said it was her right leg that hurt her, Stewie didn't do it, she did it while playing tag with him. She likes the food I'm giving her now, but was unhappy about it 2 weeks ago (I had her totally off meat). We also let her know she was going to Auntie Sarah's for a few days with Stewie while we go on vacation, and there will be lots of dogs for her to play with. She said Shiva is nervous but also excited about going there. Shiva was in the most playful mood when we were there, it was very interesting.

I have to say she is improving so fast and I gave her a bath today for the first time in 3 weeks! She is walking better every day and loves to be off leash. Its nice now that the weather isn't so warm, too. 

And Stewie is doing great. I bet he will be so happy to see his fur-mommy & daddy and number 1 mommy (Sarah). 

I have to tell you all, I am almost totally convinced that my diet is what elevated their enzymes and bile acids. I am going to get a Protein C test on Stewie when we get back from Hawaii and then retest their bile acids (& CBC) in 6-8 weeks. I'll keep you all posted on how that goes, I hope that everyone can learn from my experiences.

Aloha!


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## Furbaby's Mommie (Jul 10, 2004)

:aktion033: Nothing but good news, that's great! I hope she continues to improve and you have a lovely trip. :aktion033:


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