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View Full Version : 2nd Round of Blood Work. Confused.



Zumie05
11th April 2011, 10:48 PM
Here's the history in case any didn't read my other threads:

Coco was having these weird barking/growling episodes, I explained to her neuorologist like she was bi-polor or seeing ghosts. He thought it was epilepsy. We had blood work done and then discovered a high amount of liver enzymes. They thought she had a liver shunt. Liver problems can lead to neurological problems due to the build up of toxins that the liver is normally supposed to remove.

We had an ultrasound done, liver looks fine.

I had her blood work ran again, it came back normal. What the heck?!? I don't know what to do next. I am not ready to lay down $2,000 for an MRI yet (thats what the vet wants to do next), I have to save up.

meljoy
11th April 2011, 11:17 PM
How confusing for you:shock:
What does the vet think about the blood tests being normal. Does he have an opinion on how that can be?

You certainly have a dilema knowing where to go next. I cant offer any advice on what I'd do except to speak to your vet about what he thinks caused the conflicting results.

Good luck

Reptigirl
12th April 2011, 01:47 AM
I'm happy to hear the results came back normal! But I understand how confusing that must be!

Has her growling/barking episodes stoped? (Flash has started doing it again. Going to see his neuro again soon. Tried to get a video last night so I could show you but he stopped as soon as he saw the camera.)

Could she possibly have gotten into something? Maybe on a walk? I think some poisons can cause liver issues. Then once they are out of the system things might go back to normal.

Furrfoot
12th April 2011, 03:24 AM
Maybe she will improve to having no symptoms while you're saving and you can skip it ;) . I'm glad that her tests came back normal! :D

Jasper and Holly
12th April 2011, 04:07 AM
Pleased your tests came back normal. If she isn't still doing those strange things anymore then maybe wait a while and see what happens only you know your dog. I still think it's got something to do with her being in heat?? It must be a relief to know the tests were normal, maybe the vets trying to make money out of you I wouldn't put it past them. I would just keep an eye on her. If I win the lotto I will pay for your MRI.

GraciesMom
12th April 2011, 12:38 PM
some of them may offer a discounted price for MRIs if you need one. Ours will do it for $1000 if you suspect CM.

Nicki
12th April 2011, 07:45 PM
I think it's extremely unlikely to show such extreme behaviour due to being in season.

They can be clingy, off their food etc - growling and barking would be very unusual - I've never heard of that before [and have had quite a few entire bitches] They can sometimes be a bit grumpy with each other but not with people.


Is she still having these episodes?


It seems very strange that her liver results would be so out and then correct - unless something was wrong with one of the tests? I don't think the vet was trying to make money - blood work would be a first step to rule out conditions.


I don't think this is something you can just leave - I think there are credit cards you can take out just to cover veterinary expenses which you can then repay over a set period - it is obviously also worth asking around to get the best price. I think you need a full MRI to establish if it is a type of epilepsy, or even Syringomyelia.


Keep us posted - if you're not happy I would maybe think about a 2nd opinion.

Jasper and Holly
12th April 2011, 11:26 PM
It is strange how they can be so out. I would be changing vets if I were you. It's a pity Rupert's fund only helps older Cavs to have MRI's? What a shame you didn't take out that insurance sooner. Hope you find an answer soon.

Zumie05
13th April 2011, 02:30 AM
It is strange how they can be so out. I would be changing vets if I were you. It's a pity Rupert's fund only helps older Cavs to have MRI's? What a shame you didn't take out that insurance sooner. Hope you find an answer soon.

I knowwww. If only I had waited 1 more week to make her appointment. *Sigh*

Karlin
17th April 2011, 05:07 PM
It's a pity Rupert's fund only helps older Cavs to have MRI's?

Just to clarify: Rupert's Fund is not a charity fund for helping people (whether breeders or pet owners) get MRIs for symptomatic dogs. It is a research fund specifically to try to find dogs WITHOUT SM as a critical piece of the genome work. The starting point is that the dog must be clinically clear of ANY symptom that might be associated with SM. And of course the dog needs to be older than 5-6 as the goal is also to find dogs that remain free of syrinxes at least until late adulthood. :thmbsup: So age would not have been the issue here -- it is that Coco is showing strange signs that could indicate SM or other neurological health problems that need to be diagnosed; something Rupert's Fund is not available to do.

With Coco, I think it is important to follow your vet's advice rather than risk ending up with a problem that is more serious to address and which may permanently compromise her health before she gets the care she may need now. If she is continuing to have these behaviours, then she has some sort of problem which professionals have indicated they think is serious enough to merit a proper scan.

If your breeder guarantees her puppies for health, as you noted in another thread, surely she will help fund the scan or else refund your money for Coco in which case you would have a significant amount towards a scan? It is unfortunate that Coco's problems are overlapping your wedding plans and costs, but she cannot help whatever she has going on and dog ownership (especially of purebreds) always carries the risk of serious costs -- as you experienced before with your uninsured rottweiler puppy that had so many costly health issues. Sadly, no breeder, even the best and most responsible, can guarantee a healthy puppy for life and this breed has some terrible and unfortunately, common health issues especially with MVD and SM that can be very expensive to diagnose and treat. It is why seeing all health certs including MRI and cardio certs is so critical before getting a puppy, and why insurance is so advisable from the day the puppy comes home, for the most comprehensive coverage for the dog's life.

In your situation I would return to discuss this with the breeder. I would also at the very least, make an appointment with a neurologist just for a clinical exam and to have the videos you took reviewed. You can then discuss whether an MRI is necessary and talk about how that might be funded.

You will need to consider as well what happens if she is diagnosed with something like SM -- there potentially will be substantial further costs with either medications or surgery. But she does need to have this addressed now -- if she has a serious problem causing those signs, it would be cruel to postpone dealing with them and leaving her to suffer.

anniemac
17th April 2011, 05:40 PM
some of them may offer a discounted price for MRIs if you need one. Ours will do it for $1000 if you suspect CM.

Check out rods website but one should note that some of the discounted mris are for breeders that do "mini scans". Believe me, I know mris can be expensive, but the important thing is making sure to get an accurate diagnosis. It would be important for diagnosis reasons for a full mri. If nc state is doing full mris for $1000 that is something I would like to know, but I thought the price was reduced for breeders and are mini scans.

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anniemac
17th April 2011, 05:43 PM
They do have things like care credit ect. But if people feel you should see a neurologist, don't let price stop from getting at least a consultation.

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Pat
17th April 2011, 05:46 PM
Alisha,

Which liver values were off originally? Can you give the exact values along with the normal ranges? Also, didn't you run a bile acids test which was also abnormal? Has that test been repeated and was it normal or still abnormal? Your GP vet did all these tests, right? Same lab do the interpretation? Inhouse vet's office lab or an outside lab like Antech? What is this vet advising? And this same vet did the ultrasound?

You referred to her "neurologist" - has she actually had an evaluation by a bd. certified neurologist? What did the physical exam show as far as any abnormalities? And that neurologist suspected epilepsy and is recommending an MRI to diagnose epilepsy? Did neuro explain that an MRI cannot diagnose idiopathic/primary epilepsy? I found a good chart about the different causes of epilepsy and diagnostic procedures:

http://www.canine-seizures.freeservers.com/Diagnosis.htm

If you read up on canine epilepsy, you'll see that primary or idiopathic epilepsy is diagnosed by excluding all other potential causes of seizures. An MRI actually will not diagnose idiopathic epilepsy, it will only rule out causes of seizures such as brain tumors, hydrocephalus, etc.

Is that one episode that you recorded the ONLY symptom that you've seen? Has that happened on more than one occasion? No other symptoms of SM, seizures, pain, or anything else? No other symptoms of liver disease?

Frankly, depending on the answers to the above questions, I wouldn't be particularly anxious to do an MRI. I'd probably do some monitoring and "watchful waiting" - including keeping a diary of any symptoms/abnormal behavior and probably repeating the blood chemistry and bile acids test another 4-6 weeks down the road. I prefer using an outside laboratory such as Antech or Idexx rather than a vet office lab, but that's just my personal prejudice.

Keep us posted,

Pat

Pat
17th April 2011, 05:58 PM
I was composing the above post and only read Karlin's and Anne's posts after I sent this.

I agree fully with Karlin and Anne - if Coco hasn't had a neurology exam yet don't put that off thinking that you MUST have an MRI as part of that exam. You can get an appointment which will include a review of her history (take copies of all blood chem reports and ultrasound report) and a physical exam for a reasonable fee - about $150 or so in my area. You'll get valuable information which will help you to determine if and when an MRI should be done. Your GP vet really isn't in a position to make that recommendation. It isn't at all clear to me if she has seen someone other than GP vet and, if so, which clinician is recommending which tests.

Pat

Zumie05
17th April 2011, 07:56 PM
I would also at the very least, make an appointment with a neurologist just for a clinical exam and to have the videos you took reviewed.

My first visit with our neurologist was a clinical exam, and he said she showed no signs of any neurological issues. I also showed him the video and that is why he thought she had epilepsy.

Strangely enough, Coco's strange behavior has seemed to VANISH...and she is coming out of heat too. I really am thinking this is all related, but I am still keeping her on a low protein diet just in case.

My breeder is in the process of discussing her blood test results and ultrasound results. I have a feeling since it all came back ok that I won't get any refund, as Coco seems to be back to normal now. It is so confusing :confused:

Zumie05
17th April 2011, 08:09 PM
Alisha,

Which liver values were off originally?

Pat

I'll do my best to answer all your questions:

The only thing wrong with Coco's first blood test was her bile acid. The test takes a fasting sample, then a sample 2 hours after a meal. If the bile acid is elevated, it suggests the liver is having a hard time digesting protein (or something like that). The first test results were only slightly above normal, but enough to raise concern - so the ultrasound followed; showing no liver shunt.

I ran the bile acid test again, and that time it had come back normal. I do not have the exact #s, but I bet I can request to see them and then I will try to post the results here. Our regular vet sent the blood out to be done elsewhere, and the neurologist ran the test in house. It does make me wonder about the margin of error...

My normal vet housed the ultrasound, but called in a traveling radiologist to do the test.

The neurologist I took Coco to is Board Certified. I found the place on this website http://www.cavalierhealth.org/neurologists.htm#Washington and took her to Dr. Sanders in Kirkland, Washington. Dr. Sanders said her exam was 100% normal and thought the video I showed him looked like epilepsy, or partial seizures. He wanted to do an MRI simply because she is a Cavalier and wants to see if she has the skull malformation - which could cause seizures. He did explain that there is no diagnosis for epilepsy really...it was a while back so what I was told is becoming blurry now.

The episode I recorded is the only symptom I am seeing. I explain it like Coco is seeing ghosts, or that she is bi polar. She will be all happy and normal one second, then lower her head and bark/growl at nothing at all. This happened 2 days before her heat, and is going away now as she is coming out of her heat...strange.

The only symptom of liver disease she may have is anorexia. She really is hard to get to eat, and always has been. I am diligent about leaving her food down and taking it away, giving NO people food or treats unless training, and so forth. She just seems to have no appetite, and even my breeder commented that she looks kinda skinny when I went to visit them a few weeks back.

No other SM symptoms that I have noticed, except for scratching!! She doesn't air scratch, but when she does scratch I just tend to always think it is related to SM...so it is hard to tell :( Actually now that I think about it, she does have a rear leg twitch sometimes when she is going to sleep. But other than that, nothing else.

I hope I answered all your questions.

Zumie05
17th April 2011, 08:14 PM
Check out rods website but one should note that some of the discounted mris are for breeders that do "mini scans". Believe me, I know mris can be expensive, but the important thing is making sure to get an accurate diagnosis. It would be important for diagnosis reasons for a full mri. If nc state is doing full mris for $1000 that is something I would like to know, but I thought the price was reduced for breeders and are mini scans.

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Great news is I found a vet school that will do MRIs at a discounted rate at the Washington State University.

Jasper and Holly
17th April 2011, 10:17 PM
[QUOTE=Karlin;386623]Just to clarify: Rupert's Fund is not a charity fund for helping people (whether breeders or pet owners) get MRIs for symptomatic dogs. It is a research fund specifically to try to find dogs WITHOUT SM as a critical piece of the genome work. The starting point is that the dog must be clinically clear of ANY symptom that might be associated with SM. And of course the dog needs to be older than 5-6 as the goal is also to find dogs that remain free of syrinxes at least until late adulthood. :thmbsup:

My comment made previously was not to offend anyone and I am sorry if it did. I'm sure Alisha will do what is right for Coco, regardless of costs, you can see she loves her dog. It must be confusing to go through all what she has and Coco seems normal again now. She did do the right thing by taking out insurance but sadly for her not at the right time. Hopefully she will get some sort of result soon.

Karlin
18th April 2011, 10:30 AM
Hi Deb: was just clarifying what the fund is for as there has been some misunderstanding before. I would love if there were a fund to help underwrite costly scans. or if more locations offered reduced cost scans (in the UK, I have seen them for as low as 100 with breed club subsidy, to my mind a great allocation of breed club funds to encourage scanning :) ). But Rupert's Fund has a quite specific purpose for the genome research and can only consider clinical symptom-free dogs (as determined by a neurologist) with a pedigree that helps research/the breed as much as possible, and of course they also need to be older dogs :thmbsup:

What we all hope for is the research, helped by the Rupert's Fund scans, will produce a genetic test that will enable an easier and less costly determination of whether a dog has SM.

MishathePooh
18th April 2011, 09:09 PM
I haven't read your previous thread - but it might be like Springer Rage Syndrome (http://en.wikipedia.org/wiki/Rage_Syndrome) which is thought originate from epilepsy. It is also thought to have genetic influence.

Care Credit is no interest for 12 months if it is over $1000. Misha had an MRI in November, and I used Care Credit. Best of luck.

Zumie05
18th April 2011, 09:29 PM
I haven't read your previous thread - but it might be like Springer Rage Syndrome (http://en.wikipedia.org/wiki/Rage_Syndrome) which is thought originate from epilepsy. It is also thought to have genetic influence.

Care Credit is no interest for 12 months if it is over $1000. Misha had an MRI in November, and I used Care Credit. Best of luck.

Hmmm..I could imagine Coco's behavior to look aggressive, but she hasn't tried to attack anyone or anything during an episode so I am not sure. She usually seemed scared, like she just saw or heard something. Then she would just go back to being normal after a minute or two.

Any thoughts and ideas are welcome of course so I can discuss them with my vet.

A no interest loan is a really good idea, thanks!