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Ask Dr. Michael Salkin Your Own Question
Dr. Michael Salkin
Dr. Michael Salkin, Veterinarian
Category: Dog
Satisfied Customers: 30383
Experience:  University of California at Davis graduate veterinarian with 45 years of experience.
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My dog is 7 years old and for quite a few years now he has

Customer Question

My dog is 7 years old and for quite a few years now he has episodes where he can not settle he walks up and down all the time, he barks at the back door, but he does not want to go out, and if he does go out he does not want to come in, these episodes can last all day or all night, he is just up and down, he cannot relax, and sometimes he will just start running after pacing up and down, there is nothing I can put this down too, he used to have them about twice or three times a year but he has had 3 in the last month please help
Submitted: 2 years ago.
Category: Dog
Expert:  Dr. Michael Salkin replied 2 years ago.
Aloha! You're speaking to Dr. Michael Salkin
I'm sorry that your question wasn't answered in a timely manner. Aimless wandering as you've described is an indication of encephalopathy - brain disorder - particularly involving the cerebrum or thalamus. Both intracranial (within the skull) and extracranial (outside the skull) disorders should be considered. Please let me know what Oscar's breed is as some breeds are more prone to one or the other forms of disorder.

Idiopathic epilepsy is a common example of an intracranial etiology for Oscar's behavior. Hepatoencephalopathy - a poorly functioning liver can intoxicate the brain - is a common example of an extracranial etiology. The proper manner in which to proceed is to have Oscar's vet perform diagnostics in the form of blood/urine tests. If nothing untoward is found in those tests, we can proceed to MRI or by the process of elimination assume that the etiology lies within his brain and initiate anticonvulsive medication in the form of phenobarbital, levetiracetam, zonisamide, or imepitoin. His behavior would be considered to represent complex partial seizures which hopefully the anticonvulsives would abate.

Please respond with further questions or concerns if you wish.
Customer: replied 2 years ago.
Thank you for this information he is a cross between ***** ***** and Yorkshire terrier
Expert:  Dr. Michael Salkin replied 2 years ago.
The Yorkshire terrier is greatly overrepresented with portosystemic shunting and microvascular dysplasia of the liver - both disorders are vascular abnormalities and which can predispose to hepatoencephalopathy. A blood test called bile acids should be included in Oscar's biochemical testing. Increased bile acids are possibly the most sensitive biochemical indicator of congenital portosystemic shunting.

Please continue our conversation if you wish.
Customer: replied 2 years ago.
Can this be cured or is a life condition and will it decrees oscars life thank you
Expert:  Dr. Michael Salkin replied 2 years ago.
If hepatoencephalopathy underlies Oscar's behavior, it might be cured if a shunt could be surgically closed. If that weren't possible, dietary protein restriction and decreasing the number of bacteria in his gastrointestinal tract with lactulose and antibiotics can be attempted. This would be a lifelong treatment.
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Expert:  Dr. Michael Salkin replied 2 years ago.
Thank you for your kind accept. I appreciate it.

I'm going to check back with you in a week for an update. Feel free to return to our conversation - even after rating - prior to my contacting you if you wish.

Please disregard the info request.