Bruno, 5-year-old male dog, having seizures since Sep 2025. Seizures occur early morning (3-6 AM) — body stiffens, shakes, salivates heavily, loses bladder/bowel control, followed by confusion. 6-7 seizures over 9 months. Last episode: 5 May 2026, 3:30 AM. Blood work shows persistently elevated ammonia (71-162, normal 16-71), elevated SGOT, low albumin, and lymphocytosis. Kidney function and electrolytes normal. Treated for Ehrlichia (tick fever) in April 2026. Currently on lactulose, L-ornithine, liver supplements. No anti-epileptic medication yet.

Conditions worth asking your vet about

These are the specific named diagnoses a vet would typically investigate for this presentation — not categories like “metabolic disorder”, but the actual conditions you can mention by name.

1. 🫀

   Hepatic encephalopathy (acquired liver disease)

   Hepatic encephalopathy occurs when the liver fails to detoxify blood, leading to high ammonia levels that affect the brain. Bruno's elevated ammonia, liver enzyme abnormalities, and neurological symptoms suggest this condition. A bile-acid stimulation test and imaging can help confirm liver dysfunction.

2. 🫀

   Portosystemic shunt (liver shunt)

   A portosystemic shunt is an abnormal blood vessel that bypasses the liver, causing toxins like ammonia to accumulate and affect the brain. Bruno's elevated ammonia and liver abnormalities could indicate a shunt. Imaging studies like ultrasound or CT can help identify this condition.

3. 🧠

   Idiopathic epilepsy

   Idiopathic epilepsy is a common cause of seizures in dogs with no identifiable structural brain disease or metabolic cause. Although Bruno has liver abnormalities, idiopathic epilepsy could still be considered if liver issues are secondary or controlled.

4. 🫀

   Liver cirrhosis

   Liver cirrhosis is the scarring of liver tissue, leading to impaired liver function and elevated ammonia levels. Bruno's liver enzyme abnormalities and low albumin suggest chronic liver damage, which could lead to cirrhosis.

5. 🫀

   Chronic hepatitis

   Chronic hepatitis is long-term inflammation of the liver, which can lead to liver dysfunction and elevated ammonia levels. Bruno's liver enzyme abnormalities and symptoms could be due to chronic hepatitis, which can be confirmed with a liver biopsy.

6. 🫀

   Copper-associated hepatopathy

   Copper-associated hepatopathy is a condition where excessive copper accumulates in the liver, causing damage and dysfunction. This could explain Bruno's liver abnormalities and seizures. A liver biopsy with copper quantification can confirm this diagnosis.

Easily confused with: Hypoglycemia · Meningoencephalitis of unknown origin (MUO) · Brain tumor · Toxin exposure

Real peer-reviewed cases

Each link below opens the full PetCaseFinder write-up of a published case report. Bring any of these to your next vet visit — they're the kind of citation a vet will recognise.

• #1 match

  Electroencephalographic Features of Presumed Hepatic Encephalopathy in a Pediatric Dog with a Portosystemic Shunt—A Case Report

  Life · 2025 · CH

  A 3-month-old Bichon Frise puppy was diagnosed with a condition called hepatic encephalopathy, which is a brain problem caused by liver issues. This puppy had a portosystemic shunt, meaning that blood from the digestive system was bypassing the liver and causing harmful substances to enter the bloodstream. During testing, the puppy showed specific brain wave patterns that suggested it was experiencing a type of seizure without convulsions. Understanding these brain wave patterns helps veterinarians choose the right treatment to avoid worsening the puppy's symptoms and reduce the risk of serious complications. The outcome of the treatment is not specified in the abstract.

  Read the full case →

• #2 match

  Ammonia concentrations in arterial blood, venous blood, and cerebrospinal fluid of dogs with and without congenital extrahepatic portosystemic shunts.

  American journal of veterinary research · 2017 · United States

  This study looked at the levels of ammonia in the blood and spinal fluid of dogs with a condition called extrahepatic portosystemic shunts (EHPSS), which affects how blood flows in the liver. The researchers compared 19 dogs with this condition to 6 healthy dogs. They found that the dogs with EHPSS had much higher ammonia levels in their blood and spinal fluid than the healthy dogs, suggesting that their bodies might be allowing too much ammonia to enter the brain. This could be important for understanding how EHPSS affects dogs and what symptoms they might show, but more research is needed to see how these ammonia levels relate to the dogs' health and treatment outcomes.

  Read the full case →

• #3 match

  Syndrome of Inappropriate Secretion of Antidiuretic Hormone in a Dog With Meningoencephalitis of Unknown Etiology.

  Veterinary medicine and science · 2026 · South Korea

  A 5-year-old male Maltese dog started having seizures about 10 days before being brought to the vet, and by the time of the visit, he was very tired, had trouble moving, and was showing signs of confusion. Tests showed that he had swelling in his brain and a condition called hydrocephalus, which is an accumulation of fluid in the brain. He was treated with medications to suppress his immune system and control the seizures, but blood tests revealed low sodium and chloride levels, along with other signs of a condition called syndrome of inappropriate secretion of antidiuretic hormone (SIADH), which means his body was holding onto too much water. While restricting his water intake helped a bit, he still felt very thirsty, so he was given a medication to help manage his condition, which improved his sodium levels. Unfortunately, after about four months, his seizures returned, and the owner decided to stop treatment, after which the dog was lost to follow-up.

  Read the full case →

• #4 match

  Putative precipitating factors for hepatic encephalopathy in dogs: 118 cases (1991-2014).

  Journal of the American Veterinary Medical Association · 2015 · United States

  This study looked at 118 dogs diagnosed with hepatic encephalopathy, a condition where the liver fails to remove toxins from the blood, leading to brain issues. Researchers wanted to see if the level of ammonia in the blood was linked to how severe the symptoms were and if certain factors, like inflammation or dietary mistakes, could trigger the condition. They found that dogs who had been treated for hepatic encephalopathy before arriving at the hospital showed fewer symptoms than those who hadn't been treated. However, the severity of the condition at admission didn't seem to relate to ammonia levels, and none of the suspected triggers were clearly linked to the symptoms at that time. Overall, the treatment for hepatic encephalopathy appeared to help reduce the symptoms in these dogs.

  Read the full case →

• #5 match

  Bilateral hippocampal malformation and concurrent granulomatous meningoencephalitis in a dog with refractory epilepsy.

  Journal of comparative pathology · 2014 · United States

  A 5-year-old dog was taken to the vet because it had stopped eating and was very tired for three weeks, and then it experienced a serious seizure episode. Despite being treated with anti-seizure medications, the dog continued to have seizures and was sadly put to sleep ten weeks later. A closer look at the dog's brain showed that there were problems with a part of the brain called the dentate gyrus, which helps with memory, and there was also a severe inflammation affecting the brain and its coverings. This case is notable because it is the first time this specific brain malformation has been reported in a dog. Unfortunately, the treatment did not work, and the dog's condition did not improve.

  Read the full case →

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