# HEPATIC MICROVASCULAR DYSPLASIA



## RMCALLIS (Jan 25, 2008)

I have been in and out of the vet with my nine month maltese puppy due to high ALT and high bile acid tests. We have had an ultrasound and the vet could not see anything, his last blood tests came back normal but we reran his bile acid tests and they were still high. HE HAS NO SYMPTOMS but the vet is recommending we put him through a biopsy and exploratory surgery. Has anyone had any situations similar?


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## Cosy (Feb 9, 2006)

Some treat with diet, lactulose and testing so often when the dog is
asymptomatic.
Here's an article you may find informative from U of TN.
Have you had scintigraphy done?
The Univ. of TN College of Veterinary Medicine - Portosystemic Shunts
I had a tiny yorkie who lived quite some time by dosing with lactulose,
flaxseed and low protein diet. 
There are others on this board who have dealt with surgery, etc. I'm
sure they'll see this thread and respond.


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## elly (Sep 11, 2006)

My Ellie has MVD and has never had symptons, I would not biospy. There is some good info on the thread Pixel is sick. You may want to look into having a Protein C test done.
.


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## MaryH (Mar 7, 2006)

> I have been in and out of the vet with my nine month maltese puppy due to high ALT and high bile acid tests. We have had an ultrasound and the vet could not see anything, his last blood tests came back normal but we reran his bile acid tests and they were still high. HE HAS NO SYMPTOMS but the vet is recommending we put him through a biopsy and exploratory surgery. Has anyone had any situations similar?[/B]


If your dog is at a normal weight for his age and is acting normal, especially after a meal, I would ask your vet to contact Cornell University Vet School (607-253-3060), ask for Dr. Sharon Center and get instructions from her for drawing blood and sending it to Cornell for a Protein C test. If that test comes back normal, chances are that your dog does not have a shunt. Don't ignore the issue but don't jump into a liver biopsy when it may not be needed.

MaryH


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

I'm sorry you are having to go through this. My Shoni has had several blood and urine tests and so far we don't have a definite diagnosis, but looks like MVD for sure and may be shunt. There are about a dozen dogs here with one or the other. Search in the Health section for Bile Acids test, and Protein C test.
The researcher and vet. internal med. specialist most refered to here is Dr. Sharon A. Center, DVM of Cornell University Vet. School. Also Dr. Karen Tobias, DVM, I think at Tennessee State University Vet School. There is also Dr. Dodds who has a diet, etc. You can search those names here and also Google. Search Canine MicroVascular Dysplasia (MVD) and Portosystemic Shunt (PSVA).
From what I've been able to find the diagnosic procedure best used is the total bile acids test--premeal and 2 hr. post meal, if it is high then a protein C test to rule out shunt. The protein C test is only done at the lab at Cornell. They have specific instructions to your vet for drawing the preparing the blood and shipping it over night to Cornell.
There is a bile acids urine test, and urine test for ammonia crystals that can be present in these liver diseases. It may be helpful also. I found my vets were not familiar with most of this. I pointed them to the work Dr. Center at Cornell has done and they were grateful for that. Most will rush to the biopsy if they aren't. Dr. Center doesn't. A regular ultrasound or X-ray is not very helpful. They suggest a Portal Scintigraphy. It is a special kind of nuclear injected ultrasound usually found only in a speciality vet practice or vet school.
Please keep us updated on what is happening. What is your dog's name, etc. We love getting to know all the furbabies! :wub: Give your baby a kiss from me and Shoni who is almost 8 mos. old.


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## kodie (Aug 24, 2004)

I also agree not to have any surgery done unless your pup is showing symptoms.. etc.. I have been in a similar situation and I choose to get scintigraphy done... which is not invasive. My Kodie has MVD... and showing no symptoms...


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

I agree with the others, don't have surgery unless you absolutely have to. Tanner had the surgery a couple of years ago and the surgeon took only a teensey tinsey sample of the liver then was surprised that he couldn't get a definitive diagnosis for me. I had the tissue sample sent to Dr. Center who told me he should have taken larger samples and from 3 different lobes of the liver. I was not happy. But the bottom line is Tanner's bile acids were 43/41, not particularly high, (25 is the high range I believe), he is not symptomatic. As a matter of fact, when I changed his diet from low protein to the regular food the other dogs get, he gained weight and his ALT increased dramatically, 295ish to over 400. He is now back on low protein, i.e., canned food around 7% or less, Chicken Soup Senior, Canidae Platinum, Innova Senior, Merrick Rocky Mountain Trout. (I have to alternate foods as he doesn't like the same thing more than twice in a row!)


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## RMCALLIS (Jan 25, 2008)

> I'm sorry you are having to go through this. My Shoni has had several blood and urine tests and so far we don't have a definite diagnosis, but looks like MVD for sure and may be shunt. There are about a dozen dogs here with one or the other. Search in the Health section for Bile Acids test, and Protein C test.
> The researcher and vet. internal med. specialist most refered to here is Dr. Sharon A. Center, DVM of Cornell University Vet. School. Also Dr. Karen Tobias, DVM, I think at Tennessee State University Vet School. There is also Dr. Dodds who has a diet, etc. You can search those names here and also Google. Search Canine MicroVascular Dysplasia (MVD) and Portosystemic Shunt (PSVA).
> From what I've been able to find the diagnosic procedure best used is the total bile acids test--premeal and 2 hr. post meal, if it is high then a protein C test to rule out shunt. The protein C test is only done at the lab at Cornell. They have specific instructions to your vet for drawing the preparing the blood and shipping it over night to Cornell.
> There is a bile acids urine test, and urine test for ammonia crystals that can be present in these liver diseases. It may be helpful also. I found my vets were not familiar with most of this. I pointed them to the work Dr. Center at Cornell has done and they were grateful for that. Most will rush to the biopsy if they aren't. Dr. Center doesn't. A regular ultrasound or X-ray is not very helpful. They suggest a Portal Scintigraphy. It is a special kind of nuclear injected ultrasound usually found only in a speciality vet practice or vet school.
> Please keep us updated on what is happening. What is your dog's name, etc. We love getting to know all the furbabies! :wub: Give your baby a kiss from me and Shoni who is almost 8 mos. old.[/B]




My baby's name is Derby. Thanks for your response.


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