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RLC12345678 · 08-03-2006, 01:51 PM

I found these things on the Internet:

Hepatic microvascular dysplasia is a condition in which there is mixing of venous blood and arterial blood at the microscopic levels in the liver. If you search for information on this condition, it is also called hepatoportal microvascular dysplasia so you may find information using either name. This condition has been recognized in a number of small dog breeds but seems especially prevalent in Cairn terriers and Yorkshire terriers.

It is likely that most dogs with this condition have no readily apparent clinical signs associated with the microvascular dysplasia and are diagnosed when bile acid response testing is done to rule out liver disease for some reason. Unfortunately, some dogs with this condition do have clinical signs, which can include seizures or other central nervous system disorders, gastrointestinal problems or urinary tract disease associated with ammonium biurate cystals in the urinary tract, which form due to the liver problems.

Abnormal bile acid response testing usually provides the initial suspicion that this disease is present. High bile acid levels can occur with portosystemic shunts, as well. It is necessary to rule out that possibility when considering the possibility of hepatic microvascular dysplasia. Liver biopsy adds further evidence for the presence of this condition, in part by ruling out other liver diseases.

When dogs have microvascular dysplasia without clinical signs, their prognosis is very good. In many instances there is not a need for therapy. In dogs that are diagnosed because they have clinical signs, it is often possible to manage the signs through the use of dietary therapy and medications. The dietary therapy is aimed at reducing excess protein in the diet and the medications, including lactulose and antibiotics such as neomycin or metronidazole, which are used to lower ammonia levels in the digestive tract and thus in the body. The prognosis is variable for patients who have clinical signs from hepatoportal microvascular dysplasia. Some dogs do well with therapy and live normal, or nearly normal, life spans. Others have worsening of the clinical signs over time. I do not know of a method for predicting how well an individual patient will do.

There are a number of reduced protein diets that might be helpful, including Hills k/d (tm) and l/d (tm) diets, Purina's NF diet and others. Lactulose dosage is adjusted to individual patient's needs by using it to obtain a soft but formed stool. Neomycin is usually given at a dosage of 22mg/kg of body weight twice a day and metronidazole at 7.5mg/kg twice a day. This is a lower metronidazole dosage than is used for many other conditions. I have seen recommendations for the use of other antibiotics but these two are the most commonly mentioned ones.

Hepatic Microvascular Dysplasia
Hepatic microvascular dysplasia is a recently described liver abnormality that is poorly understood. Affected animals often present clinically much like a dog with a congenital portosystemic vascular shunt. However, there is not a grossly identifiable shunt present. It can take multiple liver biopsies to find the microscopic lesions characteristic of these micro shunts. (some dogs have lesions in one or two liver lobes but not in the others.) Diagnosis of hepatic microvascular dysplasia is made by first eliminating PSS and then by finding histologic lesions. Treatment is supportive because the cause is unknown.

Treatment
Supportive treatment may include special diets and/or drugs which help improve liver function.

Hope your little one gets to feeling better soon!. Welcome to YorkieTalk!

08-03-2006, 01:51 PM	#2
RLC12345678 I heart Hootie & Hobbs Join Date: Jan 2006 Location: USA Posts: 7,149	I found these things on the Internet: Hepatic microvascular dysplasia is a condition in which there is mixing of venous blood and arterial blood at the microscopic levels in the liver. If you search for information on this condition, it is also called hepatoportal microvascular dysplasia so you may find information using either name. This condition has been recognized in a number of small dog breeds but seems especially prevalent in Cairn terriers and Yorkshire terriers. It is likely that most dogs with this condition have no readily apparent clinical signs associated with the microvascular dysplasia and are diagnosed when bile acid response testing is done to rule out liver disease for some reason. Unfortunately, some dogs with this condition do have clinical signs, which can include seizures or other central nervous system disorders, gastrointestinal problems or urinary tract disease associated with ammonium biurate cystals in the urinary tract, which form due to the liver problems. Abnormal bile acid response testing usually provides the initial suspicion that this disease is present. High bile acid levels can occur with portosystemic shunts, as well. It is necessary to rule out that possibility when considering the possibility of hepatic microvascular dysplasia. Liver biopsy adds further evidence for the presence of this condition, in part by ruling out other liver diseases. When dogs have microvascular dysplasia without clinical signs, their prognosis is very good. In many instances there is not a need for therapy. In dogs that are diagnosed because they have clinical signs, it is often possible to manage the signs through the use of dietary therapy and medications. The dietary therapy is aimed at reducing excess protein in the diet and the medications, including lactulose and antibiotics such as neomycin or metronidazole, which are used to lower ammonia levels in the digestive tract and thus in the body. The prognosis is variable for patients who have clinical signs from hepatoportal microvascular dysplasia. Some dogs do well with therapy and live normal, or nearly normal, life spans. Others have worsening of the clinical signs over time. I do not know of a method for predicting how well an individual patient will do. There are a number of reduced protein diets that might be helpful, including Hills k/d (tm) and l/d (tm) diets, Purina's NF diet and others. Lactulose dosage is adjusted to individual patient's needs by using it to obtain a soft but formed stool. Neomycin is usually given at a dosage of 22mg/kg of body weight twice a day and metronidazole at 7.5mg/kg twice a day. This is a lower metronidazole dosage than is used for many other conditions. I have seen recommendations for the use of other antibiotics but these two are the most commonly mentioned ones. Hepatic Microvascular Dysplasia Hepatic microvascular dysplasia is a recently described liver abnormality that is poorly understood. Affected animals often present clinically much like a dog with a congenital portosystemic vascular shunt. However, there is not a grossly identifiable shunt present. It can take multiple liver biopsies to find the microscopic lesions characteristic of these micro shunts. (some dogs have lesions in one or two liver lobes but not in the others.) Diagnosis of hepatic microvascular dysplasia is made by first eliminating PSS and then by finding histologic lesions. Treatment is supportive because the cause is unknown. Treatment Supportive treatment may include special diets and/or drugs which help improve liver function. Hope your little one gets to feeling better soon!. Welcome to YorkieTalk!