MVD- To Liver Biopsy or not? - YorkieTalk.com Forums

ashleybug · 09-23-2008, 08:42 PM

My little Sophia was just diagnosed with MVD yesterday. They want to do a liver biopsy on her next. I've talked with a few people who have experience with it and some say do it and others say no way for right now. What should we do?

Ladymom · 09-23-2008, 08:57 PM

No, please don't have a liver biopsy done!

What tests has she had done so far? Bile acids? What were her numbers?

The protocol for diagnosing liver disease is first a bile acids test, then a Protein C test, then a scintigraphy. Don't let anyone tell you to get a biopsy done or waste your money on an ultrasound as they are only 80% accurate at best.

Unfortunately, most vets just don't see enough cases of liver disease in their practice to know how to diagnose and treat it. Are you close to a vet school?

Here are some links for you. If you scroll down to page 10 of the first one, you will see a flow chart of how to diagnose liver disease.

http://www.idexx.com/animalhealth/an...r0905final.pdf

Hepatic Vascular Disorders - WSAVA 2006 Congress

Portosystemic Shunts FAQ

ashleybug · 09-24-2008, 04:34 AM

Sophia had high ALT and BUN along with GI issues, 1 seizure that we know of and enlarged salvary glands causing her to do nonstop licking/smacking. Did the fasting bile acid and post test. Pre was 11......great! Post was 34. I know 34 is very mild but the doctors were concerned because of her other signs. But that could be explained with other causes maybe? She's 3.5 yrs old and only weighs 3 lbs....too risky I thought!

Ladymom · 09-24-2008, 05:54 AM

Quote:

Originally Posted by ashleybug

Sophia had high ALT and BUN along with GI issues, 1 seizure that we know of and enlarged salvary glands causing her to do nonstop licking/smacking. Did the fasting bile acid and post test. Pre was 11......great! Post was 34. I know 34 is very mild but the doctors were concerned because of her other signs. But that could be explained with other causes maybe? She's 3.5 yrs old and only weighs 3 lbs....too risky I thought!

Oh, good heavens, with BAT numbers like that no way should she get a biopsy. Since she has some shunt symptoms, though, I'd get a Protein C test done to be safe.

TLC · 09-24-2008, 06:26 AM

I have to agree - with a post number of 34 - I would NOT open her up for a liver biopsy - NO WAY

I am in NY and Roxy's Internal Medicine Specialist (Vet Center in Westbury, NY) gets concerned with a post number above 40 (I know below 20 is normal).

There are other tests to do right now that are less invasive.

Have you seen a Specialist yet?

P.S. Roxy's post number was 100.9 (after about 5 more - ranging from 60-85) I will NOT put her through a biopsy. She is 4 yrs and 5 lbs. She most likely has MVD, which there is no cure for, only treatment and 'if' we knew 100% for sure that she has MVD, the treatment would be the same exact as what we are doing now. So no need to risk anything with a Liver Biospy

Ellie May · 09-24-2008, 10:18 AM

I would NOT open her up to just do a biopsy but I also would not necessarily agree with a diagnosis of MVD without one. That is really the only way to tell for sure.

If she had had any drugs (heartworm, flea) before the BAT, that would easily skew the results. Things like allbladder issues can make the BAT high also.

High ALT and a seizure does sound like MVD (or shunt but the number is reeeally low for that) but that is really just an educated guess.

If all other tests are coming back normal (including Protein C), why not just put her on supplements and see if the ALT and BAT come down?

SassyAnn101 · 09-24-2008, 11:59 AM

I will agree with every one else. Dont open your baby with such low numbers. If its not too far from you, I'd recommend the University Of Tennessee. They are great, and have alot of experience dealing with MVD and Liver Shunts in Yorkies.

smartpuppiepets · 09-24-2008, 01:00 PM

I Got an update from the purina breeders member about new research data and the only test really able to diagnose this is MRI, which can be very expensive.
My self i have no experience with it, but i saved the article, it is very interesting.
It came on the mail not online , but if you want to try giving them a call or contact them directly i am sure they would send you the info. It is specifically about a yorkie study they did, reaserching a very extensive data base.

I wish you all the best of luck with your baby, hopefully you can start getting good news !!!

ashleybug · 09-26-2008, 10:26 AM

So I talked with the vet about all the opinions I have received and more of my concerns. She said that she still thinks the biopsy would be good to do on OCT 8th as scheduled because she is also getting spayed at that time. She said that since they are opening her up anyway they might as well do it now instead of undergoing 2 anesthesias. They promised that the biopsy would not cause her to be under much longer at all.

To answer some questions: no frontline or heartguard right before the testing. She of course receives these but it had been about 3 weeks prior. UT is not too far to travel for little Sophia, but only plan on going if really needed since it is 2 states away.

Also, vet said when they look at her liver they might find a very very very slight shunt that could be causing her numbers that we would otherwise have no idea about.

Not sure if I had mentioned the spay at the same time before in my posts....so does anyone have any different opinions now? Thanks so much!!!

TLC · 09-26-2008, 10:39 AM

Ok, much better information. As long as she is getting spayed anyway then I think it is ok to do the biopsy. Thanks! Also, you may want to ask Ellie May this....b/c I remember reading that she wrote she too had to biopsy done at her spay, but the Vet only took one sample and it didn't show MVD ~ however, if they took a few samples (from other areas

) it may have showed MVD, but they will never know now....So my point is, tell your Vet to take a few samples (I think...)

Keep us posted

Ladymom · 09-26-2008, 12:26 PM

No, you didn't mention she was getting spayed and that changes everything. Yes, definitely get a biopsy done since she will be under anesthesia already.

Just remember that Dr. Center states that a diagnosis cannot be made from a biopsy alone. It must be combined with a Protein C test and/or imaging (preferably scintigraphy, not ultrasound).

Hepatic Vascular Disorders - WSAVA 2006 Congress

Ellie May · 09-27-2008, 02:14 PM

Quote:

Originally Posted by TLC

Ok, much better information. As long as she is getting spayed anyway then I think it is ok to do the biopsy. Thanks! Also, you may want to ask Ellie May this....b/c I remember reading that she wrote she too had to biopsy done at her spay, but the Vet only took one sample and it didn't show MVD ~ however, if they took a few samples (from other areas

) it may have showed MVD, but they will never know now....So my point is, tell your Vet to take a few samples (I think...)

Keep us posted

Yes, you got that exactly right.

It is okay to do that if she is already being opened.
If there is a shunt inside the liver though, they won't see it...

bellasmomok · 09-29-2008, 05:41 AM

What is MVD? I opened this thread because I didn't know what that was and have been reading (getting a lot of education in liver shunts!), but I'm still confused about what MVD is....
My thoughts and prayers are with your baby, though! And, I'm hoping everything turns out better than you're thinking it could!!!

Ellie May · 09-29-2008, 06:06 AM

Quote:

Originally Posted by bellasmomok

What is MVD? I opened this thread because I didn't know what that was and have been reading (getting a lot of education in liver shunts!), but I'm still confused about what MVD is....
My thoughts and prayers are with your baby, though! And, I'm hoping everything turns out better than you're thinking it could!!!

MVD (microvascular dysplasia) is tiny or microscopic shunting throughout the liver that cannot be surgically corrected. It can be diagnosed by liver biopsy.

bellasmomok · 09-29-2008, 06:21 AM

Thanks Ellie May! I'm a sonographer (ultrasounds) for people, and have done a LOT of ultrasounds on people with liver disease, transplants, shunts (both congenital and created [to solve a problem temporarily until a transplant]), etc... I have never even heard of microvascular dysplasia, but it makes sense that the tiny vessels can have abnormal pathways just like the big ones can. I sure hope that turns out to not be the problem! I'll have my fingers crossed for sure!!!!

09-23-2008, 08:42 PM	#1
ashleybug Yorkie Talker Join Date: Jul 2007 Location: Ohio Posts: 11	MVD- To Liver Biopsy or not? My little Sophia was just diagnosed with MVD yesterday. They want to do a liver biopsy on her next. I've talked with a few people who have experience with it and some say do it and others say no way for right now. What should we do?

09-23-2008, 08:57 PM	#2
Ladymom Donating YT 2000 Club Member Join Date: Sep 2007 Location: North Carolina Posts: 8,317	No, please don't have a liver biopsy done! What tests has she had done so far? Bile acids? What were her numbers? The protocol for diagnosing liver disease is first a bile acids test, then a Protein C test, then a scintigraphy. Don't let anyone tell you to get a biopsy done or waste your money on an ultrasound as they are only 80% accurate at best. Unfortunately, most vets just don't see enough cases of liver disease in their practice to know how to diagnose and treat it. Are you close to a vet school? Here are some links for you. If you scroll down to page 10 of the first one, you will see a flow chart of how to diagnose liver disease. http://www.idexx.com/animalhealth/an...r0905final.pdf Hepatic Vascular Disorders - WSAVA 2006 Congress Portosystemic Shunts FAQ __________________ http://www.myladysdogbows.com/ http://www.facebook.com/home.php?ref...6213341?ref=nf

09-24-2008, 04:34 AM	#3
ashleybug Yorkie Talker Join Date: Jul 2007 Location: Ohio Posts: 11	Tests Sophia had high ALT and BUN along with GI issues, 1 seizure that we know of and enlarged salvary glands causing her to do nonstop licking/smacking. Did the fasting bile acid and post test. Pre was 11......great! Post was 34. I know 34 is very mild but the doctors were concerned because of her other signs. But that could be explained with other causes maybe? She's 3.5 yrs old and only weighs 3 lbs....too risky I thought!

09-24-2008, 06:26 AM	#5
TLC Slave to My Rug-Rats Donating Member Join Date: Jun 2005 Location: Long Island Posts: 7,247	I have to agree - with a post number of 34 - I would NOT open her up for a liver biopsy - NO WAY I am in NY and Roxy's Internal Medicine Specialist (Vet Center in Westbury, NY) gets concerned with a post number above 40 (I know below 20 is normal). There are other tests to do right now that are less invasive. Have you seen a Specialist yet? P.S. Roxy's post number was 100.9 (after about 5 more - ranging from 60-85) I will NOT put her through a biopsy. She is 4 yrs and 5 lbs. She most likely has MVD, which there is no cure for, only treatment and 'if' we knew 100% for sure that she has MVD, the treatment would be the same exact as what we are doing now. So no need to risk anything with a Liver Biospy __________________ Adopt Donate Foster www.yorkie911rescue.com

09-24-2008, 10:18 AM	#6
Ellie May And Rylee Finnegan Donating Member Join Date: Apr 2007 Location: Metro Detroit, MI Posts: 17,928	I would NOT open her up to just do a biopsy but I also would not necessarily agree with a diagnosis of MVD without one. That is really the only way to tell for sure. If she had had any drugs (heartworm, flea) before the BAT, that would easily skew the results. Things like allbladder issues can make the BAT high also. High ALT and a seizure does sound like MVD (or shunt but the number is reeeally low for that) but that is really just an educated guess. If all other tests are coming back normal (including Protein C), why not just put her on supplements and see if the ALT and BAT come down? __________________ Crystal, Ellie May (RIP), Rylee Finnegan, and Gracie Boo🐶

09-24-2008, 11:59 AM	#7
SassyAnn101 Donating YT 500 Club Member Join Date: Apr 2008 Location: Tennessee Posts: 647	I will agree with every one else. Dont open your baby with such low numbers. If its not too far from you, I'd recommend the University Of Tennessee. They are great, and have alot of experience dealing with MVD and Liver Shunts in Yorkies. __________________ My Gang: Tanner,Trouble, Chip, Gus, Pee Wee,Haley, Razzle, & Pixie Rest In Peace My Sweet Gizmo & My Pretty Pretty Princess Tenci

09-24-2008, 01:00 PM	#8
smartpuppiepets YT 1000 Club Member Join Date: Jun 2007 Location: Beverly Posts: 1,042	I Got an update from the purina breeders member about new research data and the only test really able to diagnose this is MRI, which can be very expensive. My self i have no experience with it, but i saved the article, it is very interesting. It came on the mail not online , but if you want to try giving them a call or contact them directly i am sure they would send you the info. It is specifically about a yorkie study they did, reaserching a very extensive data base. I wish you all the best of luck with your baby, hopefully you can start getting good news !!! __________________ "The reason a dog has many friends is because it wags it's tail instead of it's tong " [I]Smartpuppiepets@yahoo.com /I][

09-26-2008, 10:26 AM	#9
ashleybug Yorkie Talker Join Date: Jul 2007 Location: Ohio Posts: 11	More info about my little Sophia with MVD So I talked with the vet about all the opinions I have received and more of my concerns. She said that she still thinks the biopsy would be good to do on OCT 8th as scheduled because she is also getting spayed at that time. She said that since they are opening her up anyway they might as well do it now instead of undergoing 2 anesthesias. They promised that the biopsy would not cause her to be under much longer at all. To answer some questions: no frontline or heartguard right before the testing. She of course receives these but it had been about 3 weeks prior. UT is not too far to travel for little Sophia, but only plan on going if really needed since it is 2 states away. Also, vet said when they look at her liver they might find a very very very slight shunt that could be causing her numbers that we would otherwise have no idea about. Not sure if I had mentioned the spay at the same time before in my posts....so does anyone have any different opinions now? Thanks so much!!!

09-26-2008, 10:39 AM	#10
TLC Slave to My Rug-Rats Donating Member Join Date: Jun 2005 Location: Long Island Posts: 7,247	Ok, much better information. As long as she is getting spayed anyway then I think it is ok to do the biopsy. Thanks! Also, you may want to ask Ellie May this....b/c I remember reading that she wrote she too had to biopsy done at her spay, but the Vet only took one sample and it didn't show MVD ~ however, if they took a few samples (from other areas ) it may have showed MVD, but they will never know now....So my point is, tell your Vet to take a few samples (I think...) Keep us posted __________________ Adopt Donate Foster www.yorkie911rescue.com

09-26-2008, 12:26 PM	#11
Ladymom Donating YT 2000 Club Member Join Date: Sep 2007 Location: North Carolina Posts: 8,317	No, you didn't mention she was getting spayed and that changes everything. Yes, definitely get a biopsy done since she will be under anesthesia already. Just remember that Dr. Center states that a diagnosis cannot be made from a biopsy alone. It must be combined with a Protein C test and/or imaging (preferably scintigraphy, not ultrasound). Hepatic Vascular Disorders - WSAVA 2006 Congress __________________ http://www.myladysdogbows.com/ http://www.facebook.com/home.php?ref...6213341?ref=nf

09-29-2008, 05:41 AM	#13
bellasmomok ♥ love my girls!! ♥ Donating Member Join Date: Aug 2008 Location: OKC area Posts: 1,140 Blog Entries: 1	What is MVD? I opened this thread because I didn't know what that was and have been reading (getting a lot of education in liver shunts!), but I'm still confused about what MVD is.... My thoughts and prayers are with your baby, though! And, I'm hoping everything turns out better than you're thinking it could!!!

09-29-2008, 06:21 AM	#15
bellasmomok ♥ love my girls!! ♥ Donating Member Join Date: Aug 2008 Location: OKC area Posts: 1,140 Blog Entries: 1	Thanks Ellie May! I'm a sonographer (ultrasounds) for people, and have done a LOT of ultrasounds on people with liver disease, transplants, shunts (both congenital and created [to solve a problem temporarily until a transplant]), etc... I have never even heard of microvascular dysplasia, but it makes sense that the tiny vessels can have abnormal pathways just like the big ones can. I sure hope that turns out to not be the problem! I'll have my fingers crossed for sure!!!!