Vacuolar Hepatopathy
 

Yorkies have liver issues, we know that, and we certainly hear many people talking about MVD and shunts here on YT. But my Barney was just presumptively diagnosed with a liver condition I hadn't heard of before and have not seen on YT. Barney's vets seem to think that Barney has a liver disease called Vacuolar Hepatopathy.

The condition usually shows up in an older dog with few or no clinical symptoms. In Barney's case, he is a healthy but older dog whose liver enzyme ALP has been rising raising some concern for us. The cause can be unknown (idiopathic) in some cases but in others it results from steroid use or from Cushing's disease. It is diagnosed for certain by a liver biopsy.

We have sought the opinion of a board certified (ACVIM) internal medicine specialist who has treated Daisy for several years. Barney has had a bunch of testing and imaging done. Because his ALP proportionally exceeds ALT and there are no other abnormal findings, it is most likely Barney has Vacuolar Hepatopathy. Since atypical cushings dogs often have similar ALP readings and vacuolar hepatopathy, I am asking my vet to rule it out for certain, if possible. I am asking her to do a cortisol creatinine ratio test today which is just a simple urine test that would rule out cushing's, which might be another explanation for the vacuolar hepatopathy instead of an unknown, or idiopathic cause.

I am sharing this here for anyone else who might have an older dog whose liver enzymes show up in this pattern - ALP proportionally exceeding ALT with no other abnormalities -- Vacuolar Hepatopathy is an emerging disease and regular vets may not be as familiar as ACVIM vets with this condition. The liver bile acids were normal and the liver itself is normal in size and proportion. The treatment is supportive and Barney will stay on Denosyl and will be starting a medication called Ursadiol that is also used for other kinds of liver issues.

My prayers are with you and Barney.

Good luck today at the vet with Barney. You are an amazing advocate for all of your babies. Thank you for your willingness to share your growing knowledge base to others so they too can properly advocate for their little ones as well. :hug:

Barney decided to be extra special and come up with something new. Sending prayers that it is not Cushing's, and that he remains asymptomatic and that the medicine manages it.

I'm keeping you and Barney in my thoughts and prayers.

I'll just say that Barney is so very lucky to have you, as are all of your other kids.

Thank You for the information. You are a very special lady, we all love and respect you. Prayers for your sweet Barney and you too.

Poor Barney. I'm so glad he ended up in your life, he probably wouldn't have been so well taken care of else where.

Keeping Barney in my prayers. ((Hugs)) to you Cathy. Hope everything turns out well at the vet.

Sending prayers and hugs to Barney. Keep us updated.

Sending prayers and hope that Barney continues to do well, and the tests today rules out Cushings.

Thank you so much for sharing with all of us!! You are a very special mom and I will pray for the very best outcome for Barney!!

Keeping Barney in my prayers. When my pom had Cushing's the medicine she was on caused her to go in to some type of liver failure. Not sure what the specialist called it. They took her off the Cushing's medicine and put her on liver medicine and in less than a year her liver was back to normal. I hope Barney responds well to the medicine.

I hope Barney is doing well. He's lucky he has you to advocate for him.

Thanks everyone. Barney is feeling great. He is a wonderful pet and I am the lucky one. I feel so comfortable starting the management plan for him having made sure my vets went over his case with a fine tooth comb. They have been so wonderful to Barney, and they have been patient and understanding with me and my interrogation :) We are sad though as the internist is moving to the midwest. We will miss his knowledge and skill and also his kindness and compassion to the dogs.