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Symptoms of MVD?? - Hepatoportal Microvascular Dysplasia

MVD Diarrhea

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#1 spoiledhavanese

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Posted 11 May 2013 - 08:39 AM

I have a 13 month old male "white chocolate" havanese. I purchased him from a reputable breeder in the Philadephia, PA area. He came to me with "tummy troubles". In fact, I picked him up a week later than I was supposed to b/c of a bout of bad diarrhea after his vaccination. I followed up a week later and the breeder assured me he was okay to be picked up to come home. When I got there (2 hours away), I was told "This kibble is not agreeing with him, you need to change it." He was eating Natural Balance. The diarrhea was so bad the first few days he was with us. He was treated with Flagll, although stool sample showed no parasites. The vet then put him on Science Diet's ID food. That did immediately fix the problem, but the goal was to get off that food...as slowly as possible. He was then very slowly transitioned to Science Diet puppy kibble at the recommendation of the vet. He was good on that for awhile. Then started to have intermittent diarrhea again, so I added some chicken to his kibble. That seemed to help quite a bit and we were good again for awhile, until Science Diet changed the puppy food formula drastically and he could not tolerate it at all...more diarrhea. I have switched his kibble a couple of times since then and he has been eating Nutro Chicken, Brown Rice & Oatmeal kibble for small breed adult dogs, but I was still adding diced baked chicken as a topper. His poop was pretty good for awhile, but diarrhea returned and continued. Poop was baby food consistency and I was literally having to bring paper towels to appropriately clean up after him on walks. I decided to call vet to look into this diarrhea problem again. I thought maybe food allergy? Stool sample was normal, although she treated him w/ Flagll just in case. She also prescribed Amoxcillian and Ciprofloxin in case of bacteria infection. She also told me to feed him Hill's Z/D ultra allergen food and discontinue the chicken. Diarrhea became much, much worse. Not going more often, just not good at all when he does go. One morning he refused to eat z/d food and I was worried about giving meds with no food, so vet said cook him small meals of chicken and brown rice and continue meds. The next poop (a day later) was drastically improved...closest thing to normal dog poop I had seen in weeks, yet 12 hours later this morning, very small amount of diarrhea again. Now vet wants to run liver enzyme test. What are the symptoms for Hepotoportal Microvascular Dysplasia (MVD)? Would the dog show other symptoms other than somewhat chronic intermittent diarrhea if he had this genetic problem? I am concerned, but he seems to be normal happy dog other than stool problem that has been on and off since we got him. Also, I have spend close to $600 on this problem in one week between vet visit, blood work for vit b12 test and food allergy testing, meds, prescription food, etc. Now another test? We have not finished antibiotics yet or gotten results for food allergy test. Any advice or experience with MVD symptoms? Worried about our little havanese!

#2 Christy

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Posted 11 May 2013 - 08:48 AM

I'm so sorry to hear you are going through such problems with your pup. How old is the little one? Is he small for his age? I haven't experienced this before but hopefully someone else will chime in that is familiar with this.

Is the breeder helping? She may know of other breeders that have seen this before. Hopefully she is also asking around.
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#3 Suzi

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Posted 11 May 2013 - 09:17 AM

Did you stick with the chicken and rice? And are you sure hes not getting anything else when he gets the diarrhea again? Pumpkin is good for their digestive system. It helps both the runs and constipation. I'm not sure of the amount but its the canned pumpkin What does his breeder say?.I hope it clears up with out liver testing.
Did you vet have you do the chicken and rice to see if it is an allergy? Has he thought about testing for food allergies?

Edited by Suzi, 11 May 2013 - 09:33 AM.

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#4 spoiledhavanese

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Posted 11 May 2013 - 10:15 AM

Thanks so much for you kind comments. My Bailey is 15.1 lbs. He is a larger Havanese in structure, not overweight or underweight. I am definitely sticking with the chicken and rice while giving him the antibiotics, and have stopped giving him any kibble until I get results of food allergy testing. Vet agrees. I have contacted the breeder a few times since I've had him to discuss feeding options and various bouts of puzzling diarrhea over the past year. She actually had suggested Nutro kibble a few months ago as an option. I haven't contacted her yet about vet wanting to run liver enzyme test and our discussion of how MVD is a common prob in Havenese breed, but I plan to.

#5 Amanda

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Posted 11 May 2013 - 08:06 PM

Sorry to hear all of the troubles. I would definitely talk to the breeder. I know liver shunts can run in some lines. I also know sometimes you can't tell by the size of the dog and you don't find out until they are adults. I haven't had to deal with liver issues but attended a seminar on it. Make sure if you go through with the testing you do the full fasting panel.
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#6 spoiledhavanese

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Posted 11 May 2013 - 09:07 PM

Breeder says she has never heard of one of her puppies having liver shunt. She said based on what she has read, the dog would not feel well and act sick right after eating. She didn't think it was necessary to have the test performed at this point. She suggested feeding him home cooked doggie meals. Boiled chicken, mixed with yams, chopped green beans, and a tiny bit of fruit. She also told me to buy Missing Link supplement. Breeder said she did have one pup once who did have chronic intermittent diarrhea problems and when the owner started feeding him people food, the dog had normal stools. He just couldn't tolerate commercial dog food. She did seem concerned and asked if I could let her know how he is doing. Vet said liver test is $148. I think I will do it for peace of mind.

#7 klomanchiodo

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Posted 11 May 2013 - 09:33 PM

My Bella is a liver shunt dog. We had her shunt surgically repaired in October of last year, most of her follow up tests point to some underlying MVD, which is not uncommon in liver shunt dogs and our breed. Bella was 2.5 years old before we discovered she had a liver shunt, which are often discovered when dogs are much younger. She was 11 lbs at the time and our vet and the specialist all thought it would be unlikely that she would have a shunt due to her size and apparent health and age. Even the local specialist did not expect a shunt, instead she expected MVD. Bella NEVER showed any of the classic signs (poor doer, underweight, head pressing, anorexia, stomach upset after eating, etc.) of a liver shunt, she was always a happy, healthy dog - she simply had some confidence issues and noise sensitivity.

Our journey began when Bella got a UTI and after 4 weeks of treatment with antibiotics still had issues. The first signs of her liver shunt were puzzling crystals in her urine. Many dogs have crystals, but Bella had crystals that should not have been present in the urine at the particular pH. It was on her third urinalysis that biurate crystals appeared. I immediately requested a blood panel with liver values and a bile acid test. The BAT requires that you fast your dog, but it is the true indicator of liver issues. It will not be a definitive test, but it can help you in the differential. If your BAT comes back with high values, further testing needs to be done to rule out a shunt. This further testing may well involve an ultrasound (which can often miss a shunt, which we learned with Bella as hers was not visible on the ultrasound), CT, MRI, or portoscintigraphy. Portoscintigraphy is the gold standard for confirming the presence of a shunt, but not the location. During surgical repair they also do a liver biopsy, but the results will be the same if the dog has a shunt or MVD. Only a follow-up biopsy will confirm any underyling liver disease. 6 months post surgery Bella's BAT values remain high and may never return to normal, we have decided to continue with her liver protocol since she is doing so well on it. We are assuming the higher values are an underlying MVD on the advise of our surgeon, Dr. Karen Tobias at University of TN. Our current plan is to not have another biopsy unless Bella starts to show signs of distress.

My vet was very honest about her lack of experience with liver shunt dogs, but has been amazing to work with as we learn together. She read everthing I supplies to her in terms of liver shunt, testing, treatment, and maintenance. She has consulted at length with our surgeon and written every prescription and referral we have requested.

We were unable to get in contact with Bella's breeder, which makes me a bit sad since there were two other pups in her litter.

If I were in your shoes, I would have the liver panel and bile acid test done regardless of anyones advice, if for no other reason than your own peace of mind and as a tool for a diagnostic. If it is not a liver shunt, or MVD you will be futher along in finding out what is causing the issues. I am more than happy to serve as a resource for you in terms of sharing information I have learned and our personal experience. You can also learn about our journey on facebook: Havanese Hope - We Love Bella.

Best of luck to you, I know this is a stressful time.
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#8 Marj R.C.

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Posted 12 May 2013 - 08:18 AM

I am sorry to hear your new Havanese is having bowel troubles. It is frustrating not knowing how to help him, though I'm glad to read he is acting playful and still eats well. Personally, I would steer from commercial foods for now, and especially "vet/prescription" food. I don't like them one bit. If you read the ingredients in those formulas, you will see there is very little meat, there can be corn, soy, cellulose, grains, meat "products" and "flavors". Horrible stuff. I know some dogs do well on them, but they provide very little nutrition and it sounds like your dog (what is his name?) needs all the nutrition he can get.

IF he does have liver issues, then there are canine food experts online that can provide diet recipes, though I would go with the highest recommended experts. Members at this forum and elsewhere have used Sabine's services, so maybe one of them can chime in with her site link and other info. Monica Segal, you'll find her online, also provides great tips for dogs with liver issues, as does Dr. Jean Dodds from Hemopet. I like all their input and you can see what sits right with you. I would not give a diet this vet recommends, based on what she's already recommended, but that's just me and what bit I know about dog nutrition. I'm no expert, but I had to look into this years ago with my Ricky, after he almost died from a toxic reaction to a vaccine and it affected his liver. He is not a "liver dog" but I did learn a ton about the commercial foods out there, raw diets, homecooked and supplementation. I also worked at a pet boutique (food and accessories) for 4 years and consulted with customers who had diverse health problems in their pets. I learned a lot! Have a look at our Diet section for lots of great advice, links, recipes and help for some health issues in our dogs.

I don't think liver problems are typical or "common in our breed" as the vet said, but it does happen and most especially in Havanese bred from backyard breeders and puppy mills, which are commonly found online and in pet shops. That really sways the health issues in any breed! :(

I would give up any kibble for now and stick with home cooking either chicken or boiled ground beef. In fact, what your breeder suggested sounds good, though I'd not give the fruit. I wouldn't want to up the sugars in his system. Also, I HIGHLY recommend you give him a probiotic supplement in his food. When on antibiotics, the good gut bacteria are also wiped out and so the gut is off-kilter, but because of his issues, I'd give him probitiocs long term. Find capsules that you can open up or tablets that you can crush. I have a powder form of probiotic that I sprinkle on the food and it helps keep things stable in the stomach and intestines. It can't hurt and is pretty easy to find at pet stores or online.

Best of luck, and please keep us posted!
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#9 Christy

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Posted 12 May 2013 - 10:21 AM

OK a link for Sabine? Here ha go! http://www.betterdogcare.com/ She has a lot of knowledge about dog nutrition. I had her work up a diet for mine when Marley was having so many problems with anal gland abscesses. The diet she designed was great, very nutritionally balanced and the dogs love it. She will work with you and design a diet based around raw, kibble, cooked with added supplements etc. I was well pleased with her consult and others have used her and have been pleased as well. She has you fill out a couple questionairres that are extensive to really work the diet around any possible issues your dog is having as well as custom fitting it to how much work you want to put out in the kitchen. :D

In my Marley's case I was desperate to find answers and avoid surgery which ultimately he end up having surgery anyway. *Anal gland issues are hard to find the cause of, so diet was only one thing I was trying to alter to help!

I also did allergy testing for him JIC it was allergy related. From what I have heard the standard allergy tests do not always give cut and dried answers and are very expensive. I chose to do the Nutriscan test developed by Jean Dodds. It's a food sensitivity test that uses saliva as a test medium. http://nutriscan.org/ I ran both panels on Marley. As it turned out that wasn't my answer either but it was part of our journey to find possibly causes, so I could rule out another thing which was good. Marley tested well with many foods that I feared could be an issue. So lucky for Marley he isn't allergic and I won't be limiting his diet LOL!

I hope you find answers to your dogs problems. I know how frustrating it can be not to know how to help your little one.
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#10 klomanchiodo

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Posted 12 May 2013 - 10:22 AM

As you and your vets work on a differential to determine what is wrong with sweet pup, you may find his information useful to learn about liver problems:

http://www.vet.utk.e...INAL-201304.pdf
Kristy

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#11 Poornima

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Posted 12 May 2013 - 05:44 PM

You have received very good advice and information.

I have used Sabine and I am very happy with her diet plan. I consulted her when my Benji suffered from loose stool, blood in stool for months due to what the vet thought was either IBD or colitis. All his tests were normal. I changed him from Natural Balance Duck and Potato to homecooked meals. Sabine mentioned that chicken, oily, fatty meat or fish can be irritants for dogs with delicate tummies. Lean turkey is the best and so is white fish.

I feed homecooked meal of cooked ground turkey, potato, green beans and carrots. I give him organic homemade yogurt. He has been doing well on this diet for last 4 years. He does have loose stool occasionally when he gets anxious (he has anxiety colitis due to fear of thunder and lightening). He cannot not tolerate any commercial foods at all. I had to feed him commercial grain-free kibble when I had a personal medical emergency in my family. He started to have runs and bloody stool all over again. So I highly recommend trying consistently homecooked food.

I hope it is nothing serious and the home cooked diet gets your puppy back to health.
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