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Discussion Starter #1
Hi Everyone. I am so upset with my Vet right now I needed to vent and ask if any of you can tell me what this biopsy results means; as in what kind of a shunt it is; possible prognosis from one of our experts here on SM. My vet has gone on a vacation and the other vet didn't know for sure what it means
The report says MICROSCOPIC DESCRIPTION:- Multiple punch or wedge biopsies of the liver are examined. All similar. Portal Triads are in close approximation to one another. Each exhibits one or more redundant blood vessels, which appear to be small arterioles. The capsular surface is somewhat irregular. Scattered Lipogranulomas are evident within the sinusoibs. - DIAGNOSIS: - See Comments. COMMENTS: - The spectrum of lesions identified is compatible with a Portosystmic Shunt. No Hepatic inflammation, Fibrosis, or Necrosis is present.

HELP: Does she have a portosystemic shunt or MVD? Fibrosis, or Necrosis isn't present - what does this mean? I will go nuts waiting for the Vet to be back from his vacation even if it is only 1 more week. Thanks for letting me vent my anger with my Vet and please help me understand if you have any knowledge from what the report says. Would this be genetic or heredity and my breeder should make things right? Thanks!
Disgruntled Jackie & Belle
 

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no fribrosis and no necrosis is a good thing...fibrosis is scarring and necrosis is death..let me go look in my pathology book to see what the findings are for mvd verses shunt...
 

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Discussion Starter #4
Originally posted by Holliberry@Feb 22 2005, 01:12 PM
I'm sorry I cant help but I wanted to offer some support to you and your darling little baby. 

Isnt there anyone in your vet's office at all who can answer your questions??  I would be mad too!  You can't wait a week for heavens sake! 

good luck!
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No, not really and that's why I am so angry and upset. The other vet said well she does have a liver shunt problem as I took a peek at the report but I don't really know what kind or the prognosis.WHAT???? Then why the heck are you there. I reallly like or liked my Vet but I'm wondering now. I know I could have them find him and demand that he call me but if he isn't even in the office where the report is how sure am I that he is really going to give me an accurate diagnosis and prognosis. Sorry, here I go ranting again, my husband didn't help he said well he will be back in one more week and then we will know. Not good enough for me so back off buddy! I think I best go take a chill pill. Thanks for our support!
 

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Discussion Starter #5
Originally posted by LadyMontava@Feb 22 2005, 01:15 PM
no fribrosis and no necrosis is a good thing...fibrosis is scarring and necrosis is death..let me go look in my pathology book to see what the findings are for mvd verses shunt...
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Thank you so much Lady Montava. Belle & I appreciate it. :D
 

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oh man... I would love to hear what that all means! Did you try looking on the internet for more info?
 

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I'm sorry I can't help with what all this means, but I am sure you'll find answers. LadyMontava is such a valuable resource here.

Extra kisses for your pooch.
 

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I'm sorry I don't know what it means either.
You have my best wishes though! I hope you find out what you need to know. Big hugs and kissses for Belle
 

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i found this: Hepatic histologic changes in animals with PSS include generalized congestion of central veins and sinusoids, lobular collapse, bile duct proliferation, hypoplasia of intrahepatic portal tributaries, proliferation of small vessels and lymphatics, diffuse fatty infiltration, hepatocellular atrophy, and cytoplasmic vacuolization. These pathology changes can also be seen in dogs with hepatic microvascular dysplasia that do not have single congneital shunts.

which to me means the biopsy can look the same for both...im still lookin around though...
 

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well im not finding n e thing else..wish i was closer to school..i would run to the library...seems to be they could have seen the shunt when they had her open..but im not sure...maybe JMM can help more since she knows more about MVD
 

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yes, i have been told that they will or could see the shunt if kodie had one if they opened him up... (the first vet told me that)... after doing the radioactive test at cornell (which was the last vet I took him to)... it showed no shunt. But... if they were still in question after that test they would have requested to open him up and LOOK at the liver to see if there was a shunt.
Sounds to me like MVD... thats when you have many tiny vessals instead of just one big one (which would be a shunt). Just from common knowledge of what i know from my little kodie... he appears healthy and you have told us that belle seems healthy too.. sooo i bet its MVD.
I'm NOOOO doc though... just voicing my opinion like always..


let me rephrase that... cornell or any normal hospital should always check VISUALLY for the shunt when the pup is open.. not just take the sample.
 

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thats what i was thinking too but didnt want to say "yes thats what it is" and be wrong cause im supposed to be the "all knowing one" LOL
 

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If the vet at your vet's office doesn't understand how to read the report, is it possible that she can refer to you a vet at another practice who might know more? Vets usually know each other and who is good, etc. Even if you had to pay for a consultation fee, that is better than waiting.

If she can't help you with a referral then can you check with friends and see who their vets are and then call one for a consultation appointment... Using a friend's name who is a good client may help you get the appointment quickly. I agree... waiting is not an option!!
 

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i dont understand why the vet that is there cant call the pathologist and let the pathologist explain it, so they can explain it to u. that is usually how it works.
 

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Didn't you say the surgery/biopsy was done at UC Davis? Can you contact the doctor you worked with there for an interpretation of the pathology report? They probably are more knowledgeable on this sort of thing anyway ??

EDIT: I went to Google and searched for "Portosystemic Shunt in Maltese" and quite a few sites came up. You may want to look at some of them as you may find some information that is useful until you can speak with a vet.... Here is one that is very good. It explains things in a simplified manner. It may not be an answer to your biopsy but it does give a lot of info, in general.http://www.vetsurgerycentral.com/pss.htm
 

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Discussion Starter #17
Thanks everybody. I know they were thinking MVD but all of that report didn't sound like that to me. The word Portosystemic shunt surprised me but I'm not very knowledgeable about shunts yet. Thanks Kallie & Catcher's Mom. I'll check out the website you found for me. I did fax a copy of the biopsy to Davis and ask the Doctor that examined Belle there to check it over and get back to me. Belle's own Vet here did the spay and biopsy.
Jackie & Belle
 

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Discussion Starter #18
Originally posted by LadyMontava@Feb 22 2005, 01:43 PM
i found this: Hepatic histologic changes in animals with PSS include generalized congestion of central veins and sinusoids, lobular collapse, bile duct proliferation, hypoplasia of intrahepatic portal tributaries, proliferation of small vessels and lymphatics, diffuse fatty infiltration, hepatocellular atrophy, and cytoplasmic vacuolization. These pathology changes can also be seen in dogs with hepatic microvascular dysplasia that do not have single congneital shunts.

which to me means the biopsy can look the same for both...im still lookin around though...
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On Belle's Biopsy Result there is a website to receive the information on the biopsy. You have to be a vet and sign in so it did me no good. I don't know if it would say more than the report that I was faxed. It is www.vetconnect.com and Belle's account # is 1208. You think it is MVD, is that correct? Which would mean watching the diet and prayerfully no clinical signs will appear later if we are careful? Thanks!`
Jackie & Belle
 

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Sorry you are going tru all this mess.

I will keep you and your baby in my prayers!
 

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Originally posted by Maltese Adora-Belle+Feb 22 2005, 06:40 PM-->
<!--QuoteBegin-LadyMontava
@Feb 22 2005, 01:43 PM
i found this: Hepatic histologic changes in animals with PSS include generalized congestion of central veins and sinusoids, lobular collapse, bile duct proliferation, hypoplasia of intrahepatic portal tributaries, proliferation of small vessels and lymphatics, diffuse fatty infiltration, hepatocellular atrophy, and cytoplasmic vacuolization. These pathology changes can also be seen in dogs with hepatic microvascular dysplasia that do not have single congneital shunts.

which to me means the biopsy can look the same for both...im still lookin around though...
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On Belle's Biopsy Result there is a website to receive the information on the biopsy. You have to be a vet and sign in so it did me no good. I don't know if it would say more than the report that I was faxed. It is www.vetconnect.com and Belle's account # is 1208. You think it is MVD, is that correct? Which would mean watching the diet and prayerfully no clinical signs will appear later if we are careful? Thanks!`
Jackie & Belle
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i tried to see if students could register..but there was nothing that said vet student..it prob is the same results..maybe images are available.
i think it sounds like MVD but according to the article i read they can both look the same under the microscope. so i am still unsure..i couldnt find MVD in my pathology book to compare the results..it only had PSS. did they look for a shunt when they had her open?
 
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