Hepatocutaneous syndrome in Shih Tzus: 31 cases (1996–2014)

Hall-Fonte, Deborah L.; Center, Sharon A.; McDonough, Sean P.; Peters‐Kennedy, Jeanine; Trotter, Thomas S.; Lucy, John M.; Berger, Elyse; Byers, Christopher G.; Cummings, Clifford G.; Burke, Elizabeth; Stegemen, Julie; Pintar, Jason; Kantrowitz, Larry; Sharpe, Kristopher S.; Weinkle, Tristan

doi:10.2460/javma.248.7.802

Cited by 17 publications

(28 citation statements)

References 31 publications

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“…In the present report, portosystemic shunting was ruled out based on CT angiography and on a second bile acids stimulation test, but iron or pyridoxine deficiencies were not investigated. Serum chemistry abnormalities were also consistent with previous HCS studies where ALKP has been reported to be consistently elevated and there is seldom elevation of total bilirubin 3 4 9. It is speculated that the cause of elevated ALKP is from induction due to skin lesions with acute phase inflammatory response or due to chronic illness-related glucocorticoid isoforms 4…”

Section: Discussionsupporting

confidence: 89%

“…The severity of skin lesions appears to be a negative prognostic indicator in reported cases. Longest survival times have been recorded for dogs without cutaneous lesions or with less aggressive clinical signs 4. The skin lesions were milder at the time of presentation in this case study, which supports the slow or non-progressive nature of the disease.…”

Section: Discussionsupporting

confidence: 77%

“…Affected dogs are middle-aged and older. Although there is no clear gender predisposition, males have been reported in higher numbers by several authors 3 4 8 9. There is no known breed predisposition with reports including cross breeds and pure breeds such as terrier, collie, Maltese, German shepherd, Shetland sheepdog and Shih Tzu, where a heritable component has been speculated 3–5 9.…”

Section: Introductionmentioning

confidence: 99%

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Hepatocutaneous syndrome in a Maltese, diagnosis, treatment and the value of CT in the diagnosis

Almendros

Sandy

Kirberger³

2019

Vet Record Case Reports

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A 10-year-old Maltese neutered female was presented for lip dermatitis and mild generalised pruritus. On examination, there were multiple lesions affecting the peri-oral and peri-nasal mucocutaneous junctions as well as distal limbs. Serum chemistry and a bile acids test were indicative of hepatocellular injury and hepatic dysfunction. Plasma amino acids were markedly depleted. Ultrasonography of the liver revealed a honeycombed appearance. A CT scan was performed to rule out a porto-vascular abnormality, hepatic or pancreatic neoplasia. Abnormalities in hepatic architecture are described in this confirmed case of hepatocutaneous syndrome (HCS) for the first time on CT. This is the first reported case of HCS in Hong Kong. The dog was treated with a high-quality protein diet and amino acids transfusions. Eleven months after presentation the dog was still alive with good control of clinical signs.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionsupporting

confidence: 77%

Section: Introductionmentioning

confidence: 99%

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Hepatocutaneous syndrome in a Maltese, diagnosis, treatment and the value of CT in the diagnosis

Almendros

Sandy

Kirberger³

2019

Vet Record Case Reports

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“…In contrast to people, the majority of dogs with SND have nonglucagonomarelated disease associated with an underlying hepatopathy typically of unknown etiology or associated with phenobarbital administration. Diseases that have been reported to occur concurrently with SND in dogs includes diabetes mellitus and hyperadrenocorticism (1,2,(5)(6)(7)(8)(9)(10)(11). The specific pathomechanism of the hepatic form of SND in dogs is unknown but is postulated to occur secondary to metabolic disturbances that result in increased hepatic catabolism of amino acids.…”

Section: Discussionmentioning

confidence: 99%

“…Medical management in dogs with SND because of nonglucagonoma-related disease, similar to people with pseudoglucagonoma syndrome, is aimed at treating the underlying condition and repletion of various nutrients including zinc, essential fatty acids, and amino acids (1,4,11). Parenteral administration of amino acids is preferred in both people and dogs with SND over the oral route in order to bypass portal circulation and an exaggerated hepatic first pass effect (1,2,4).…”

Section: Discussionmentioning

confidence: 99%

Successful Long-Term Management of Canine Superficial Necrolytic Dermatitis With Amino Acid Infusions and Nutritionally Balanced Home-Made Diet Modification

et al. 2020

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A 10-year old, castrated male, Bichon Frise with a history of hyperadrenocorticism and intrahepatic portal vein hypoplasia was diagnosed with superficial necrolytic dermatitis (SND). The dog exhibited thick crusts on the chin, muzzle, prepuce, and paws. In addition, the dorsal surfaces of all paws were erythematous while the palmar/plantar surfaces were hyperkeratotic, hardened, and painful. The dog was treated with intravenous amino acid infusions (AAI), raw egg yolks, as well as zinc and omega-3 fatty acid oral supplements. The dog required AAI once every 2-3 weeks because this coincided with recrudescence of painful skin lesions. The dog was subsequently diagnosed with diabetes mellitus. A consult with the Nutrition Service was pursued 220 days after the original SND diagnosis because of concern for feeding raw eggs and for malnutrition since appetite was variable, muscle condition was reduced, and greater than 50% of ingested calories were from foods that were not nutritionally complete. There was also concern regarding the variability of the diet and the impact it would have on the management of diabetes mellitus. The diet was prepared by the dog owner according to a provided recipe and presented twice daily. The diet was rich in high quality protein and fat. All other treatments including medications, supplements, and bathing schedule remained unchanged at the time of diet modification. The dog was subclinical for SND associated clinical signs approximately 3 weeks after the diet modification, which also coincided with the last AAI. The AAI was postponed and was next administered 7 weeks later (i.e., 10 weeks from the previous infusion). The dog remained subclinical for SND related clinical signs and continued to receive AAI once every 10-12 weeks until he was euthanized 718 days later for complications related to severe multi-drug resistant, skin infections. In conclusion, this report highlights a novel role for nutritionally balanced home-made diets designed by a board-certified veterinary nutritionist could substantially increase time interval between AAI and outcome in dogs with SND.

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Nutritional Management of Skin Diseases

Outerbridge,

Owens

2023

Applied Veterinary Clinical Nutrition

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Hepatocutaneous syndrome in Shih Tzus: 31 cases (1996–2014)

Cited by 17 publications

References 31 publications

Hepatocutaneous syndrome in a Maltese, diagnosis, treatment and the value of CT in the diagnosis

Hepatocutaneous syndrome in a Maltese, diagnosis, treatment and the value of CT in the diagnosis

Successful Long-Term Management of Canine Superficial Necrolytic Dermatitis With Amino Acid Infusions and Nutritionally Balanced Home-Made Diet Modification

Nutritional Management of Skin Diseases

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