Today's Veterinary Practice provides comprehensive information to keep every small animal practitioner up to date on companion animal medicine and surgery as well as practice building and management.
Issue link: http://todaysveterinarypractice.epubxp.com/i/38074
CONSIDER THIS CASE | UÊ"À>lÊ>`miniÃÌÀ>ÌionÊovÊ>minoÊ>Vi`ÊÃolÕÌionÃÊ>n`Ê supplementation with raw egg yolks, zinc, and iÃÃinÌi>lÊv>ÌÌÞÊ>Vi`ÃÊnoÌÊ>ÃÊivviVÌiÛiÊ>ÃÊ 6Ê>minoÊ acid supplementation) UÊ/Ài>ÌminÌÊÜiÌhÊ>nÌi-invl>mm>ÌoÀÞÊ`oÃiÃÊovÊ«Ài`- nisone (considered controversial, but may tempo- rarily improve skin lesions) UÊ-Þm«Ìom>ÌiVÊ Ìo«iV>lÊ ÌhiÀ>«iiÃÊ voÀÊmoiÃÌÕÀiâin}Ê skin lesions. Parenteral amino acid supplementation is the symptomatic treatment of choice for improving skin lesions in animals with chronic liver disease and may prolong survival time by several months. Treatments, which may be repeated every 7 to 10 days as needed, may result in improvement in 1 to 3 weeks.4 Ê improvement is noted by this time, then the prognosis is guarded. In-Clinic Therapy The dog received amino acid supplementation, which was performed by administering hydromorphone (0.1 mg/kg) and midazolam (0.1 mg/kg) and placing a central line in the left jugular vein for administration of a 10% crystalline amino acid solution (Aminosyn, abbott.com). This solution is hypertonic and likely to cause thrombo- «hliLiÌiÃÊ ivÊ >`miniÃÌiÀi`Ê ÌhÀoÕ}hÊ >Ê«iÀi«hiÀ>lÊ Ûiin°Ê ÌÊ was dosed at 150 mLs of Aminosyn, which was added to 250 mLs of 0.9% sodium chloride for a total volume of 400 mLs administered over 10 hours. vÊnoÊ At-Home Therapy A therapeutic plan was outlined with the owner and included: UÊ Êhi}hlÞÊ`i}iÃÌiLli]Êhi}h-µÕ>liÌÞÊ«ÀoÌiinÊ`iiÌÊÜiÌhÊ ÛiÌ>minÊ Ê>n`ÊÃolÕLliÊviLiÀ]ÊÜhiVhÊ>LÃoÀLÃÊÃomiÊ of the toxins not filtered by the liver (Prescription 1A 1B Figure 1. (A) Lateral and (B) ventrodorsal radiographs of the abdomen 2A 2B Figure 2. Ultrasound image of liver gall bladder demonstrating the “honeycomb” appearance (A and B) July/August 2011 Today’s Veterinary Practice 41 Hepatocutaneous Syndrome in a Shiba Inu