Mochi
A complex diagnostic journey revealing a multi-systemic congenital profile.
Clinical History
Initial presentation: 9-month history of multi-systemic signs.
Neurological
- Aggression (worse at night)
- Pacing & Circling
- Sudden head-jerking
Gastrointestinal
- Morning vomiting
- Ptyalism (Drooling)
- Polyuria / Polydipsia
Respiratory
- Stridor (Wheezing)
- Stertor (Snoring)
- Sneezing
Derm & Other
- Symmetrical alopecia
- Retained deciduous teeth
- Occasional lameness
Hepatic Microvascular Dysplasia (MVD)
Initial bloodwork suggested a large liver shunt. However, advanced imaging (CT) ruled out a surgical shunt and confirmed Microvascular Dysplasia (MVD)—a microscopic anomaly where portal vessels within the liver are underdeveloped.
Clinical Implication:
While not surgically correctable like a standard shunt, MVD causes similar symptoms because toxins aren't properly filtered. It requires strict lifelong medical and dietary management, similar to a shunt.
Additional Diagnostic Findings (CT)
Beyond the liver diagnosis, advanced imaging revealed a constellation of concurrent anomalies explaining the multi-systemic symptoms.
Cranial Anomalies
- Open Fontanelles: Multiple unfused sutures leaving the brain vulnerable.
- Enlarged Foramen Magnum: Opening at base of skull is too large.
- Brainstem Kinking: Mild compression by C2 vertebra.
Airway (BOAS)
Explaining the snoring and wheezing:
- Severely deviated nasal septum
- Elongated soft palate
Abdominal & Spinal
- Hemivertebra: Congenital malformation of caudal vertebra.
- Cryptorchidism: Bilateral undescended testes.
- Kidney Stones: Small mineralised foci in left kidney.
Dental Anomalies
Treatment
Strategy
Focus: Symptom control
Medication
- Lactulose
- Amoxicillin-Clavulanate
Dietary
Hepatic Diet (Vegetarian)
Ultra-Low Protein
Specialized vegetarian hepatic diet to support liver function.
Monitoring
- Urination
- Vomiting