Question Details
Microvascular Dysplasia In A Dog
by Hen4761@gmail.com - May 6, 2026    View Case Report
2yr old MI Shih Tzu presented for routine wellness exam and labs. He has been eating a raw diet since puppyhood. No clinical signs at home. Patient’s ALT was 203 U/L. Previous year was 194 U/L. Pre and Post bile acids elevated (18, 42 respectively). Radiographs illustrated smaller liver silouhette otherwise WNL. U/S report results: no primary large liver shunt but cannot R/O MVD, otherwise WNL.

Discussed suspected MVD with the owner and we talked about Happy Wanderer and rectal insufflation of ozone. She had read it was okay to give Cessorex and Happy Wanderer together, so I wanted to confirm if this is okay to use both together? Or just one is best?

Thank you!
Replies
by naturevet
May 11, 2026
Hi there!

They can be used together, but it's perhaps overkill. Cessorex comes in granules, which are more potent, but Happy Wanderer is generally the first pick. Cessorex is more balanced in its effect, which means it is not as strong a Liver Blood tonic as Happy Wanderer, whose anti-inflammatory and decongesting effects are milder. BUT Happy Wanderer is not as strong as the granule version called Xiao Yao San (from www.atimetohealherbs.com). If I had both Cessorex and Xiao Yao San on my shelf, I'd try XYS first. If the owner finds it easy to give Happy Wanderer even at the inflated dose of two or three times the label dose, I suppose she could start there.

Hopefully, I didn't muddy the waters for you!

Steve
by Hen4761@gmail.com
May 13, 2026
Thank you so much! What would be your dosing recommendation for the Natural Path XYS? He weighs 8.5 lbs
by naturevet
May 17, 2026
He would need at least 60 mg/kg of the NPHC version. That's about 250mg. The formula is 1g per 1/4 tsp, so you'd be looking at as low as 1/16 tsp. That's not really that easy to measure. Maybe go with 1/8 tsp and give that twice a day to start with.

Hopefully, it works well for you!
by Hen4761@gmail.com
May 20, 2026
Thank you so much!
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