Systemic amyloidosis presents a diagnostic challenge because of the multi-systemic manifestations of the disease, as illustrated in the case of Bonnie, a 3 year old female Chinese Shar-Pei. She presented to Cornell University Hospital for Animals for evaluation of vomiting, anorexia, and lethargy. Diagnostic tests revealed abnormalities potentially involving the liver, kidney, and gastrointestinal system. Additionally, hypoadrenocorticism was suspected. Initial case management was supportive and aimed at correcting dehydration, gastro-protection, and preventing emesis. After 3 days, Bonnie showed marked improvement and the owner chose not to pursue further diagnostics. Six months later, Bonnie re-presented to the Emergency Service with similar clinical signs. Repeat diagnostics revealed an identical problem list to the previous visit. Cytological evaluation of hepatic fine needle aspirates revealed amyloid, which enabled definitive diagnosis of hepatic amyloidosis, and concurrent renal involvement was presumed. The long term treatment goals were to decrease proteinuria, control blood pressure, reduce accumulation of amyloid and dissolve amyloid deposits.