Like all 3 Scottish Deerhounds reported to have died from DEPOH in a previous study (8), this case was homozygous variant SERPINF2 c.605 T/T genotype thereby implicating a role for alpha-2 antiplasmin deficiency or dysfunction in the pathophysiology of this case. The gene discussed is SERPINF2; the disease is hyperinsulinemic hypoglycemia, familial, 4.