Fig 1: Lagotto Romagnolo dog with variant ATG4D gene. Case 1. Transmission electron microscopy (TEM) and immunoelectron microscopy (IEM). Figure 2. Pancreas. Acinar cells have numerous cytoplasmic membrane-bound clear vacuoles. TEM. Bar = 5 µm. Figure 3. Dorsal root ganglion (DRG). A neuron has extensive cytoplasmic vacuolization. IEM; isotype control antibody. Bar = 5 µm. Figure 4. Pancreas. Immunolabeling for LAMP2 protein by gold particles (arrows) on the limiting membranes of the cytoplasmic vacuoles. IEM for LAMP2. Bar = 500 nm. Figure 5. DRG. Gold particles (arrows) represent immunolabeling for ATG4D on the vacuolar limiting membrane. IEM for ATG4D. Bar = 500 nm. Figure 6. Pancreas. There is lower immuno-gold labeling density for LC3 on the vacuolar membrane (black arrows) and in the cytoplasm (arrowheads). IEM for LC3. Bar 500 nm. Figure 7. DRG. There is weak labeling for TFR2 on the vacuolar membrane. IEM for TFR2. Bar = 500 nm.