Hi, This is Patches, a cat I posted about a few weeks back and I thought I could see a thrombus or embolus in portal vein. Owners did not want any sampling taken. There was then mild free fluid and mild biliary stasis. Liver enzimes had gone back to normal. A few days later I re scanned and found the situation worse, but surprisingly, patient´s liver enzimes were better and also himself is doing well. So… I am puzzled at my findings…

Hi, This is Patches, a cat I posted about a few weeks back and I thought I could see a thrombus or embolus in portal vein. Owners did not want any sampling taken. There was then mild free fluid and mild biliary stasis. Liver enzimes had gone back to normal. A few days later I re scanned and found the situation worse, but surprisingly, patient´s liver enzimes were better and also himself is doing well. So… I am puzzled at my findings…

I couldnt quite find the same image of a thrombus in PV but…there is a severe GB distension with CBD also moderately to severely dilated, and what appears to be PV or CBD with a strong flow of echogenic material…if it´s not portal vein…then what can it be? Bile? There are multiple regional Lns enlargement and very “messy”area in pancreas/portal vein/CBD. Pancreas appears very hypoechoic and irregular. Free fluid is more abundant.

This looks very much like neoplasia to me but…I can’t explain how the cat is clinically better, including bloods results…Even if I were to take FNA…I would feel a bit nerveous now with so many abnormal vessels in the area…(and so swollen…)My doppler lights up everywhere…

Any new ideas on these clips and case? My last advice was that without taking any samples of any sorts…I am stuck at diagnosis…So I adviced CT scan to be considered. I can sample free fluid…and pancreas…but trying to hit the abnormal area even for LNs looks scary to me…In any case, owners are against any invasive measures…

Thanks…for your help.

Silvana.