Hi again, this one is a shorter post. You may remember PATCHES, the 1 year 3months old MN cat with history of multiple cholangiohepatitis episodes, one traumatic episode which we think triggered the last episode (moment in which I see him for the first time for scanning) and I detect a potential PV thrombus/mass. After the cat went home on barely any treatment and owner was convinced cat was nothing but healthy, he has suddenly developped severe signs of Hepatic encephalopathy. So at that point I thought acquired PSS but needed to prove it.

Hi again, this one is a shorter post. You may remember PATCHES, the 1 year 3months old MN cat with history of multiple cholangiohepatitis episodes, one traumatic episode which we think triggered the last episode (moment in which I see him for the first time for scanning) and I detect a potential PV thrombus/mass. After the cat went home on barely any treatment and owner was convinced cat was nothing but healthy, he has suddenly developped severe signs of Hepatic encephalopathy. So at that point I thought acquired PSS but needed to prove it.

I would like your opinion on these images. I am pretty sure now that such mass is in PV and I can see multiple shunting vessels  (appear porto-caval) cranial (and even caudal) to thrombus.

I find these clips cool. 1+ month ago I had already suggested referal to the local surgeon specialist. I now know he doesnt want to do any ex lap unless FIP is confirmed negative, owners opt for CT scan and an angiogram is performed on cat…So after loads of discussions, all the cat is getting is supportive HE treatment.

Single question: would it be possible that the mass is actually originating from right adrenal (even though it looks pretty normal to me) and invaded PV instead of CVC?? this is quite difficult to happen, I think. I just consider this due to the last crisis being hypertensive and there seem to be shunting vessels prior to the mass (that is, caudal to clot).

Thanks for any input. I will keep up the updates.