Hello this is Bailey a 6 month old Shi-tzu with elevated bile acids and liver enzymes.
The US showed “Swollen” kidneys, no sand in the bladder, small liver but not markedly. I suspect that the liver will get smaller the older the pet gets if it truly is a shunt.We tried tracing the portal vein it’s entire length but seem to lose it cranially. We believe we can see it on some images under the bile duct near the GB but has little to no color flow.
Hello this is Bailey a 6 month old Shi-tzu with elevated bile acids and liver enzymes.
The US showed “Swollen” kidneys, no sand in the bladder, small liver but not markedly. I suspect that the liver will get smaller the older the pet gets if it truly is a shunt.We tried tracing the portal vein it’s entire length but seem to lose it cranially. We believe we can see it on some images under the bile duct near the GB but has little to no color flow.
I posted CF pictures that show a possible connection but I could not find a tortuous vein in 2 D. Wonder if this is real or color bleeding?
Looked at the CVC to PV ratio and appears normal but we lose the PV right at that location. Wondering if these images are suggestive of it or if it would require a further work-up to confirm. Does look like turbulent flow and attempted to adjust the doppler to ensure it wasen’t artifact. Thanks. Looking forward to impressions. Brent.
Comments
Videos 1 and 2 look
Videos 1 and 2 look suspicious for a splenocaval or splenoazygos shunt but I can’t call it on these views.
check out my lecture from ecvim on this subject ECVIM 2010
http://sonopath.com/resources/research-publications
and search shunts in the archive
http://sonopath.com/members/case-studies/search?text=shunt&species=All
then maybe give it another shot or run a CT with contrast if need be. The BA should be well over 80 post of a shunt.
The Curbside guide has a thorough practical writeup on elevated BAs and shunts and non shunt causes as well.
https://sonopath.com/products/book
We do have a CT
We do have a CT scanner!
Would that be more accurate vs. jejunum portovenography?
The client wants the dog spayed so we could do either. Which do you think would be the best way to confirm? Thanks