Odd PV in cat

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Odd PV in cat

– 4 month  old FS DSH from a shelter with a history of on and off anorexia

– presented with fever and anorexia and tongue ulceration (suspect calici)

– abdominal u/s showed enlarged jejunal and medial iliacl LN’s’  – every thing else normal except for an enlarged and tortuous PV with  high velocity flow

– I could not connect the PV to the CVC (or any other blood vessel ); the CVC appeared normal with laminar flow up until the diaphragm

– 4 month  old FS DSH from a shelter with a history of on and off anorexia

– presented with fever and anorexia and tongue ulceration (suspect calici)

– abdominal u/s showed enlarged jejunal and medial iliacl LN’s’  – every thing else normal except for an enlarged and tortuous PV with  high velocity flow

– I could not connect the PV to the CVC (or any other blood vessel ); the CVC appeared normal with laminar flow up until the diaphragm

– could this be some sort of shunt? PV anomoly? (in the last video, the CVC is incorrectly labelled PV fyi)

 

Comments

randyhermandvm
November 13, 2017 at 11:05 am -

Im no expert for sure on

Im no expert for sure on shunts, but it appears in the last video that the PV is about the size of the CVC and Aorta until a short vessel empties into it with flow away from the probe. Where that is coming from I am not certain.

EL
November 17, 2017 at 5:40 am -

This looks like 

This looks like  agastriocaval shunt given the contour and position. From your video 3 position slide caudally about 1-2 cm keeping the focus on the cvc and look dorsally to it with the cf sector in that region. My bet is you see the shunt enter the cvc there at about 2 cm depth

Pankatz
November 17, 2017 at 12:08 pm -

Thank-you EL – will ty to get

Thank-you EL – will ty to get patient back on to take another look.

randyhermandvm
November 17, 2017 at 2:04 pm -

I am a bit confused here.

I am a bit confused here. Please clear this up for me.

It the portal vein dilated and torturous? 

How does this happen when in most cases the shunt flows from the portal vein into the CVC or aorta.

Can you reference on Sonopath a drawing of this type of shunt.

Just trying to learn.

EL
November 19, 2017 at 4:17 pm -

yes this is the diagram from

yes this is the diagram from the upcoming textbook (clinical approach to sonographic pathology) and the shunt hunt posters we are creating. Would need more views to confirm but the curve is that of a gastrocaval shunt or maybe gastroazygos. More images to see the post shunt pv would be needed as well but the pv will be small and tough to see after the shunt especially in a cat.

randyhermandvm
November 19, 2017 at 4:27 pm -

Thank you EL. That clearifys

Thank you EL. That clearifys the Gastic Caval Shunt. I understand.

Could you – if you have time identify the structures in a still I made of the final cine. Maybe I am interpreting the vessels incorrectly. This is a learning lesson for me.

Thanks 

Randy

 

 

Pankatz
November 19, 2017 at 5:57 pm -

Randy, to clarify this

Randy, to clarify this picture, the dark blue vessel labelled PV was incorrectly labelled. It is in fact the CVC if that helps clarify things. This was a transverse view of the portahepatis. FYI I am rescnning this cat next week, so will see if I can get more images.

Jacquie

Pankatz
November 19, 2017 at 5:57 pm -

Randy, to clarify this

Randy, to clarify this picture, the dark blue vessel labelled PV was incorrectly labelled. It is in fact the CVC if that helps clarify things. This was a transverse view of the portahepatis. FYI I am rescnning this cat next week, so will see if I can get more images.

Jacquie

randyhermandvm
November 19, 2017 at 11:54 pm -

Totally. Please post any

Totally. Please post any pertinent images.

Thanks

EL
November 20, 2017 at 3:32 pm -

Here you go Randy this should

Here you go Randy this should help:)

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