03-00406 Cutie K Intrahepatic portosystemic shunt———NEED CDX——–

Case Study

03-00406 Cutie K Intrahepatic portosystemic shunt———NEED CDX——–

The patient is a canine Maltese, SF, 3 years old who was presented for seizures which started 1.5 years ago but are sporadic in nature. Chemistry showed BUN 2.8, low TP 5.3, Albumin 2.3, AST 73, Bile Acids random 125. CBC is wnl.

 

Sonographic Differential Diagnosis

Intrahepatic portosystemic shunt.

Image Interpretation

The urinary bladder presented calculus at 0.6 cm and other small calculi that measured 0.2-0.4 cm. The bladder wall was unremarkable.
The right kidney was subnormal in size and measured 3.16 cm with cortical remodeling and slight mineralization. The right kidney revealed slight pyelectasia. The patient is likely passing calculi periodically. The left kidney was normal in size at 3.7 cm with dystrophic mineralization and ill defined pelvic fat.
The liver was subnormal in size and coarse in architecture. The portal vein revealed a right divisional intrahepatic shunt connecting to the vena cava within the liver. This is not a surgical type of shunt; however, vascular plug placement with interventional radiology would be ideal in this case. Even though this is a small breed this is an intrahepatic shunt and not extrahepatic. The intrahepatic branch of the shunt measured approximately 0.4 cm at the division from the portal vein and 0.8 cm at the level of the vena cava. However, the prehepatic portal vein, vena cava and aorta were 1:1:1, which is what we would expect for an intrahepatic shunt.

DX

Intrahepatic portosystemic shunt

Outcome

None

Sampling

None

Patient Information

Gender : Female, Spayed
Species : Canine
Type of Imaging : Ultrasound

Clinical Signs

  • Seizures

Images

_20141206154211kharrasova_cutie_right_divisional_ih_shunt_lkkharrasova_cutie_right_divisional_ih_shunt_mcirohepaticakharrasova_cutie_right_divisional_ih_shunt

Blood Chemistry

  • Albumin, Low
  • AST (SGOT), High
  • BUN low
  • Post-Prandial Bile Acids, High
  • Pre-Prandial Bile Acids, High
  • Total Protein, Low

Clinical Signs

  • Seizures
Skip to content