The patient has hepatic encephalopathy, which responds to Clindamycin and Lactulose. Bile acids pre: 127, post: 260.
The patient has hepatic encephalopathy, which responds to Clindamycin and Lactulose. Bile acids pre: 127, post: 260.
Case Of the Month
Splenocaval Shunt with Minor Microhepatica in a 1-year-old MN DSH Cat: Our Case Of the Month November 2018
DX
Splenocaval shunt with normal portal vein to vena cava ratio. Minor microhepatica.
Outcome
Recommend surgical intervention with ameroid constrictor therapy and concurrent liver biopsy +/- renal biopsy. The patient underwent shunt repair surgery with ameroid ring constrictor placement and did well post-operative. Follow up blood work found all values completely normalized. The patient continues to thrive at home and at his last wellness check up he weighed 11.6 pounds compared to his pre-shunt treatment weight of 6 pounds.
Image Interpretation
The liver presented mild coarse architecture and increased portal markings. The portal vein revealed a 1:1 with the vena cava. This would be abnormal in dogs; however, cats can have a normal portal vein to vena cava ratio. The portal vein measured 0.55 cm, vena cava 0.47 cm. The portal vein continued deep into the cranial liver until its separation. However, a definitive splenocaval shunt was identified approximately 1.0 cm prior to the portal hilus and measured 0.5 cm in width. This decoursed dorsally and then entered the vena cava dorsally with an undulating contour. The length of the shunt was approximately 1.5 cm with a width of 0.5 cm.
Video
Patient Information
Patient Name :
Gronk Bogdan AC Flanders
Gender :
Male, Neutered
Species :
Feline
Images
Blood Chemistry
- Post-Prandial Bile Acids, High