A 4-year-old SF Shih Tzu was presented for evaluation of poor appetite and some lethargy. There were no abnormalities on physical exanimation. Low BUN (4) and mild hypoalbuminemia (2.5) were present on serum biochemistry.
A 4-year-old SF Shih Tzu was presented for evaluation of poor appetite and some lethargy. There were no abnormalities on physical exanimation. Low BUN (4) and mild hypoalbuminemia (2.5) were present on serum biochemistry.
Bladder calculi.
Swollen kidneys with minor mineralization.
Double aorta sign noted, suggestive for azygos shunt.
Extrahepatic portosystemic shunting present. Splenoazygos or gastroazygos shunt possible.
The liver was significantly subnormal in size. The width in short axis measured 2.1 cm. Increased portal markings were noted. Double aorta sign was noted and measured 0.5 cm. This would be consistent with azygos shunt. The vena cava to aortic ratio was normal at 0.3 cm. Significant gas artifact was noted in the region of the portal hilus. An extrahepatic portosystemic shunt was clearly visible entering into the azygos region. This measured approximately 0.6 cm in width. This was in the position of a splenoazygos shunt. However, gastroazygos shunt could not be entirely ruled out. The dorsal aspect of the shunt was best represented in video #1 as entrance into the aortic hiatus of the shunt was clearly visible. The gallbladder was unremarkable.
The urinary bladder, trigone and pelvic urethra presented normal wall thicknesses with anechoic urine and normal tone. Bladder calculi were noted with an accumulation of which measuring 1.06 cm. No evidence of inflammatory or neoplastic changes were noted. The ureters were not visible and considered normal.
None
Liver – porto-caval shunt, primary portal vein hypoplasia, chronic hepatopathy, cirrhosis
Protein losing enteropathy
Protein losing nephropathy
None
