A 6 year-old NM West Highland white terrier with a history of ammonium urate calculi was presented for evaluation severe hepatic encephalopathy. Abnormalities on CBC and serum biochemistry were mild leukocytosis and anemia, low urea, and mild hypokalemia.
Extrahepatic portosystemic shunt.
Gastrocaval shunt.
Severe microhepatica and remodeling.
Bladder calculi and renal calculi; nonobstructive.
Liver was subnormal in size, coarse architecture. Short axis measured 1.8 cm. Increased portal markings noted. Gallbladder was unremarkable. The portal vein in this patient was normal to the level of the portal hilus where a gastrocaval shunt initiated the coursing just caudal to the pylorus extending approximately 3 cm caudally and then changed direction heading dorsally into the vena cava. The vena cava at that point was turbulent measuring approximately 1 cm in width whereas the aorta measured 0.5 cm in width. The residual portal vein was minimal measured approximately 0.4 cm.
Left kidney 4.35 cm; minor calculi noted; nonobstructive at this time. Right kidney 3.58 cm with similar calculi pattern to the left. Color flow appeared adequate to the kidneys.
The urinary bladder, trigone and pelvic urethra presented normal wall thicknesses with anechoic urine and normal tone. Small calculi were noted the largest of which measured 0.4 cm. No evidence of inflammatory or neoplastic changes were noted.
The ureters were not visible and therefore considered normal.
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Porto-caval shunt, micovascular dysplasia, congenital fibrosis, chronic hepatitis, cirrhosis
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