CT – R/O of liver shunt in a 5 year old MN Rat Terrier with microhepatica and elevated bile acids

Case Study

CT – R/O of liver shunt in a 5 year old MN Rat Terrier with microhepatica and elevated bile acids

This 5 year old MN Rat Terrier presented with microhepatica on ultrasound, R/O liver shunt

CBC/Chem: BUN 47.3, bile acids pre 12.2, post 43.4

This 5 year old MN Rat Terrier presented with microhepatica on ultrasound, R/O liver shunt

CBC/Chem: BUN 47.3, bile acids pre 12.2, post 43.4

DX

The computed tomography is negative for macroscopic portosystemic vascular anomalies

Image Interpretation

CT of the abdomen –  There is no evidence of a single congenital nor multiple acquired abnormal vascular pathway connecting the portal vasculature with the systemic circulation. The extra- and intrahepatic anatomy of the portal vasculature is within normal limits. Second & third order portal veins are seen within the hepatic parenchyma.  Mild microhepatica is noted. The gallbladder is moderately distended. The spleen is enlarged which likely is a function of congestion. Both kidneys present with normal size, but irregularly undulating contour and an abnormal enhancement pattern.

Outcome

. Microvascular dysplasia/primary portal venoud hypertension cannot be ruled out as a differential based on the normal computed tomogrphic findings and would require histopathologic examination of parenchymal tissue samples. There is mild microhepatica which may be a variation of normal anatomy versus an expression of fibrosis or emerging cirrhosis. There is evidence of bilaterally symmetric chronic nephropathy with decreased renal function such as in chronic nephritis with or without polyuric renal failure.

Patient Information

Patient Name : Joey Diaz/MPI
Gender : Male, Neutered
Species : Canine
Type of Imaging : Ultrasound
Status : Complete
Liz Wuz Here : Yes
Code : 16-_00074

Exam Finding

  • Microhepatica

Images

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Blood Chemistry

  • Post-Prandial Bile Acids, High
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