Case Study

CT- structurally normal abdomen in a 3 year old FS Yorkshire Terrier with signs of portosystemic shunt (PSS)

This 3 year old FS Yorkshire Terrier exhibits signs of PSS (post meal odd behaviors and focal seizures, small and thin). Elevated post meal bile acids (90.6 umol/L) . Began low protein diet.

Chem: phos 2.1, amylase 493. U/A: turbid, protein +2, bilirubin +1

This 3 year old FS Yorkshire Terrier exhibits signs of PSS (post meal odd behaviors and focal seizures, small and thin). Elevated post meal bile acids (90.6 umol/L) . Began low protein diet.

Chem: phos 2.1, amylase 493. U/A: turbid, protein +2, bilirubin +1

DX

Structurally normal abdomen, no evidence of macroscopic PSS

Image Interpretation

CT of the abdomen-

Both kidneys present within normal limits for size, shape and organ architecture. The portal vein presents a normal order of its tributary veins and intrahepatic branching. No abnormal vessel is noted inside and outside of the liver parenchyma.

Outcome

No macroscopic vascular bypass of the liver was noted in the pre- and post contrast
studies of the abdomen. However if the clinical signs are consistent with insufficiency
of the liver primary non-cirrhotic portal hypertension (microvascular dysplasia) or
other diffuse parenchymal liver disease cannot would still be a potential and should be
ruled out by means of ultrasound guided or surgical liver biopsy.
In general ultrasound guided Tru-cut biopsies of the liver may be performed with
reasonably low potential for complications under the following conditions: platelet
count > 50*103/μl, <25% prolongation of PT/PTT – less of deviation from normal values acceptable in presence of peritoneal effusion. The intensity of the post procedural patient monitoring needs to be tailored to the degree of deviation from normal reference ranges.

Patient Information

Patient Name : Tina Sylvestre/MPI

Gender : Female, Spayed

Species : Canine

Type of Imaging : Ultrasound

Status : Complete

Liz Wuz Here : Yes

Code : 16_00128

Clinical Signs

Seizures

Images

Blood Chemistry

Amylase, High
Phosphorus, High
Post-Prandial Bile Acids, High

Clinical Signs

Seizures

Urinalysi

Appearance Turbid
Bilirubin Present
Protein Present