Extrahepatic portosystemic shunt in a 4 year old FS Norwich Terrier

Case Study

Extrahepatic portosystemic shunt in a 4 year old FS Norwich Terrier

A 4-year-old SF Norwich Terrier dog was presented for one-week duration of intermittent anorexia and constipation. Abnormalities on blood work included mild anemia, elevated ALT activity, and low BUN. The dog was also Lyme positive.

 

Sonographic Differential Diagnosis

Extrahepatic portosystemic shunt, likely splenoazygos. Microhepatica.

Image Interpretation

The liver was significantly subnormal in size at 2.1 cm in short axis. A splenazygous shunt was noted in this patient and measured 0.85 cm in width and approximately 1.8 cm in length prior to entering dorsally into the vena cava. The pre-shunt portal vein measured 0.5 cm. Vena cava after the shunt measured 0.5 cm, and the aorta was 0.6 cm. Residual portal vein 0.3 cm. It appears that the shunt exits the splenic entry to the portal vein and creates a “double aorta” appearance cranial to the diaphragm, which is most consistent with a splenoazygos shunt. Hepatic parenchyma was hypovascular and relatively uniform with slightly increased portal markings. Concurrent inflammatory hepatopathy is likely along with the extrahepatic portosystemic shunt. The gallbladder was unremarkable.

DX

Portosystemic shunt, likely splenoazygous.

Outcome

None

Clinical Differential Diagnosis

Hepatic disease: resolving acute hepatitis (viral, bacterial), chronic-active hepatitis, porto-caval shunt, primary portal vein hypoplasia, cirrhosis (congenital, acquired).

Sampling

None

Patient Information

Patient Name : Piper H
Gender : Female, Spayed
Species : Canine
Type of Imaging : Ultrasound
Status : Complete
Liz Wuz Here : Yes
Code : 03_00443

Clinical Signs

  • Anorexia
  • Constipation

Images

hurte_piper_splenoazygos_shunthurte_piper_splenoazygos_shunt_double_aorta

Blood Chemistry

  • ALT (SGPT), High
  • BUN low

CBC

  • RBC, Low

Clinical Signs

  • Anorexia
  • Constipation

Special Testing

  • Lyme Positive
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