Sukar is a five-year-old male neutered persian cross. He had his first seizure on second of December 2021 and till to date he had in total 3 seziures. Blood work was done and it was completely normal. The cat was sent for the MRI scan and it showed hyperintensity of the lentiform nucleus. According to the radiologist, it may be associcated with the PSS. I am attaching the MRI report along and want your input. What should be the best course of action
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I would start with a bile
I would start with a bile acid profile. If not elevated then there wont be a shunt. If elevated then SDEP 9-14 covers all the intrahepatic and extrahepatic shunt potentials and i would expect bladder sand swollen kidneys and stones but microhepatica can be variable in cats wiht shunts. cats also get portal hypoplasia/microvascular dysplasia too.
Thanks for the reply. But
Thanks for the reply. But isn’t this cat too old for the PSS
no not at all. clincial signs
no not at all. clincial signs develop variably depending on shunt fraction. For example a gastrocaval shunt or an HAVM have big shunt fractions and develop signs early but spleno- azygos shunts for example have less shunt fraction and develop signs later in life. Ive seen them develop signs at 10 years of age with a primary azygos shunt or even be incidental for other causes for the ultrasound to be performed. Just depends how clean their life is if they stay away from acute phase disease shunt animals often run under the radar until they get an hepatic insult and then become clinical. Same with portal hypoplasia they do fine with medical management til an acute phase event happens to push them over the edge.
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Thanks Erric. It was very
Thanks Erric. It was very helpful. I had suggested abdominal scan to the owner but will also do the bile acids