Congenital disease

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Congenital disease

Hello,

I need Your help please in this case. I have never seen such vascular malformation before.

The cat is a maine coon- 8 month old cat with severe ascites, pleural effusion, and mild pericardial effusion.

The effusion contains only lymphocytes-and is a milky modified transsudatum ( lymph). Blood work wnl.

There is no tricuspid regurgitation- the left side of the heart looks normal, the right side is a bit dilatated. I can’t see the diaphragm on the right side ( just the pericardium separates the liver from the heart)

Hello,

I need Your help please in this case. I have never seen such vascular malformation before.

The cat is a maine coon- 8 month old cat with severe ascites, pleural effusion, and mild pericardial effusion.

The effusion contains only lymphocytes-and is a milky modified transsudatum ( lymph). Blood work wnl.

There is no tricuspid regurgitation- the left side of the heart looks normal, the right side is a bit dilatated. I can’t see the diaphragm on the right side ( just the pericardium separates the liver from the heart)

I can see a huge v. cava, and severly dilatated hepatic veins-they form in the ventral liver lobe huge veinic plexus-where the blood flows slowly and turbulent flow is present.

The cat is now on furosemide and clopridogrel- doing better.

 

What kind of malformation is this? What would be the prognosis? What kind of treatement should we follow?

 

Thank You,

Rita

Comments

EL

Nice image set… so lets

Nice image set… so lets start form the abdomen. The CVC and hepatic veins are big so the ascites can be from passive congestion and also an effusive process depending on if straight transudate or mod trans or exudate. So have to tap the belly. But with the CVC big the main problem is cranial to the diaphragm. There is pleural effusion but the LA is normal size so thats not due to left heart failure. The right atrium is normal as well but there is pericardial effusion which is likley th ecause of right heart failure and passive congestion in the liver. So the answer is in the pericardial and pleural effusion. I’m betting on FIP here or other effusive process. Need to tap the pleural effusion +/- the pericardial effusion cytospin culture and run FIP titers. Nice case

pacsit

Thank You, i will tap the
Thank You, i will tap the cranial effusions culture and cytospin:)

cgshang

Peritoneopericardial

Peritoneopericardial Diaphragmatic Hernia maybe also a possible?  Maine coons are known to have this congenital issue…

 

pacsit

I will controll the cat next
I will controll the cat next week after treatment. Thank you-could be a good idea-i will apload the picture again next week!

EL

Good thought on the

Good thought on the pericardial d hernia but the pericardium is completely separate from the liver in his case and has effusion separating the epicardium from the pericardium. Compare with this Pericardial DH form the basic search archive and see how the herniated liver is contiguous with the epicardium and the pericardium wraps the heart and the liver.

http://sonopath.com/members/case-studies/cases/peritoneopericardial-diaphragmatic-hernia-ppdh-12-year-old-fs-dlh-cat

cgshang

Wow!  That’s cool!!!

Wow!  That’s cool!!!

EL

we aim to please 🙂

we aim to please 🙂

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