Suspected Hepatic Arteriovenous Malformation (HAVM) Shunt in a 3-year-old, intact M, Yorkshire Terrier

Suspected Hepatic Arteriovenous Malformation (HAVM) Shunt in a 3-year-old, intact M, Yorkshire Terrier

History: presented for  evaluation of abdominal effusion, parasitism (flea infestation), anemia, low albumin, and elevated liver enzymes. PE: Abdomen- Distended with fluid but not overly tense, unable to palpate individual organs. 648 ml clear fluid via abdominocentesis first visit; fluid continued to accumulate and approximately 650 ml removed a week later.  Fleas and mild alopecia….