16 mo cryptorchid Husky.  This shunt was partially closed with a coil in February and has now developed encephalopathy symptoms again.  Owner has not been giving medications (lactulose) or prescription diet consistently. We are restarting lactulose and rx diet and adding metronidazole and setting up a consult with the cardiology service that placed the original coil for 3 weeks from now to likely put another coil in.  It was gratifying to see the shunt and, I think (arrow?), the coil.  What should I expect to see with doppler measurements?

16 mo cryptorchid Husky.  This shunt was partially closed with a coil in February and has now developed encephalopathy symptoms again.  Owner has not been giving medications (lactulose) or prescription diet consistently. We are restarting lactulose and rx diet and adding metronidazole and setting up a consult with the cardiology service that placed the original coil for 3 weeks from now to likely put another coil in.  It was gratifying to see the shunt and, I think (arrow?), the coil.  What should I expect to see with doppler measurements? Am I getting artifact from surrounding arteries.  The baseline looks to be between about 2-4 cm/s.