Intrahepatic shunt or branch of portal vein?


10 month-old 50# M/N goldendoodle.

Vomiting food just after he eats for the last 10 days. Good appetite. No diarrhea. Likes to eat things.

Chem/cbc/lytes WNL

U/S: diffusely thickened stomach wall (7.2mm). Gastritis.

Reactive jejunal LN (1cm wide), Gi parasites vs puppy LN vs other. 

Kidneys are big. Left 7cm. right 6.4cm.

Thin left adrenal (cr. 3.3mm, cd. 3.6mm), normal R adrenal (6.4mm, 4.9mm). Adrenal stress vs atypical Addison.

Liver: either the liver is small or the GB is huge. Dilated hepatic veins and CVC. 

10 month-old 50# M/N goldendoodle.

Vomiting food just after he eats for the last 10 days. Good appetite. No diarrhea. Likes to eat things.

Chem/cbc/lytes WNL

U/S: diffusely thickened stomach wall (7.2mm). Gastritis.

Reactive jejunal LN (1cm wide), Gi parasites vs puppy LN vs other. 

Kidneys are big. Left 7cm. right 6.4cm.

Thin left adrenal (cr. 3.3mm, cd. 3.6mm), normal R adrenal (6.4mm, 4.9mm). Adrenal stress vs atypical Addison.

Liver: either the liver is small or the GB is huge. Dilated hepatic veins and CVC. 

Question: one small curved vessel in mid liver. Is that a portal vein branch or an intrahepatic shunt? The blood flow looks 
blue on some views, but red on other views.

Recommended supportive care for gastritis, deworming, resting cortisol and BA.

Thank you for your help and Happy New Year!

Julie

 

1) Shunt or portal branch?  2) Dilated veins


4 responses to “Intrahepatic shunt or branch of portal vein?”

  1. I think this IH vessel is a

    I think this IH vessel is a normal variant especially if sedated as minor vascular congestion occurs during sedation especially with dex dom or similar. The red is a lobar artery and the blue is a lobar veing heading to the cvc as they are separate parallel vessels.

    In video 1 the pv tapers normally.

    Shunts are usually very tortuous unless right divisional which is a short connection.

    You can peruse out archive of shunts under education tab, clinical search and input your key word(s).

    Try this link tons of shunts CT and ultrasound

    https://sonopath.com/members/case-studies/search?text=shunt&species=All

  2. Thank you so much Eric!
    His

    Thank you so much Eric!

    His BA came back: normal pre, 60 post.

    He was not sedated though.

    Julie

  3. Hmmm well 60 post could go

    Hmmm well 60 post could go with small IH shunt and would increase over time but this vascular pattern doesnt fit wiht shunt… I would sit and wait and retest as in the growth phase you can get spurious elevations that go away later

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