Possible shunt?

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Possible shunt?

  • Bulldog, 4 years, male, non sterilized
  • hemograma ok, liver enzimes too, normal size kidneys
  • the only complain is that it is not eating well, but is active
  • hepatic veins a little congest, vena cava caudal enlarged (1,40 cm), Aorta 1 cm, portal vein 0,81 cm
  • at first I thought it was right side of the heart, but I scanned twice and found nothing
  • to be shunt, the vena cava being dilated in this way, the portal vein would not have to be smaller? 

 

Regards,

Adams.

  • Bulldog, 4 years, male, non sterilized
  • hemograma ok, liver enzimes too, normal size kidneys
  • the only complain is that it is not eating well, but is active
  • hepatic veins a little congest, vena cava caudal enlarged (1,40 cm), Aorta 1 cm, portal vein 0,81 cm
  • at first I thought it was right side of the heart, but I scanned twice and found nothing
  • to be shunt, the vena cava being dilated in this way, the portal vein would not have to be smaller? 

 

Regards,

Adams.

Comments

KV CVT SonoPath
April 7, 2018 at 2:08 am -

Hi there, any possibility you

Hi there, any possibility you have some video clips with color doppler?

While you are waiting for a specialist to comment, I thought this case might be helpful. The first still image of this case is very similar to yours.

https://sonopath.com/resources/cases-month/portosystemic-splenocaval-shunt-4-year-old-mn-maltese-our-case-study-month-aug

KV CVT SonoPath
April 7, 2018 at 2:11 am -

(No subject)

EL
April 8, 2018 at 2:04 pm -

The PV is very solid in size

The PV is very solid in size in your still and good flow from the pdv on the right so not likely a shunt. If sedated for the exam especially with dexdomitor the cvc dilates. Otherwise right heart disease possible especially with the breed and the right atrium doesnt have to be big for this. Needs solid TR velocities to check for pht. Chest rads to assess caudal mediastinal disease that can cause congestion of the cvc as well if PHT isnt present.

gadams
April 8, 2018 at 11:24 pm -

Thanks KV and EL!

In several

Thanks KV and EL!

In several cuts I did not succeed in detecting tricuspid regurgitation. 
Is it possible to have pulmonary hypertension without regurgitation? 
For the RX the pulmonary artery appears dilated in the VD but not in the laterolateral. 
This case is being challenging!

 

 Regards,

Adams.

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