Sonopath Forum

Shunt Hunt

* Cuddles is a 4 1/2 year old DSH with a history of hematuria, dysuria, poilakuria

* Exam: very small cat with ? vision and mentition/vision- which I believe to be central. No seizure activity

* Labs mostly normal except for a mildly low Albumin and elevated pre and post SBA (post prandial 128)

* X-rays: large urolith noted. Surgical removal: 50% Struvite and 50% Urate. 3 month history of receiving CD multicare (my clinic was a second opinion)

* Cuddles is a 4 1/2 year old DSH with a history of hematuria, dysuria, poilakuria

* Exam: very small cat with ? vision and mentition/vision- which I believe to be central. No seizure activity

* Labs mostly normal except for a mildly low Albumin and elevated pre and post SBA (post prandial 128)

* X-rays: large urolith noted. Surgical removal: 50% Struvite and 50% Urate. 3 month history of receiving CD multicare (my clinic was a second opinion)

I have done very few ultrasounds looking for a shunt. Is there anyway we are seeing a Spleno-caval shunt in my cines?

I do not believe that surgery is an option for this cat- but I want to decide if I should treat medically as a shunt cat and hope the stone does not recur at some point.

Comments

August 31, 2016 at 1:10 am -

Nice view Randy this sure

Nice view Randy this sure looks splenocaval but if you get this same view and let up on the pressure and let the cvc dilate then add the CF it will come out cleaner. As is is the shunt looks like a foramen as opposed to the shunt. I added an image screen shot from your second video.

randyhermandvm

August 31, 2016 at 1:29 am -

Thanks EL.
I tried to let up

Thanks EL.

I tried to let up on the pressure – but this cat had alot of gas in the colon that kept interfereing with my views. As you can see this is just a bit cranial to the R kidney. Is this to far caudal to be a Spleno-Caval shunt?

Thanks

August 31, 2016 at 1:35 am -

No actually this looks like

No actually this looks like the correct position. Push the colon out of the way and use your scanning fingers to keep it out of the way then lighten the probe pressure… the hand is the same posiiton as if you had a beer in your hand:)

jobrag

September 23, 2016 at 5:50 pm -

Hi, you could always do the

Hi, you could always do the micro-bubbles test to confirm the shunt 🙂

jobrag

September 23, 2016 at 5:50 pm -

Hi, you could always do the

Hi, you could always do the micro-bubbles test to confirm the shunt 🙂

September 25, 2016 at 12:15 am -

Cool Ive never done a bubble

Cool Ive never done a bubble study on a PSS Ive only done it in the heart. Do you have any pics? If so please do another thread on video if you can.

jobrag

October 6, 2016 at 9:52 am -

I still have not had the

I still have not had the opportunity to do it myself, but here are some videos of a friend that has done it in a cat:

– Micro-bubble test in a extra-hepatic acquired shunt in a cat: https://www.youtube.com/watch?v=83cZ_XsJGDQ&list=UUaI_SYhf2s18ok3i516JJ8g&index=23

Here are some more videos from the same cat:

randyhermandvm

October 6, 2016 at 1:03 pm -

Can you describe the

Can you describe the technique?

jobrag

November 28, 2016 at 5:23 pm -

Sorry for the (huge) delay

Sorry for the (huge) delay Randy,

Here is the paper (Pablo Gómez-Ochoa and Guillermo C. Couto) that describes the technique.

October 6, 2016 at 11:01 pm -

This is sonographic artistry

This is sonographic artistry way cool!