Blastomycosis granuloma involving the cranial vena cava associated with chylothorax and cranial vena caval syndrome in a dog

A four-year-old, sexually intact, male dachshund was diagnosed with pulmonary blastomycosis. Itraconazole was administered for 60 days, and the dog was considered to be disease-free at three- and 12-month reevaluations. Two years following discontinuation of itraconazole, the dog developed a granuloma of the cranial vena cava resulting in chylothorax and cranial vena caval obstruction. To the authors' knowledge, this is the first case of a blastomycotic granuloma involving the vena cava reported in the dog. Blastomycosis should be considered as a differential diagnosis for both chylothorax and cranial vena caval syndrome in the dog.     

Persistent left cranial vena cava associated with multiple congenital anomalies in a six-week-old puppy

A six-week-old male puppy was presented with a distended abdomen, dypsnoea and cyanosis. Auscultation revealed a grade II/VI systolic murmur. Thoracic radiographs showed gross cardiomegaly. An electrocardiogram revealed a narrow-complex tachycardia, deep S waves in leads I, II, III and aVF, and negative P a waves in lead III. Two-dimensional echocardiography showed a high ventricular septal defect and marked dilation of the right-sided chambers. There was also an echolucent structure lateral to the left atrium at a site corresponding to the coronary sinus. Contrast echocardiography revealed right-to-left shunting through the septal defect. Necropsy confirmed the existence of a septal defect in the membranous part of the septum and a persistent left cranial vena cava with dilation of the coronary sinus. In addition, a small patent t ductus arteriosus and tricuspid dysplasia were present.     

Use of a jugular vein autograft for reconstruction of the cranial vena cava in a dog with invasive thymoma and cranial vena cava syndrome

A spayed female dog was evaluated because of edema of the ventral cervical region, lethargy, cough, and reduced exercise tolerance. Invasive thymoma and cranial vena cava syndrome were diagnosed by use of ultrasound-guided fine-needle biopsy and contrast-enhanced helical computed tomography. Resection of the cranial vena cava and an autogenous jugular vein graft were used for restoration of normal venous return to the right atrium and alleviation of the cranial vena cava syndrome.     

Use of recombinant tissue-plasminogen activator in a dog with chylothorax secondary to catheter-associated thrombosis of the cranial vena cava

A 4-year-old, castrated male Maltese developed cranial vena caval thrombosis and chylothorax following central venous catheterization for treatment of postoperative sepsis. Vena caval thrombolysis was attempted using recombinant human tissue-plasminogen activator (t-PA). Thrombolytic therapy led to an acute reduction in the size of the caval thrombus and was followed by prompt resolution of the chylothorax. Hemorrhage at the entry sites of a jugular catheter and esophagostomy tube placed at the time of treatment was a dose-limiting complication of t-PA therapy in this dog.     

Persistent left cranial vena cava draining into the left atrium associated with pulmonary stenosis in a French bulldog

A 5-month-old female French bulldog was evaluated for the presence of a heart murmur. Through clinical and echocardiographic evaluations, a severe Type A pulmonary stenosis was diagnosed. Angiography during right ventricular catheterization for valvuloplasty revealed drainage from a persistent left cranial vena cava (PLCVC) into the left atrium; this was confirmed later by contrast echocardiography. This report is the first to describe this anatomical variant of a PLCVC in a dog.     

Thrombosis of the cranial vena cava in a cow with bronchopneumonia and traumatic reticuloperitonitis

This paper reports the clinical findings, surgical and medical management, and necropsy of a 6-year-old cow with thrombosis of the cranial vena cava and thrombo-embolic pneumonia following traumatic reticuloperitonitis. The clinical diagnosis was confirmed by necropsy.     

Cor triatriatum sinister and persistent left cranial vena cava in a kitten

An approximately 8-week-old, 0.61 kg, male Bengal kitten was evaluated by the referring veterinarian for a 5-day history of sneezing, lethargy, anorexia, coughing, and dyspnea. Thoracic radiographs revealed cardiomegaly with left atrial enlargement, a patchy distribution of pulmonary edema, and loss of abdominal detail.     

Combined chylothorax, chylopericardium, and cranial vena cava syndrome in a dog with thymoma

A dog was examined because of anorexia and development of submandibular, sternal, and forelimb edema. Physical examination revealed engorged jugular veins and engorged blood vessels of the conjunctivae and nictitating membranes. Thoracic radiography revealed pleural and pericardial effusions, later identified as chyle. Contrast angiography revealed an intravascular mass, later identified as thymoma, in the cranial vena cava.     

Diagnostic imaging and pacemaker implantation in a domestic goat with persistent left cranial vena cava

Difficulty was encountered with the insertion of a right atrial pacing lead via the left jugular vein during lead and pacemaker implantation in a clinically normal goat as part of an ongoing rapid atrial pacing – induced atrial fibrillation research project. Fluoroscopic visualization of an abnormal lead advancement path prompted angiographic assessment which revealed a persistent left cranial vena cava (PLCVC) and prominent coronary sinus communicating with the right atrium. Angiography facilitated successful advancement and securing of the pacing lead into the right side of the interatrial septum. Cardiac magnetic resonance imaging/magnetic resonance angiography (MRI/MRA) allowed further characterization of this rare venous anomaly. Even though PLCVC has been reported once in a goat, to the authors' knowledge this is the first report to include MRI/MRA characterization of PLCVC and prominent coronary sinus with successful cardiac pacemaker implantation using the PLCVC.     

Clinical findings and diagnosis of thrombosis of the caudal vena cava in cattle

This paper describes the causes, clinical findings and diagnosis of caudal vena caval thrombosis in cattle. Occlusion of the vein is caused by a 'white' thrombus, and typical clinical signs include chronic weight loss, poor general condition and intermittent fever. Most affected cattle have respiratory signs; in some, pulmonary haemorrhage, ascites and sudden death occur. Haematological analyses, endoscopy of the respiratory tract and ultrasonographic examination of the pleura, liver and abdomen should be carried out in cattle suspected of having thrombosis of the caudal vena cava. The most important diagnostic finding is dilatation of the caudal vena cava seen via ultrasonography. Normally, the caudal vena cava appears triangular in cross section but in cattle with thrombosis it is oval or circular. The prognosis is poor and there is no treatment.     

Transvenous pacemaker placement in a dog with atrioventricular block and persistent left cranial vena cava

The case reported herein describes the placement of a permanent transvenous pacemaker in an older dog with a previously undiagnosed persistent left cranial vena cava (PLCVC) and recent onset symptomatic third-degree atrioventricular (AV) block. On presentation the dog was found to have atrial flutter and third-degree AV block and echocardiography demonstrated evidence of chronic valvular disease and pulmonary arterial hypertension. The persistent left cranial vena cava was discovered via angiography when difficulties were encountered with pacemaker placement. Successful right ventricular pacing necessitated passage of the lead through the coronary sinus. The attendant complications in pacemaker placement in the presence of a PLCVC are well-described in man but, to the authors' knowledge, have not been described in companion animals.     

Ultrasonographic findings in a cow with ascites due to thrombosis of the caudal vena cava.

This case report describes a three-year-old Swiss Braunvieh cow with ascites due to thrombosis of the caudal vena cava. Ultrasonography verified the ascites and revealed dilatation of the abdominal portion of the caudal vena cava (4.8 cm). It was presumed that the caudal vena cava was occluded by a thrombus or by perivenous compression cranial to the dilatation. Post mortem findings included: a massive accumulation of fluid in the abdominal cavity; a 15 cm long thrombus in the subphrenic region of the caudal vena cava; multiple pulmonary abscesses; severe thrombosis of the pulmonary vasculature; hepatic congestion; oedematous abomasal folds; and severe thrombophlebitis of the left jugular vein and both udder veins, due to poor intravenous injection technique. Ascites caused by thrombosis of the caudal vena cava is rare because collateral routes of venous return, including the udder veins, are usually established. It was therefore concluded that the ascites was attributable to bilateral thrombosis of the udder veins.     

Central venous access to the cranial vena cava via the omobrachial vein in the dog

Background– The omobrachial vein is a superficial vein that crosses the brachial region of the dog. It terminates in the cranial vena cava, offering a novel site for central venous catheterization into the cranial thorax. Case Summary– The omobrachial vein served as a point of access to the cranial vena cava for treatment and monitoring of a critical canine patient in this report. The omobrachial vein was catheterized using the modified‐Seldinger technique due to contamination of or lack of availability of commonly used central venous catheter insertion sites. Conclusion– Access to the cranial vena cava via the omobrachial vein was easily achieved, and the catheter was maintained without complication for 10 days. Although the site was successfully used in the patient in this report, omobrachial vein anatomy is not consistent in all dogs.     

Lymphangiographic evaluation of experimentally induced chylothorax after ligation of the cranial vena cava in dogs

Ligation of the cranial vena cava (CrVC) distal to the entrance of the azygous vein resulted in chylothorax in 7 of 10 dogs. Of the remaining 3 dogs, 1 developed a serosanguineous effusion that did not become chylous, and 2 dogs did not develop pleural effusion. In 2 of the 7 dogs developing chylothorax, the pleural effusion became serosanguineous within 2.5 weeks after CrVC ligation. Mesenteric lymphangiography was performed 2 to 6 weeks after ligation of the CrVC. Lymphangiectasia was seen in 4 dogs with chylothorax, but was not seen in the 3 dogs with serosanguineous effusions or the 2 dogs that did not develop effusions. One dog with chylothorax died prior to repeat lymphangiography. Less dye entered the thoracic duct, and alternate lymphaticovenous communications to the caudal vena cava were evident in the dogs without chylothorax. Ligation of the thoracic duct at the lymphaticovenous junction was performed in 3 dogs. These dogs did not develop pleural effusion. Lymphangiography was performed immediately after ligation and indicated filling of abdominal lymphatics but not of the thoracic duct. Lymphangiographic findings 6 weeks after ligation also indicated filling of intestinal lymphatics. Results of the present study indicated that ligation of the CrVC causes chylothorax, and that thoracic lymphangiectasia is a consistent finding in animals with experimental chylothorax. Obstruction of the thoracic duct did not induce lymphangiectasia or chylothorax. Impedence of thoracic duct flow into the CrVC may be a cause of clinical chylothorax in the dog.