An unusual portosystemic shunt in a dog

An unusual portosystemic shunt was diagnosed in a 4-month-old male Miniature Poodle examined because of stunted growth and episodes of dementia characterized by hysteria, ataxia, and staggering. Operative splenoportography revealed a portosystemic shunt. Exploratory surgery to identify and correct the shunt was attempted. Evidence of any portal circulation was not detected, and the dog was euthanatized. The possible embryologic basis for this vascular anomaly is discussed.     

Circumcaval ureter associated with an intrahepatic portosystemic shunt in a dog

CASE DESCRIPTION: A 4-month-old Bernese Mountain Dog was examined because of shifting hind limb lameness and lethargy of 2 weeks' duration. CLINICAL FINDINGS: The lameness was attributed to hypertrophic osteodystrophy. Portosystemic shunting was suspected on the basis of low serum albumin concentration and high serum bile acids concentration, and an intrahepatic shunt was identified ultrasono-graphically. Celiotomy was performed, and the shunt was partially closed with a cellophane band. During follow-up ultrasonography 7 months later, dilation of the left renal pelvis and proximal portion of the left ureter was identified. During exploratory celiotomy, the left ureter was found to pass dorsal to the caudal vena cava, and circumcaval ureter was diagnosed. TREATMENT AND OUTCOME: The ureter was transected, repositioned ventral to the vena cava, and anastomosed. Follow-up ultrasonographic examinations revealed gradual resolution of the hydronephrosis and hydroureter. CLINICAL RELEVANCE: Findings suggest that circumcaval ureter should be considered in the differential diagnosis for hydronephrosis and hydroureter in dogs. Partial obstruction of the middle segment of the ureter on ultrasonograms or contrast radiographs should increase the index of suspicion for this condition.     

Imaging diagnosis--Complex intrahepatic portosystemic shunt in a dog.

An unusual form of congenital intrahepatic portosystemic shunt was identified in a 3 1/2-month-old female Labrador Retriever with neurologic signs. Ultrasonography and contrast-enhanced computed tomography were used to characterize the shunt morphology. An unusual, looping right-divisional shunt connected back to the portal vein that formed an ampula in the right-central portion of the liver. An irregularly shaped window-like opening connected the combined right-divisional loop and aneurysmal portal vein, and the caudal vena cava, while this vascular pool gradually fused more cranially. Imaging features of this complex vascular anomaly, which has not been previously reported, are presented.     

Hepatic lesions of a standard poodle dog with intrahepatic portosystemic shunt

A 1-year-and-3-month-old, male standard poodle dog with intrahepatic portosystemic shunt (PSS) was autopsied. Nineteen regions of the liver were prepared for detailed examination, and the distribution of hepatic lesions caused by PSS was studied in the liver of this dog. Histopathologically, the liver revealed a variety of hepatic lesions including lipogranulomas in the hepatic parenchyma, and a ductular reaction and microvascular proliferation in portal areas. The distribution of the lesions was not significantly different among liver regions. It is concluded that, in the present case, hepatic lesions caused by PSS are independent of shunt location, and are distributed equally in the liver.     

Magnetic resonance imaging findings of hepatic encephalopathy in a dog with a portosystemic shunt

A 6-year-old ShihTzu presented with tonic-clonic cluster seizure. T2-weighted magnetic resonance (MR) images showed bilateral diffuse hyperintense lesions at the cerebral cortex with enlarged sulci. Computed tomography revealed a portosystemic shunt (PSS) and azygos continuation. Based on the clinical signs, blood examinations and diagnostic images, the dog was diagnosed with hepatic encephalopathy secondary to PSS. The neurologic signs were gradually improved after medical therapy for hyperammonemia. This is the first report of hyperintensity of the cerebral cortex on T2-weighted MR images associated with acute hepatic encephalopathy in a dog.     

Congenital hepatic arteriovenous fistula with intrahepatic portosystemic shunt and aortic stenosis in a dog

Examination of a 2-month-old male golden retriever presented to the hospital revealed malnutrition, ascites, cardiac murmur and hyperammonemia. Identification of subaortic stenosis and hepatic arteriovenous fistula was made through ultrasonography and angiocardiography. In addition, intrasurgical mesenteric portography showed an intrahepatic portosystemic shunt. The dog did not show portal hypertension and secondary multiple extrahepatic portosystemic shunts. Surgical correction was attempted after medical treatment. The hepatic artery branch which was connected to the hepatic arteriovenous fistula was separated, and completely ligated using silk ligature. However, the separation of the intrahepatic shunt blood vessel was unsuccessful and the dog died 15 hr postoperatively.     

Successful treatment by percutaneous transvenous coil embolization in a small-breed dog with intrahepatic portosystemic shunt

A Miniature Dachshund, 3-month-old, 3.1 kg, was diagnosed as an intrahepatic portosystemic shunt (PSS) with the shunting vessel in 6-mm diameter. Percutaneous transvenous coil embolization (PTCE) was performed with a stainless steel coil in 8-mm diameter. Intraoperative portal pressure elevated about 2.5 times after one-stage coil occlusion. Two weeks after the PTCE, serum bile acid levels reduced within the normal range. The portogram showed complete occlusion of the shunting vessel 4 months after the PTCE. Approximately 3 years after the PTCE, the patient has shown no clinical signs. PTCE could be performed more easily and less invasively in a small-breed dog. It is therefore suggested that PTCE is a promising therapeutic technique in canine intrahepatic PSS.     

Necrotizing meningoencephalitis associated with cortical hippocampal hamartia in a Pekingese dog

A 4-year-old male Pekingese dog was referred to the clinic with a history of recurrent seizures and progressive abnormal gait and behavior, which did not respond to treatment. At necropsy, a large cortical defect in the right temporo-parietal cortex, malacia of subcortical white matter, right basal nuclei, and capsula interna, as well as abnormalities of the right hippocampus were observed. Histological examination of the brain revealed moderate to severe nonsuppurative meningoencephalitis in the left cerebral hemisphere and extensive infarction-like lesions with milder inflammation in the right hemisphere. In the right hippocampus, the pyramidal cells were arranged in a gyrus-like pattern and intermingled with gemistocytic and fibrillary astrocytes. The histopathological features of the inflammatory lesions were consistent with necrotizing meningoencephalitis and resembled those described in so-called Pug dog encephalitis. The hippocampal changes were interpreted as dysplasia (monolateral hippocampal cortical hamartia), unrelated to clinical signs and necrotizing inflammatory lesions.     

Multilobular tumor of the mandible in a Pekingese dog

Multilobular tumor of bone detected in a 2.5-year-old male Pekingese dog is reported. Grossly, the neoplasm consisted of multiple, variably sized, gritty, grayish-white to yellow nodules separated by thick collagenous septa. Histologically, these nodules contained multiple lobules of irregularly shaped and sized islands of well-differentiated osteoid and cartilage, separated by anastomosing fibrovascular septa. Chondrocytes and osteocytes were observed in the lacunae and in more osseous islands in the lobule, respectively. These lobules were surrounded by mesenchymal spindle cells. Mitotic figures were not evident. The neoplastic pattern was consistent with that of a multilobular bone tumor. Diagnosis was based on gross and light microscopic findings. The cause of this neoplasm was not determined.     

Atypical portosystemic shunt in a cat

An adult cat with vague signs of gastrointestinal dysfunction was found to have a congenital portosystemic shunt. There were no signs of hepatoencephalopathy, which is in contrast to what has been reported in other cats with the disease.     

Contrast-enhanced computed tomography angiography and volume-rendered imaging for evaluation of cellophane banding in a dog with extrahepatic portosystemic shunt

A 4-year-old, 1.8 kg, male, castrated Maltese was presented for evaluation of urolithiasis. Urinary calculi were composed of ammonium biurate. Preprandial and postprandial bile acids were 44.2 and 187.3 micromol/l, respectively (reference ranges 0-10 and 0-20 micromol/l, respectively). Single-phase contrast-enhanced computed tomography angiography (CTA) with volume-rendered imaging (VRI) was obtained. VRI revealed a portocaval shunt originating just cranial to a tributary of the gastroduodenal vein and draining into the caudal vena cava at the level of the epiploic foramen. CTA revealed a 3.66 mm-diameter shunt measured at the level of the termination of the shunt and a 3.79 mm-diameter portal vein measured at the level between the origin of the shunt and the porta of the liver. Surgery was performed using cellophane banding without attenuation. Follow-up single-phase CTA with VRI was obtained 10 weeks after surgery. VRI revealed no evidence of portosystemic communication on the level of a cellophane band and caudal to the cellophane band. CTA demonstrated an increased portal vein diameter (3.79-5.27 mm) measured at the level between the origin of the shunt and the porta of the liver. Preprandial and postprandial bile acids were 25 and 12.5 micromol/l, respectively (aforementioned respective reference ranges), 3 months post-surgery. No problems were evident at 6 months.     

Intraoperative contrast echocardiography to verify the surgical occlusion of a single extrahepatic portosystemic shunt in a dog

This report details a bubble echocardiographic study carried out during the surgical treatment of a congenital single extrahepatic portosystemic shunt (PSS) in a Labrador Retriever. After celiotomy, agitated saline was injected through a jejunal vein and microbubbles appeared rapidly in the right cardiac chambers. The test confirmed the presence of a PSS, helping the surgeon to identify the vessel concerned and to rule out a second shunt. Successively, portography confirmed what the exploratory celiotomy had revealed before with the aid of the bubble study: a single shunt was located between the portal vein and the right renal vein. It was completely ligated, as all the criteria for this solution were met. Intraoperative contrast echocardiography (ICE) was easy to perform, helpful and undemanding. It is proposed here as an intraoperative ancillary test to diagnose all PSS and to confirm successful treatment when complete shunt closure is possible.     

Long-term immunosuppressive therapy with cyclosporine plus prednisolone for necrotizing meningoencephalitis in a Pekingese dog

A 4-year-old intact female Pekingese dog was presented with ataxia and seizure episodes. Based on magnetic resonance imaging and cerebrospinal fluid analysis results, meningoencephalitis of unknown etiology was suspected. The present case survived for 1,096 days under cyclosporine plus prednisolone therapy and was definitively diagnosed with necrotizing meningoencephalitis. This report describes the clinical findings, serial magnetic resonance imaging characteristics and pathologic features of a necrotizing meningoencephalitis and long-term survival after cyclosporine with prednisolone therapy.     

京巴犬肾盂结石的诊断与根治疗法

肾盂结石是尿结石的一种,为犬、猫常见病.小动物尿石症有较高的发病率,犬的发病率为2.8%,2～8岁多发,多数为大的结石块.因结石的物理刺激而产生疼痛,引起尿路黏膜发炎,出现尿频、血尿,还并发细菌性膀胱炎、尿道炎,结果出现发热,食欲不振等症状.     

Pruritus possibly associated with a portosystemic shunt in a bichon frise puppy

A bichon frise puppy was presented with generalized pruritus. At 22 weeks, a portosystemic shunt was diagnosed. Correction of the shunt led to resolution of the pruritus. Pruritus associated with hepatobiliary disease is well documented in humans; this case suggests that hepatobiliary disease may be associated with pruritus in dogs.