Extra hepatic gastrocaval shunt in a 6 year old FS Yorkshire Terrier

History

A 6-year-old SF Yorkshire terrier was presented for possible seizure activity. Abnormalities on CBC and serum biochemistry were mild leukocytosis, hypoalbuminemia (2.2), and elevated phosphorus (2.8) and pre-and post-prandial bile acids (264 and 171, respectively).

Clinical Differential Diagnosis

Porto-caval shunt, primary portal vein hypoplasia, chronic liver failure, cirrhosis

DX

Extrahepatic gastrocaval shunt.

Image Interpretation

The liver was subnormal in size. An abnormal extrahepatic vessel was noted in this patient. This is consistent with gastrocaval shunt. The shunt was looping. The vena cava in this patient measured 1.2 cm. The portal vein measured 0.5 cm and the aorta measured 0.7 cm.

Outcome

Support for hepatic encephalopathy followed by ameroid constrictor placement, cystotomy and liver biopsy. Extrahepatic shunt size varied from 0.7-0.97 cm in width.