Shadow is a 6 year old MN, Miniature schnauzer 14#. Pet had a PSS which was reported as a vessel coming off the the gastric vessel and entering the caudal vena cava. His liver enymes returned to normal as did bile acids. The surgery was done several years ago.
Currently has a mild elevated ALT on preop bloodwork for a dental prophy (286). No other abnormalities. The bile acids currently are normal however internist was concerned about the increase from the pre to the post (pre 1.7 post 21). These were normal as per Idexx normals.
Shadow is a 6 year old MN, Miniature schnauzer 14#. Pet had a PSS which was reported as a vessel coming off the the gastric vessel and entering the caudal vena cava. His liver enymes returned to normal as did bile acids. The surgery was done several years ago.
Currently has a mild elevated ALT on preop bloodwork for a dental prophy (286). No other abnormalities. The bile acids currently are normal however internist was concerned about the increase from the pre to the post (pre 1.7 post 21). These were normal as per Idexx normals.
Haven’t looked at any livers or shunts after ligation. Does this look normal? I am thinking this is not related to the previous shunt but either a primary or reactive hepatopathy.
8 responses to “Elevated ALT after previous PSS ligation”
Tough to tell completely.
Tough to tell completely. The left branch of the pv looks solid on the first image and the intrahepatic vasculature looks decent on CF but the contour of the pv in the last image is a bit perplexing with the dorsal deviation and the cvc looks a bit big. You would need to folloow that PV to see where it goes and add CF to it. If on dexdomitor the cvc gets big so that can fool you. Post ligation is variable but you want to see normalized pv/cvc ratios >0.8 and solid hepatic vasculature and assess the parenchyma which looks a bit heterogenous here. ALT values are independent of shunt pathology because the ALT is indicating cytosol leakage so any host of insults including simple antigen surveillance can do this. Needs a parenchymal bx to assess pathology and maybe a diet change.
Tough to tell completely.
Tough to tell completely. The left branch of the pv looks solid on the first image and the intrahepatic vasculature looks decent on CF but the contour of the pv in the last image is a bit perplexing with the dorsal deviation and the cvc looks a bit big. You would need to folloow that PV to see where it goes and add CF to it. If on dexdomitor the cvc gets big so that can fool you. Post ligation is variable but you want to see normalized pv/cvc ratios >0.8 and solid hepatic vasculature and assess the parenchyma which looks a bit heterogenous here. ALT values are independent of shunt pathology because the ALT is indicating cytosol leakage so any host of insults including simple antigen surveillance can do this. Needs a parenchymal bx to assess pathology and maybe a diet change.
I had trouble tracing the PV
I had trouble tracing the PV due to the GI gas. I would agree this seems more a parenchymal problem versus shunt failure. Thanks for the help.
I had trouble tracing the PV
I had trouble tracing the PV due to the GI gas. I would agree this seems more a parenchymal problem versus shunt failure. Thanks for the help.
I had trouble tracing the PV
I had trouble tracing the PV due to the GI gas. I would agree this seems more a parenchymal problem versus shunt failure. Thanks for the help.
I had trouble tracing the PV
I had trouble tracing the PV due to the GI gas. I would agree this seems more a parenchymal problem versus shunt failure. Thanks for the help.
If you displace the gas with
If you displace the gas with your scanning hand or go right intercostal this will clear it up. We will be working on this at the PR seminar in February in the mini lab as well ass the basic lab so eveyone should be able to get the views to dx shunts whether they know what they are seeing or not:)
http://sonopath.com/products
If you displace the gas with
If you displace the gas with your scanning hand or go right intercostal this will clear it up. We will be working on this at the PR seminar in February in the mini lab as well ass the basic lab so eveyone should be able to get the views to dx shunts whether they know what they are seeing or not:)
http://sonopath.com/products