In all images here cranial is to left of image. I’ve listened to two authoritative presentations on shunts by specialist surgeons in the last month. To paraphrase, both of them said they recommend CT angio and find ultrasound too user-dependent and too unreliable. My impression is that there’s a general drift in this direction. I … Continue reading
For many years there has been sparse and confusing information available on HMVD/PHPV. Well, I find it confusing anyway! For starters, although the term PHPV has been chosen by the liver standardisation group of the WSAVA as its preferred terminology, the vast majority of dogs with PHPV don’t have a hypoplastic (main) portal vein: rather … Continue reading
Recently I’ve seen two three-month-old dogs with multiple (numerous) small portosystemic shunts in the absence of inflammatory liver disease. The patient whose images are presented below was examined on account of acute encephalopathy with bile acids >130 umol/l and ALT > 600 (ref <100). The same in video: This flow courses via colic veins to enter … Continue reading
Just a snippet of information -but something I’ve always struggled to find published confirmation of in the past: that both cats and dogs with portosystemic shunts may have normal range pre- and post-prandial bile acids. I note that in the recent JVIM paper: J Vet Intern Med. 2019 Nov 19. doi: 10.1111/jvim.15649. [Epub ahead … Continue reading
This is an issue I used to wonder about. When you see acquired shunts running, for example, from splenic to left renal veins….should flow in the gastrosplenic vein also be hepatofugal? That is, does blood flowing down the mesenteric vein from the guts continue into the main portal vein or does it all get diverted … Continue reading
A few photos of cats with the ‘classic’ copper-coloured irides often associated with portosystemic shunts. It was reported to me just recently that at least one of these cats developed the coppering in the period between 3 and 5 months old. …and sometimes they don’t have copper irides: &nbs… Continue reading
This is just a slightly unusual shunt conformation in a six-month old kitten. As is common, the anomalous vessel originates from the base of the splenic vein and courses cranially and dorsally. The slightly unusual thing is that the confluence with the cava is intra-hepatic. With colour Doppler (clip starts with cava (above) … Continue reading
