• 한국임상수의학회지
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• 제18권4호
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• pp.442-447
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• 2001

A 2-year-old 4.0-kg female Shih Tzu with history of hematemesis and melena was referred to Veterinary Medical Teaching Hospital, Seoul national University for further evaluation and treatment. During physical examination, the dog revealed mild depression, dry mucous membrane and abdominal pain. Hematologic values were normal and serum chemical values showed increased serum bile acid (53.47 umol/l, preprandial), fasting serum ammonia concentration (184 g/dl), alanine transferase (98 U/L), alkaline phosphatase (871 U/L) and gamma glutamyl transpeptidase (21 U/L), and decreased blood urea nitrogen (4 mg/dl), total protein (4.1 g/dl) and albumin (1.2 g/dl). Microhepatica was shown in abdominal radiography. During the ultrasound examination, dilated tortuous vein communicating with caudal vena cava ws observed near the stomach. Intraoperative jejunal vein portography was performed during laparotomy to confirm the location and size of shunt vessel. According to history taking, physical examination, hematologic and serum chemical examination and radiographic study, it was diagnosed as single extrahepatic portosystemic shunt. The anomalous vessel (7 mm, o.d.) that enter the caudal vena cava from the left gastric vein, near the level of the diaphragm, was identified. A Ameroid constrictor (5 mm, i.d.) was applied to the shunting vessel near the caudal vena cava. Hematologic and serum chemical values recovered gradually and were revealed normal values 4 months after surgery. Four month after surgery serum bile acids concentrations were 0.56 $\mu$mol/l (preprandial) and 18.45 umol/l (postprandial). Abdominal radiograph showed normal gastric axis and it revealed normal size of the liver. Fine texture and increased echogenecity of liver and enlargement of portal vein were shown in ultrasonography. Single extrahepatic portosystemic shunt might be treated surgically using Ameroid constrictor.

• 한국임상수의학회지
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• 제26권1호
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• pp.86-90
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• 2009

An intact female, 5-year old, Shihtzu, weighing 3.2 kg with a history of depression, hypersalivation, dullness, and ataxia for 3 days was referred. Radiographic findings included microhepatica, bilateral renal calculi, and a cystic calculus. Ultrasonography showed microhepatica, decreased visibility of portal veins in the liver, bilateral renal calculi, a cystic calculus, and an abnormal tortuous dilated vessel in the craniodorsal abdomen. A single congenital extrahepatic portoazygous shunt was confirmed through operative mesenteric portography. The patient received surgery using an ameroid constrictor ring and recovered well.

• 대한수의학회지
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• 제48권2호
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• pp.227-233
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• 2008

Portosystemic shunt (PSS) was diagnosed in 43 dogs by mesenteric portogram from January, 2002 to June 2007 in Haemaru referral animal hospital. PSS was found in various breeds including Maltese, Miniature Schnauzer and Yorkshire Terrier and there was no predisposition in gender. In laboratory parameters, mean cell volume was lower than normal value in single shunt and alanine aminotransferase was higher than normal range in multiple shunts with clinical significance. Cystic calculi were found in over 50% dogs with PSS and even in 70.8% dogs with single shunt. In 81% dogs with PSS, extrahepatic single shunt such as portocarval type and portoazygous type was identified. Extrahepatic multiple shunt and intrahepatic single shunt were observed in 4 dogs, respectively. Gradual attenuation using ameroid constrictor was applied to 35 dogs with extrahepatic single shunt and the prognosis of these dogs were good except two dogs, which showed poor prognosis because of acquired multiple PSS and renal disease unrelated with PSS, respectively.

• 한국임상수의학회지
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• 제20권4호
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• pp.508-515
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• 2003

A 4-month-old 5.7 kg male Golden retriever with history of seizure, depression, lethargy and anorexia was referred to Veterinary Medical Teaching Hospital, Chungbuk National University. Hematologic examination revealed microcytosis and nonregenerative anemia. Serum chemical values showed increased serum ammonia (423 $\mu$mol/L), ALP (1101 U/L), r-GTP (13.9 U/L) and CPK (1454 U/L), and decreased total protein (4.9 g/dl) and BUN (1.6 mg/dl). Microhepatia was shown in survey abdominal radiographs. Color doppler ultrasonographic examination revealed dilated tortuous vein with turbulent flow within liver parenchyma. Intraoperative jejunoportography and intraoperative ultrasonography confirmed the location and size of single intrahepatic shunt vessel in the left medial liver lobe. Also, the anomalous vessel entering the caudal vena cava was identified beneath the diaphragm. The shunting vessel was ligated with using an Ameroid constrictor. General conditions, hematologic and serum chemical values resolved gradually after surgery. One month after surgery abdominal radiograph showed normal gastric axis and it was consistent whit the normal size liver. Normal echogenecity of liver and enlargement of portal vein were shown in ultrasonography. It is assumed that survey radiography and ultrasonography are useful for diagnosis of single intrahepatic shunt in a dog and especially jejunoportography vein portography and intraoperative ultrasonography are suitable for confirmation of the anatomic location and size of the shunting vessels.

• 한국임상수의학회지
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• 제34권3호
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• pp.189-192
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• 2017

Thirteen dogs were diagnosed as congenital extrahepatic single PSS by intraoperative mesenteric portovenography or computed tomographic examination, repair surgery was performed by using an ameroid constrictor. Hepatic size was measured from the right lateral view using liver length/T11 length ratio. This measurement was performed on follow-up check of PSS ligation patients. Hepatic size parameter of pre-operative PSS patients is $4.13{\pm}0.13$ (range, 3.11-4.83). After surgery, hepatic size parameter of post-operative PSS patients is $4.79{\pm}0.19$ (range, 3.78- 5.93). Although follow-up periods varied 2 and 26 weeks, all patients showed increased liver size compared to that on pre-operative radiographs (P < 0.01). The increase rate was 1.01-1.46 times than those of preoperative radiographs. But in 5 patients, post hepatic liver size was small compared to the others, which showed low increase rate of body weight, total protein, albumin, and glucose level. It was thought that small value of hepatic size parameter was due to delay of hepatic regeneration. In conclusion, radiographic hepatic size parameter of pre- and post-operative patients is considered an effective evaluation for restoring after PSS surgery.