Budd-Chiari syndrome in a kitten, caused by membranous obstruction of the caudal vena cava

Abstract

An eight-month-old, male domestic shorthair kitten developed progressive abdominal distension over a six-week period. Abdominocentesis revealed a fluid with high protein (3.8 g/dl) and moderate cellularity. Infectious, cardiovascular, and neoplastic causes of posthepatic obstruction were ruled out. Partial obstruction and stenosis of the caudal vena cava (CVC) at the level of the diaphragm were detected on a contrast venogram. Exploratory surgery revealed a fibrous, web-like membrane at the site of obstruction. Resection of the stenotic segment of the CVC was not possible because of the junction of the left hepatic veins and CVC just caudal to the lesion. A 3 by 6-mm, oval Dacron patch graft was sutured into the venotomy site. Postoperative complications included fever and leukocytosis, eosinophilic pleural effusion, and transient congestive heart failure associated with volume overload. The cat is normal 16 months after surgery, with no recurrence of ascites. This is the first reported case of Budd-Chiari syndrome (BCS) in a domestic kitten. Documented herein is the first successful treatment of BCS in a small animal using a vascular, prosthetic patch graft.

Placement of a caudal vena cava stent for treatment of Budd-Chiari–like syndrome in a 4-month-old Ragdoll cat

“…11,13 Regardless of the underlying cause, the previously described cats with BCLS had similar clinical signs. 2,11,12,13 The young age of cats with fibrous membranous obstruction of the CVC but without concurrent coagulopathies or underlying hematopoietic disorders supports SMALL ANIMALS/ EXOTIC the conclusion that CVC obstructions are a congenital disorder. 12,14 This is in contrast to the veno-occlusive disease and hepatic vein obstruction in middle-aged to older cats, in which the underlying etiopathogenesis is not completely understood.…”

“…Two of the 4 cases were caused by obstruction of the CVC: one intrahepatic and the other extrahepatic. 2,12 In cats, BCLS can also be a result of hepatic vein occlusion or stenosis. 11,13 Regardless of the underlying cause, the previously described cats with BCLS had similar clinical signs.…”

“…[1][2][3][4] The obstruction that causes BCS can develop at any site between the liver and the right atrium, and the spectrum of lesions responsible includes veno-occlusive disease of the small hepatic veins as well as obstructions of the large hepatic veins or the suprahepatic portion of the inferior vena cava. 2,4 In veterinary medicine, primary BCLS has mainly been reported as affecting dogs and can develop in conjunction with congenital cardiac defects (cor triatriatum dexter), blunt trauma to the CVC, and perivenular fibrosis of the hepatic veins. 5-7 Secondary kinking and extraluminal obstruction of the CVC as a result of neoplasia, vehicular trauma, and cardiac disease can also lead to development of BCLS.…”

Body Cavity Fluids

“…The presence of eosinophils does not provide a specific diagnosis, and the cause is often unknown in these cases. Dacron implants have also been implicated as an iatrogenic etiology in eosinophilic effusions (Macintire et al, 1995). Several case reports exist noting these specific neoplasms as the etiology of the eosinophilic effusion (Barrs et al, 2002;Bounous et al, 2000;Cowgill and Neel, 2003;Harris et al, 2013;Peaston and Griffey, 1994;Tomiyasu et al, 2010).…”

Morphological classification of circulatory disorders of the canine and feline liver

“…4.18), valvular endocarditis or endocardiosis, myocardial damage, and pericardial effusion. Canine and feline cases reported as Budd Chiarilike syndrome, [15][16][17][18][19] terminology that we consider to be misleading and that we can do without, were associated with passive congestion caused by obstruction or compression of the caudal caval vein or perivenular fibrosis of the intrahepatic veins. thrombosis, neoplasia, dirofilariasis) or compression (a.o.…”