Ultrasonographic diagnosis of unusual portal vascular abnormalities in two cats

Abstract

Two cases of ascites secondary to portal vascular abnormalities associated with portal hypertension are described. In the first case a five-month-old cat was presented with recurrent ascites and investigations showed that the underlying cause was a hepatic arteriovenous fistula. Ultrasonography showed direct communication of the coeliac artery and right branch of the portal vein. There was also hepatofugal flow in the main portal vein consistent with portal hypertension. The ultrasonographic features were similar to those seen in dogs with hepatic arteriovenous fistulae. In the second case, ascites, portal hypertension and an intraluminal mass in the main portal vein was diagnosed in a 16-year-old cat that had been presented with hyperthyroidism and hepatomegaly. Acquired portosystemic collaterals involving the left renal vein were present. Additional diagnostic investigations were not permitted. Ultrasonography was useful in both cases to document portal hypertension and the underlying cause.

Hybrid technique coil embolisation for intrahepatic arterioportal fistula in a cat: case report

“…Colour Doppler ultrasonography has been reported as a useful tool for the diagnosis of IHAPF in both cats and dogs. 2,12,13 In the present case, ultrasonography revealed a dilation of an intrahepatic portal vein branch and an intrahepatic saccular dilation with pulsatile mosaic perfusion in the portal vein branch. Contrast-enhanced CT also revealed a dilated portal vein branch, tortuous vessels and a nidus in the liver.…”

“…7 Attempts at surgical treatment for feline IHAPF have not been described. 1,2 Hepatic lobectomy enables the removal of the lesion, as the origin of this disorder itself, and is useful if the IHAPF has developed within a single hepatic lobe. However, this entails a risk of major haemorrhage, and the large amount of hepatic parenchyma removed may cause liver dysfunction.…”

“…This pathology is uncommon in humans and dogs but extremely rare in cats. Only three cases of IHAPF have previously been described in cats, 1,2 whereas congenital IHAPF has been reported in 18 human cases. 3 Both congenital and acquired cases have been reported in people, 4 but almost all reported cases in dogs and cats have been congenital.…”

“…3 Both congenital and acquired cases have been reported in people, 4 but almost all reported cases in dogs and cats have been congenital. 1,2,5–7 …”

“…3,8,9 A previous study in cats only reported diagnosis, and treatment and prognosis have not been described. 1,2 …”