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Minimally invasive treatment of mesenteric arterioportal fistulas in two dogs

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  • 1 Interventional Radiology and Endoscopy Service, The Animal Medical Center, 510 E 62nd St, New York, NY 10065.
  • | 2 Interventional Radiology and Endoscopy Service, The Animal Medical Center, 510 E 62nd St, New York, NY 10065.
  • | 3 Interventional Radiology and Endoscopy Service, The Animal Medical Center, 510 E 62nd St, New York, NY 10065.
  • | 4 Interventional Radiology Service, Department of Radiology, Lenox Hill Hospital, 100 E 77th St, New York, NY 10075.

Abstract

CASE DESCRIPTION Two Pembroke Welsh Corgis with gastrointestinal signs including inappetence, diarrhea, lethargy, and hypersalivation were referred for evaluation.

CLINICAL FINDINGS Diagnostic testing included abdominal ultrasonography and CT angiography. One patient had a cranial mesenteric artery-to-mesenteric vein fistula with multiple acquired extrahepatic portosystemic shunts. The second patient had both cranial and caudal mesenteric artery-to-mesenteric vein fistulas and multiple acquired extrahepatic portosystemic shunts.

TREATMENT AND OUTCOME Both patients underwent minimally invasive coil embolization of the mesenteric arterioportal fistulas, with complete occlusion confirmed by means of angiography at procedure completion. Clinical outcome approximately 1 year after treatment was assessed as fair to good because of recurrence of clinical signs that required medical management in 1 dog and some persistent serum biochemical abnormalities.

CLINICAL RELEVANCE Outcome for the 2 patients described suggested that coil embolization may be a feasible and effective minimally invasive technique for the treatment of mesenteric arterioportal fistulas in dogs. However, further investigation of the potential for chronic hepatic disease in patients with a history of acquired portosystemic shunts is warranted.

Abstract

CASE DESCRIPTION Two Pembroke Welsh Corgis with gastrointestinal signs including inappetence, diarrhea, lethargy, and hypersalivation were referred for evaluation.

CLINICAL FINDINGS Diagnostic testing included abdominal ultrasonography and CT angiography. One patient had a cranial mesenteric artery-to-mesenteric vein fistula with multiple acquired extrahepatic portosystemic shunts. The second patient had both cranial and caudal mesenteric artery-to-mesenteric vein fistulas and multiple acquired extrahepatic portosystemic shunts.

TREATMENT AND OUTCOME Both patients underwent minimally invasive coil embolization of the mesenteric arterioportal fistulas, with complete occlusion confirmed by means of angiography at procedure completion. Clinical outcome approximately 1 year after treatment was assessed as fair to good because of recurrence of clinical signs that required medical management in 1 dog and some persistent serum biochemical abnormalities.

CLINICAL RELEVANCE Outcome for the 2 patients described suggested that coil embolization may be a feasible and effective minimally invasive technique for the treatment of mesenteric arterioportal fistulas in dogs. However, further investigation of the potential for chronic hepatic disease in patients with a history of acquired portosystemic shunts is warranted.

Supplementary Materials

    • Supplementary Figure S1 (PDF 143 kb)
    • Supplementary Table S1 (PDF 23 kb)
    • Supplementary Table S2 (PDF 26 kb)

Contributor Notes

Dr. Cocca's present address is Department of Veterinary Clinical Medicine, College of Veterinary Medicine, University of Illinois, Urbana, IL 61802.

Address correspondence to Dr. Weisse (Chick.Weisse@amcny.org).