New UC Davis veterinary surgery saves puppy with liver defect

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Interventional radiology technique helps form clots and close shunt vessel.

A 6-month-old Labrador retriever is expected to make a full recovery after undergoing a new surgery at the University of California, Davis, Veterinary Medical Teaching Hospital to treat a liver defect.

Sandy's owners trekked 500 miles to the hospital after the dog was diagnosed with intrahepatic portosystemic shunt (IHPSS). Her veterinarian recommended the dog to Bill Culp, VMD, DACVS, because of his experience performing shunt procedures. A technetium scan, blood work, a CT scan and an abdominal ultrasound confirmed the IHPSS diagnosis. The scan visualized the shunting vessel and helped identify the treatment's goal-closing the shunting vessel to redirect blood flow through the liver, allow nutrition and remove toxins from systemic circulation.

SandyOther IHPSS treatments are medical management or open surgery, but results vary and many dogs don't respond well. UC Davis offers a new interventional radiology technique-percutaneous transvenous coil embolization (PTCE)-that is minimally invasive and shows promise. Culp and Sandy's owner decided to treat the IHPSS with the new procedure.

Sandy was anesthetized, and a stent was placed in the caudal vena cava-the largest vein in the abdomen, which returns deoxygenated blood to the heart-along the region of the shunt. Coils are released into the shunt. The coils enable clots to form and seal the shunt vessel.

Following surgery, Sandy went home and rested for two weeks. The Labrador retriever returned to the hospital three months after surgery and passed recheck exams. Blood tests showed improved liver values and a CT scan revealed improved liver size and vascularity demonstrating improved blood flow.

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