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== Introduction<br> ==

== Introduction ==

This condition is an acquired or congenital obstruction to the caudal vena cava affecting venous return to the right side of the heart. The venous obstruction causes increased pressure within the liver allowing for fluid and protein to leak out of the hepatic sinusoids into the surrounding areas.  

This condition is an acquired or congenital obstruction to the caudal vena cava affecting venous return to the right side of the heart. The venous obstruction causes increased pressure within the liver allowing for fluid and protein to leak out of the hepatic sinusoids into the surrounding areas.  

== Signalment ==

== Signalment ==

'''Dogs:''' Young dogs under two years old; Male&gt; female. There has been no reported cases in cats.<br>

'''Dogs:''' Young dogs under two years old; male > female. There have been no reported cases in cats.

== Clinical Signs<br> ==

== Clinical Signs ==

Clinical signs can be vague and similar to other disease but include ascites (with modified transudate), hepatomegaly, lethargy, abdominal distension and abdominal pain and anorexia.<br>

Clinical signs can be vague and similar to other disease but include ascites (with modified transudate), hepatomegaly, lethargy, abdominal distension and abdominal pain and anorexia.

== Diagnosis<br> ==

== Diagnosis ==

Blood tests may reveal elevated liver enymes and the presence of a stress leukogram. If ascites is present, examination of this will prove it to be a modified transudate. Radiography will show the presence of ascites and an enlarged Caudal Vena Cava. If an&nbsp;Electrocardiograph (ECG) is performed, this may demonstrate right atrial enlargement (Tall P waves). Echocardiography may show visualisation of an obstruction.&nbsp;Abdominal ultrasound will also demonstrate ascites, plus hepatomegaly and enlarged heaptic veins. Angiography can be used to visualise blood flow.<br>

'''Blood tests''' may reveal elevated liver enzymes and the presence of a [[Stress Leukogram|stress leukogram]]. If ascites is present, examination of this will prove it to be a [[Modified Transudate|modified transudate]]. '''Radiography''' will show the presence of ascites and an enlarged Caudal Vena Cava. If an '''electrocardiograph''' (ECG) is performed, this may demonstrate right atrial enlargement (tall P waves). '''Echocardiography''' may show an obstruction. '''Abdominal ultrasound''' will also demonstrate ascites, plus hepatomegaly and enlarged hepatic veins. Angiography can be used to visualise blood flow.

== Treatment ==

== Treatment ==

Surgery is indicated for some cases,but is very risky. Medical treatment to provide supportive therapy, includes regular abdominocentesis, plus the use of drugs, furosemide (a diuretic) and enalapril, an ACE inhibitor.  

Surgery is indicated for some cases, but is very risky. Medical treatment to provide supportive therapy, includes regular abdominocentesis, plus the use of drugs, furosemide (a diuretic) and enalapril, an ACE inhibitor.  

== Prognosis ==

== Prognosis ==

Excellent with an experienced surgeon, but poor if only medical therapy is used.  

Excellent with an experienced surgeon, but poor if only medical therapy is used.  

== References<br> ==

== References ==

Ettinger, S.J. and Feldman, E. C. (2000) Textbook of Veterinary Internal Medicine Diseases of the Dog and Cat Volume 2 (Fifth Edition) W.B. Saunders Company<br>Ettinger, S.J, Feldman, E.C. (2005) Textbook of Veterinary Internal Medicine (6th edition, volume 2)W.B. Saunders Company<br>Fossum, T. W. et. al. (2007) Small Animal Surgery (Third Edition) Mosby Elsevier <br>Merck &amp; Co (2008) The Merck Veterinary Manual (Eighth Edition) Merial<br>Nelson, R.W. and Couto, C.G. (2009) Small Animal Internal Medicine (Fourth Edition) Mosby Elsevier. <br><br>

Ettinger, S.J. and Feldman, E. C. (2000) Textbook of Veterinary Internal Medicine Diseases of the Dog and Cat Volume 2 (Fifth Edition), W.B. Saunders Company

[[Category:Venous_Pathology]] [[Category:To_Do_-_Review]] [[Category:Vascular_Diseases_-_Dog]] [[Category:Vascular_Diseases_-_Cat]] [[Category:Vascular_Diseases_-_Horse]]

 

 

 

 

 

[[Category:Venous_Pathology]] [[Category:Expert_Review]] [[Category:Vascular_Diseases_-_Dog]]