Difference between revisions of "Budd-Chiari-Like Syndrome"

Revision as of 16:24, 15 December 2010

Description

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

Dogs: Young dogs under two years old; Male>Female

Cats: No reported cases

Diagnosis

History & Clinical Signs

-Ascites (with modified transudate)

-Hepatomegaly

-Lethargy

-Abdominal Distension & Pain

-Anorexia

Laboratory Findings

-Modified Transudate (fluid from ascites)

-Elevated Liver Enzymes (biochemistry)

-Stress Leukogram (complete blood count)

Radiography

-Ascites

-Enlarged Caudal Vena Cava

Electrocardiography (ECG)

-Indication of right atrial enlargement (Tall P waves)

Echocardiography

-Visualization of an obstruction +/-

Abdominal Ultrasound

-Ascites

-Hepatomegaly

-Enlarged Hepatic Veins

Angiography

-Visualize blood flow

Treatment

-Sugary (indicated for some cases, but very risky)

Medical Treatment:

-Abdominocentesis

-Furosemide

-Ace Inhibitor (e.g. enalapril)

Prognosis

-Excellent with an experienced surgeon

-Poor with medical treatment

@@ Line 1: / Line 1: @@
-{{OpenPagesTop}}
+====Description====
-== 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.
+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 > female. There have been no reported cases in cats.
+'''Dogs:''' Young dogs under two years old; Male>Female
+'''Cats:''' No reported cases
-== 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.
+====Diagnosis====
+=====History & Clinical Signs=====
-== Diagnosis ==
+-Ascites (with modified transudate)
-'''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.
+-Hepatomegaly
+-Lethargy
-== Treatment ==
+-Abdominal Distension & Pain
-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.
+-Anorexia
-== Prognosis ==
+=====Laboratory Findings=====
-Excellent with an experienced surgeon, but poor if only medical therapy is used.
+-Modified Transudate (fluid from ascites)
+-Elevated Liver Enzymes (biochemistry)
-== References ==
+-Stress Leukogram (complete blood count)
-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
-Ettinger, S.J, Feldman, E.C. (2005) Textbook of Veterinary Internal Medicine (6th edition, volume 2), W.B. Saunders Company
+=====Radiography=====
-Fossum, T. W. et. al. (2007) Small Animal Surgery (Third Edition), Mosby Elsevier
+-Ascites
-Merck & Co (2008) The Merck Veterinary Manual (Eighth Edition), Merial
+-Enlarged Caudal Vena Cava
-Nelson, R.W. and Couto, C.G. (2009) Small Animal Internal Medicine (Fourth Edition), Mosby Elsevier.
+=====Electrocardiography (ECG)=====
-{{review}}
+-Indication of right atrial enlargement (Tall P waves)
-{{OpenPages}}
-[[Category:Venous_Pathology]] [[Category:Expert_Review]] [[Category:Vascular_Diseases_-_Dog]]
+=====Echocardiography=====
-[[Category:Cardiology Section]]
+-Visualization of an obstruction +/-
+=====Abdominal Ultrasound=====
+-Ascites
+-Hepatomegaly
+-Enlarged Hepatic Veins
+=====Angiography=====
+-Visualize blood flow
+====Treatment====
+-Sugary (indicated for some cases, but very risky)
+Medical Treatment:
+-Abdominocentesis
+-Furosemide
+-Ace Inhibitor (e.g. enalapril)
+====Prognosis====
+-Excellent with an experienced surgeon
+-Poor with medical treatment
+[[Category:Venous_Pathology]][[Category:To_Do_-_Cardiovascular]]
+[[Category:Cardiovascular Pathology - Dog]]