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

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====Description====
+
== Introduction<br> ==
  
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>Female
+
'''Dogs:''' Young dogs under two years old; Male&gt; female. There has been no reported cases in cats.<br>  
  
'''Cats:''' No reported cases
+
<br>
  
 +
== Clinical Signs<br> ==
  
====Diagnosis====
+
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>
  
=====History & Clinical Signs=====
+
<br>
  
-Ascites (with modified transudate)
+
== Diagnosis<br> ==
  
-Hepatomegaly
+
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>
  
-Lethargy
+
<br>
  
-Abdominal Distension & Pain
+
== Treatment ==
  
-Anorexia
+
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.
  
 +
<br>
  
=====Laboratory Findings=====
+
== Prognosis ==
  
-Modified Transudate (fluid from ascites)
+
Excellent with an experienced surgeon, but poor if only medical therapy is used.
  
-Elevated Liver Enzymes (biochemistry)
+
<br>
  
-Stress Leukogram (complete blood count)
+
== References<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<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>
  
=====Radiography=====
+
<br>
  
-Ascites
+
[[Category:Venous_Pathology]] [[Category:To_Do_-_Review]] [[Category:Vascular_Diseases_-_Dog]] [[Category:Vascular_Diseases_-_Cat]] [[Category:Vascular_Diseases_-_Horse]]
 
 
-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
 
 
 
 
 
[[Category:Venous_Pathology]][[Category:To_Do_-_Cardiovascular]]
 
[[Category:Vascular Diseases - Dog]][[Category:Vascular Diseases - Cat]][[Category:Vascular Diseases - Horse]]
 

Revision as of 16:17, 15 March 2011

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.

Signalment

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


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

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 Electrocardiograph (ECG) is performed, this may demonstrate right atrial enlargement (Tall P waves). Echocardiography may show visualisation of an obstruction. Abdominal ultrasound will also demonstrate ascites, plus hepatomegaly and enlarged heaptic veins. Angiography can be used to visualise blood flow.


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.


Prognosis

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


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