Budd-Chiari-Like Syndrome

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