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Venous Obstructive Diseases
Description
Obstruction of the venous circulation creates high pressure in the capillary beds surrounding the affected area. As a result, edema and/or effusion are very common clinical signs seen in these types of diseases. Some specific examples of venous diseases are detailed below including Budd-Chari-Like syndrome, Portal Vein Thrombosis, and Cranial Vena Cava Syndrome.
Budd-Chari-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
Venous Thrombosis
Description
- Thrombus formation in the venous system occurs most commonly as the result of trauma, venous catheterisation, or neoplastic conditions.
- Obstruction of the affected area or embolisation of the thrombus to distant areas results in a variety of clinical signs. As could be expected, the location of the insult determines the type of presenting signs. For example, pulmonary emboli cause respiratory problems while portal vein thrombi result in ascites and the possible development of hepatic encephalopathy or portosystemic shunting.
Thrombophlebitis
Description
- The inflammation of a vein due to clot formation. Breaking the word down into its two parts, thrombo means clot and phlebitis means inflammation of a vein.
- Thrombophlebitis is a problem when catheters are not maintained properly or are placed under unsterile conditions. This condition can lead to more serious problems such as septicaemia or endocarditis.
- Thromboplebitis is a common problem in horses, but not dogs and cats.