CT Angiogram Case Study



Violet is a 2-year old, spayed female Yorkshire terrier that presented to NorthStar VETS with a several-month history of lethargy and intermittent vomiting. It was also found that her liver enzymes were elevated. Given her clinical signs, bloodwork, age and breed, a portosystemic shunt was suspected.

A portosystemic shunt is an aberrant vessel that bypasses the liver and enters one of the systemic vessels. This congenital abnormality can lead to an elevation in bile acids and an accumulation of ammonia in the bloodstream. This subsequently can cause neurologic complications such as depression and even seizures.

Abdominal ultrasonography is often recommended for detection of this suspected aberrant vessel. However, CT angiography is more advanced technology that is faster, reduces uncertainty and improves the ease of detection of the vessel.

This technology utilizes a multi-detector CT scanner and a small volume of intravenous contrast medium to create high resolution cross-sectional images of a pet's abdomen and create a virtual road map of all the vessels. In addition, a multi-detector scanner can reconstruct exquisite 3D images that can be rotated and viewed from any angle or perspective. And the entire process can take less than 10-minutes.

Violet was, in fact, found to have an extrahepatic, portoazygous shunt, which given its location, could not have been seen with ultrasonography. She was referred to NorthStar VETS' surgery service where one of our board-certified surgeons made an abdominal incision, located the shunt, and placed an ameroid constrictor, which would ligate (close-off) the aberrant vessel slowly over time.

We are delighted to say that Violet has renewed energy and has made a complete recovery.