Correlation of liver and splenic stiffness to portal venous pressure in dogs with intrahepatic portosystemic shunts (IHPSS) undergoing percutaneous transvenous coil embolization (PTCE)
Dogs with intrahepatic portosystemic shunts (IHPSS) have an abnormal blood vessel that connects their portal system (the system of blood vessels draining from the spleen, stomach, and small intestines) to the rest of the circulation and bypasses the liver. Percutaneous coil embolization (PTCE) is a minimally invasive procedure recommended for dogs with IHPSS in which coils are used to block this abnormal blood vessel to restore normal blood flow and improve liver function. PTCE often leads to elevations of portal vein pressure. It is unknown whether these higher pressures persist or resolve, and how they affect or reflect patient outcomes. Additionally, having long lasting high pressure in the portal vein can cause symptoms such as bleeding from the small intestine or stomach, fluid accumulation in the abdomen, or enlargement of the spleen. Portal vein pressures are difficult to accurately measure in dogs except by placing a catheter in the portal vein while the patient is under anesthesia. In people, a special minimally invasive ultrasound technique (elastography) can measure organ stiffness, which has been correlated with portal pressures. Ultrasound elastography is an advanced ultrasonographic technique that uses the ultrasound waves to assess the stiffness of the tissue. These tests have been proven to be safe in humans and animals.
In this study, we plan to evaluate the reliability of ultrasound elastography in dogs diagnosed with IHPSS treated with PTCE by comparing portal pressures measured with a catheter and ultrasound elastography measures of organ stiffness. Additionally, we plan to evaluate how long-lasting portal pressure alterations are by re-measuring these in your dog 3 months after coil embolization. This may alter treatment recommendations later and help optimize treatment in dogs with liver shunts.
Eligibility:
- Dogs diagnosed with an intrahepatic portosystemic shunt for which surgical intervention is recommended
- Dog has completed a staging evaluation that determined PTCE is a reasonable treatment option.
- Ability to attend visits at PennVet in Philadelphia
Incentives:
- Cost of some pre-anesthetic blood work
- Cost of anesthesia for PTCE procedure
- Cost of pre- and post-PTCE portal pressure monitoring and elastography
- Cost of CT with angiogram
- Cost of 3-month visit (including exam, blood work, anesthesia, portal pressure monitoring and elastography, and CT scan)
Please contact the VCIC at 215-573-0302 or vcic@vet.upenn.edu for more information about this study.