Placement of a caudal vena cava stent for treatment of Budd-Chiari-like syndrome in a 4-month-old Ragdoll cat

posted in: CT Concepts | 0

Hoehne SN, Milovancev M, Hyde AJ, et al.

 J Am Vet Med Assoc 2014;245:414-418.

CASE DESCRIPTION: A 16-week-old 1.5-kg (3.3-lb) sexually intact male Ragdoll kitten that had a 9-week history of marked modified transudate ascites was evaluated. A membranous obstruction of the caudal vena cava at the cranial aspect of the liver was identified via CT angiography. CLINICAL FINDINGS: Physical examination findings included a markedly distended abdomen and panting. Testing for circulating FIV antibody and FeLV antigen, a PCR assay for feline coronavirus performed on a sample of peritoneal fluid, and fecal flotation yielded negative results. A diagnosis of Budd-Chiari-like syndrome secondary to a membranous obstruction of the caudal vena cava was made. TREATMENT AND OUTCOME: The cat was anesthetized, and the subhepatic portion of the caudal vena cava was identified and accessed via median celiotomy and direct venipuncture. A 6F 8 x 24-mm balloon-expandable nitinol biliary stent was placed across the stenotic area under fluoroscopic guidance. The patient remained free of clinical signs at the last follow-up 13 months following the procedure. CLINICAL RELEVANCE: Budd-Chiari-like syndrome is a rare phenomenon in veterinary medicine, and congenital malformations should be considered in young feline patients with ascites. Computed tomography angiography proved to be a helpful adjunctive imaging technique to establish a diagnosis in this case. To the authors’ knowledge, this is the first report of successful treatment of a congenital caudal vena cava obstruction by means of stent placement in a juvenile cat.