• 한국임상수의학회지
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• 제29권6호
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• pp.488-493
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• 2012

두 마리의 말티즈견 (2살 중성화 암컷, 4개월 암컷)과 한 마리의 페키니즈견 (10살 수컷)이 구토, 식욕부진, 두위하강과 침흘림 등의 증상으로 내원하였다. 신체검사, 혈액검사, 방사선검사, 초음파, 컴퓨터단층촬영이 진단을 위해 실시되었다. 실험실 검사에서 높은 간수치, 담즙산 수치, 암모니아 농도가 세 마리 모두에서 확인되었다. 두 마리의 환축에서 방사선검사 상 소간증이 확인되었다.복부 초음파 검사에서 세 마리 모두 문맥전신 단락이 많이 의심되어 컴퓨터단층촬영을 실시하였고, 그 결과 모두 단일 간외성 문맥전신 단락으로 확인되었다. 진단 후 세마리는 모두 수술적인 방법을 통해 단락 혈관에 아메로이드 링을 적용하였다. 본 증례보고는 세 마리의 개에서 발생한 단일 간외성 문맥전신 단락 증례에 대한 임상적, 영상학적인 특징들을 잘 나타내고 있으며, 컴퓨터단층촬영이 문맥전신단락의 정확한 진단을 위해 유용한 진단기법임을 잘 나타내고 있다.

• 한국임상수의학회지
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• 제31권4호
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• pp.316-318
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• 2014

3년령 한국 집고양이가 갑작스럽게 발병한 간헐적 경련 증상을 주 증상으로 내원하였다. 신체검사상 구리 빛 홍채가 관찰되었고, 양안에서 위협반사 소실이 관찰되었다. 혈액학 검사와 혈청 화학 검사에서 경증의 적혈구 증가증과 심한 소적혈구증, 증가된 ALT 활성도가 확인되었으며, 추가로 실시한 간기능 평가에서는 담즙산염 농도와 암모니아 농도가 증가하였다. 방사선 검사에서 간 내 다수의 결절이 관찰되었고, 간외성 션트 혈관을 발견하였으며, 추가로 실시한 컴퓨터 단층 촬영을 통해 복합 간외션트를 확인하였다. 고양이는 션트 혈관에 대한 외과적 처치술을 받기 위해 증상 완화를 위한 디아제팜과 락툴로즈를 투여하였으나 경련이 심화되었고, 심장 정지가 와서 폐사하였다.

• 한국임상수의학회지
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• 제23권3호
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• pp.325-328
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• 2006

10년령의 암컷 Miniature Schnauzer개가 지속적인 식욕결핍, 이장열, 구토, 복통 등의 증상으로 내원하였다. 혈액검사 상에서 백혈구 수치는 만성 염증 소견을 나타내었고, 혈액 화학검사에서는 심한 담즙정체를 나타내는 중등도의 간담도계 이상 지표를 보여주었다. 복부 방사선과 초음파상에서 간종대, 담낭내 슬러지와 결석, 방광내 결석등이 관찰되었다. 이러한 진단 소견을 바탕으로 본 증례를 방광 결석증이 합병된 담낭내 담석과 슬러지에 의한 간외성 담관 폐색증으로 진단하였다. 담석과 방광결석을 담낭절제술과 방광절제술을 통해 담낭과 방광으로부터 각각 제거하였으며, 수술 후 환축의 임상증상 개선은 매우 빠르게 진행되었다.

• 한국임상수의학회지
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• 제18권4호
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• pp.442-447
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• 2001

A 2-year-old 4.0-kg female Shih Tzu with history of hematemesis and melena was referred to Veterinary Medical Teaching Hospital, Seoul national University for further evaluation and treatment. During physical examination, the dog revealed mild depression, dry mucous membrane and abdominal pain. Hematologic values were normal and serum chemical values showed increased serum bile acid (53.47 umol/l, preprandial), fasting serum ammonia concentration (184 g/dl), alanine transferase (98 U/L), alkaline phosphatase (871 U/L) and gamma glutamyl transpeptidase (21 U/L), and decreased blood urea nitrogen (4 mg/dl), total protein (4.1 g/dl) and albumin (1.2 g/dl). Microhepatica was shown in abdominal radiography. During the ultrasound examination, dilated tortuous vein communicating with caudal vena cava ws observed near the stomach. Intraoperative jejunal vein portography was performed during laparotomy to confirm the location and size of shunt vessel. According to history taking, physical examination, hematologic and serum chemical examination and radiographic study, it was diagnosed as single extrahepatic portosystemic shunt. The anomalous vessel (7 mm, o.d.) that enter the caudal vena cava from the left gastric vein, near the level of the diaphragm, was identified. A Ameroid constrictor (5 mm, i.d.) was applied to the shunting vessel near the caudal vena cava. Hematologic and serum chemical values recovered gradually and were revealed normal values 4 months after surgery. Four month after surgery serum bile acids concentrations were 0.56 $\mu$mol/l (preprandial) and 18.45 umol/l (postprandial). Abdominal radiograph showed normal gastric axis and it revealed normal size of the liver. Fine texture and increased echogenecity of liver and enlargement of portal vein were shown in ultrasonography. Single extrahepatic portosystemic shunt might be treated surgically using Ameroid constrictor.

• 한국임상수의학회지
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• 제30권4호
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• pp.273-277
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• 2013

This study was performed to compare clinical and diagnostic imaging features between asymptomatic and symptomatic extrahepatic portosystemic shunts in dogs. The data of thirty patients diagnosed with extrahepatic PSS by multi-detector CT were reviewed, and the dogs were divided into asymptomatic (9/30) and symptomatic (21/30) groups. Signalments, hematologic results, liver size, morphologic classifications and main portal vein to abdominal aortic ratio (PV/AO) at the porta hepatis level from CT images were evaluated in two groups. Shih-tzu (5/9) was the most frequent breed in asymptomatic group, and various breeds were presented in symptomatic group. Mean age of asymptomatic group ($9.2{\pm}3.2$ years) was significantly higher than that of symptomatic group ($4.5{\pm}3.2$ years). The most morphologic form of shunt vessel was the splenophrenic shunt (16/30). PV/AO of asymptomatic group ($1.1{\pm}0.19$) was significantly higher than the values of symptomatic group ($0.55{\pm}0.19$). Clinical signs, hematologic results and diagnostic imaging findings of asymptomatic PSS are too nonspecific to suspect PSS. Therefore, considering of patient's age and CT examination with application of PV/AO ratio could be useful for the diagnosis of asymptomatic PSS.

• 한국임상수의학회지
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• 제25권4호
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• pp.295-302
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• 2008

Two dogs were referred to Veterinary Medical Center, Chungbuk National University with the clinical signs of vomiting, diarrhea, anorexia, and jaundice. Both dogs were diagnosed as extrahepatic biliary tract obstruction(EHBO) with concurrent pancreatitis based on dilated common bile duct and hyperechoic or mixed-echoic pancreas in abdominal ultrasonographic examination and serum biochemical abnormalities, such as high serum bilirubin, cholesterol, and increased cholestatic enzyme activity. Percutaneous ultrasound-guided cholecytocentesis(PUCC) was performed to examine bile and decompress the gall bladder. After PUCC with medical therapy, both dogs were steadily improved clinical signs of jaundice and anorexia. Also, cholestatic enzyme activity and serum bilirubin concentration decreased. Any complications that have been described in previous studies, such as peritonitis resulting from bile leakage and hemorrhage, were not identified. It is assumed that percutaneous ultrasound guided cholecystocentesis may be an useful diagnostic and therapeutic tool in canine gallbladder disease and can be used easily and safely to gain bile for diagnosis of bacterial cholecytitis.

• 한국임상수의학회지
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• 제24권2호
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• pp.269-275
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• 2007

Two dogs referred to Veterinary Medical Center, Chungbuk National University diagnosed as multiple extrahepatic portosystemic shunt were reported. The first dog was a 20-month-old, 8 kg, male Cocker spaniel with history of peritoneal effusion, diarrhea, anorexia and stunted growth. The second dog was a 3-year-old, 13.4 kg, male Jindo with a history of severe depression. Hematologic examination of first dog revealed mild microcytosis and nonregenerative anemia. All of 2 cases, serum chemical values showed increase of serum ammonia, ALP, r-GTP and glucose. In survey radiography, microhepatia was apparent. In the color Doppler ultrasonographic examination, the first dog revealed a dilated tortuous vein communicating with caudal vena cava was observed near the left kidney and the second dog revealed numerous shunting vessels ventral to L5 and L6. Transcolonic portal scintigraphy of the first dog confirmed the presence of portosystemic shunt. In intraoperative jejunoportography, the first dog showed single congenital extrahepatic portosystemic shunt and multiple acquired extrahepatic portosystemic shunts. The second dog showed multiple acquired extrahepatic portosystemic shunts. In these dogs, the presence of congenital and acquried portosystemic shunts and histopathologic findings were considered to represent a combination of multiple extrahepatic portosystemic shunts and noncirrhotic portal hypertension or portal vein hypoplasia.