Successful management of portal vein thrombosis in a Yorkshire Terrier with protein-losing enteropathy
- PDF / 968,309 Bytes
- 7 Pages / 595.276 x 790.866 pts Page_size
- 25 Downloads / 183 Views
CASE REPORT
Open Access
Successful management of portal vein thrombosis in a Yorkshire Terrier with protein-losing enteropathy Yumi Sakamoto1, Kumiko Ishigaki1, Chieko Ishikawa1, Tomohiro Nakayama1, Kazushi Asano1 and Manabu Sakai1,2*
Abstract Background: Portal vein thrombosis (PVT) is a rare presentation in dogs with protein-losing enteropathy (PLE). Rivaroxaban, an oral, selective, direct factor Xa inhibitor, has not been reported to be administrated for canine PVT and the effect is unclear in dogs with PLE. Case presentation: An 11-year-old Yorkshire Terrier presented with moderate ascites. The dog had severe hypoalbuminemia (1.2 g/dL), and a portal vein thrombus was confirmed on computed tomographic angiography (CTA). On endoscopic examination, it became apparent that the hypoalbuminemia was caused by PLE, which was consequent of lymphatic dilation and lymphoplasmacytic enteritis. Therefore, the dog was initially treated with oral administrations of spironolactone and clopidogrel, with dietary fat restriction. However, a follow-up CTA showed no changes in the ascites, thrombus, and portal vein to aorta (PV/Ao) ratio. Therefore, the dog was additionally prescribed rivaroxaban and low-dose prednisolone for the portal vein thrombus and hypoalbuminemia due to lymphoplasmacytic enteritis, respectively. Following the treatment, the PV/Ao ratio decreased because of a decrease in the thrombus and the ascites disappeared completely with an elevation of albumin concentration (1.9 g/dL). Conclusions: This case report demonstrated that oral administration of rivaroxaban combined with low-dose glucocorticoid was effective management for PVT in a dog with PLE. Keywords: canine, computed tomography, portal hypertension, rivaroxaban
Background Portal vein thrombosis (PVT) due to thrombosis within the extrahepatic portal venous system is an uncommon occurrence. It mainly develops in dogs with hypercoagulability due to glucocorticoid therapy, hepatic diseases, including chronic hepatitis, congenital portosystemic shunt (CPSS), and in dogs with protein-losing enteropathy (PLE) [1–4]. In addition, chronic PVT may present * Correspondence: [email protected] 1 Department of Veterinary Medicine, College of Bioresource Sciences, Nihon University, 1866 Kameino, Kanagawa 252-0880 Fujisawa, Japan 2 Laboratory of Veterinary Hepatology & Gastroenterology, Depertment of Veterinary Medicine, College of Bioresource Sciences, Nihon University, 1866 Kameino, Kanagawa 252-0880 Fujisawa, Japan
with ascites and acquired portosystemic collaterals (APSCs) due to prehepatic portal hypertension (PH) [5]. Recently, in dogs with pancreatitis, computed tomographic angiography (CTA) was used to diagnose PVT [6, 7]. Furthermore, CTA can clearly identify the presence of APSCs and help to estimate the portal vein to aorta (PV/Ao) ratio [8]. Therefore, CTA is a powerful and accurate tool for identifying canine PVT and PH. The management of PVT in dogs has been attempted with anticoagulants and antiplatelet or thrombolytic therapy, including low
Data Loading...
