Buonanno A M, Carlson G P, Kantrowitz B
Department of Medicine, School of Veterinary Medicine, University of California, Davis 95616.
J Am Vet Med Assoc. 1988 Feb 1;192(3):387-9.
Portosystemic shunt was diagnosed in a 6-month-old Quarter Horse filly with acute onset of apparent blindness and a 3-month history of depression, lethargy, and ataxia. Clinicopathologic test results indicated slightly high gamma-glutamyl transpeptidase activity and serum total bilirubin concentration. Sulfobromophthalein half time was prolonged, and plasma ammonia and serum bile acid concentrations were high as well. Histopathologic findings of percutaneous liver biopsy included widespread hepatocyte atrophy and numerous prominent small arterioles in the area of the portal triad. On the basis of history, clinical findings, and clinicopathologic abnormalities, a presumptive diagnosis of portosystemic vascular anomaly was made. To confirm the tentative diagnosis, nuclear hepatic scintigraphy and operative mesenteric portography were performed. Medical treatment was unsuccessful, and the foal was euthanatized. Portosystemic shunts have been described in dogs and cats, but few cases have been reported in large animal species. Other, more common causes of neurologic abnormalities in foals, such as trauma, vertebral body abscesses, brain abscesses, and meningitis, must be ruled out before portosystemic shunt is considered.
一匹6个月大的夸特马小母马被诊断为门体分流，该马突然出现明显失明，并有3个月的抑郁、嗜睡和共济失调病史。临床病理检查结果显示γ-谷氨酰转肽酶活性略高，血清总胆红素浓度略有升高。磺溴酞钠半值期延长，血浆氨和血清胆汁酸浓度也很高。经皮肝活检的组织病理学发现包括广泛的肝细胞萎缩以及门三联区有许多明显的小动脉。根据病史、临床症状和临床病理异常，初步诊断为门体血管异常。为了确诊这一初步诊断，进行了肝脏核素闪烁扫描和手术肠系膜门静脉造影。药物治疗未成功，这匹小马驹最终被实施安乐死。门体分流在犬猫中已有报道，但在大型动物中报道的病例较少。在考虑门体分流之前，必须排除小马驹神经功能异常的其他更常见原因，如创伤、椎体脓肿、脑脓肿和脑膜炎。
