Transjugular coil embolization of an intrahepatic portosystemic shunt in a cat

A 4-month-old male domestic shorthair cat was evaluated for intermittent tremors, ptyalism, and signs of depression. The cat was small, thin, and unthrifty. Clinically important serum biochemical abnormalities included low blood urea nitrogen concentration and high baseline bile acids concentration. Abdominal ultrasonography and jejunal portography identified an intrahepatic portosystemic shunt. The cat was anesthetized, and a transjugular approach was used for percutaneous coil embolization of the shunt. Guidewires, catheters, and coils were inserted under fluoroscopic guidance to locate the shunt and define its anatomy, measure portal vein pressures before and after temporary balloon occlusion, and place thrombogenic coils to completely attenuate the anomalous vessel. The cat recovered without complications and was weaned from medical management. Ten weeks following the procedure, clinical signs had completely resolved, and baseline bile acids concentration was near reference range. Results in this cat illustrate that interventional radiology techniques can be safely used in small animals and may reduce the morbidity and mortality rates associated with traditional surgical procedures.