Multiple vascular anomalies in a regurgitating German shepherd puppy

Five cardio-thoracic vascular anomalies were detected in a German shepherd puppy. The patent ductus arteriosus (PDA) was detected on physical examination (5/6 continuous murmur) and confirmed by echocardiogram. The persistent right aortic arch (PRAA) was suspected by the signalment and history of the patient, and confirmed by survey thoracic radiographs (leftward deviation of the trachea cranial to the heart on the ventrodorsal projection). The ventrally deviated trachea cranial to the heart on the right lateral thoracic radiograph was suggestive of a persistent retroesophageal left subclavian artery and confirmed at surgery. The persistent left cranial vena cava and the left azygous vein were detected at surgery. This case report gives a thorough description of the clinical signs, diagnostics and treatments required for the detection and successful resolution of PRAA. The report describes the importance of having experienced surgeons who can recognize vascular anomalies associated with PRAA in order to successfully alleviate the arch and the coinciding oesophageal stricture without compromising vital blood supplies.