Please note that the initial imaging technique of choice for patients with suspected portosystemic shunt is ultrasound rather than CT, as voted by imaging specialists at the EAVDI (European Association of Veterinary Diagnostic Imaging) annual conference in Wales in 2015 at which there was an expert panel discussion on portosystemic shunt imaging. This was based on the following factors:
1. requirement for immediate diagnosis (differentiation from juvenile liver disease) to allow appropriate immediate medical management
2. high sensitivity for accurate diagnosis of cPSS via ultrasound (95-99% in experienced hands – that’s me!)
3. the desire to avoid anaesthesia and risks of contrast administration on a repeated basis and at an early stage
4. the ability to then schedule portosystemic shunt surgery at a later time when the patient is medically stable to undergo anaesthesia, which will then only be required once (CT may well then be performed immediately prior to surgery if the surgeon requires)
This was their expert recommendation for imaging, and it also allows for retention of the patient in your own practice, until such a time as surgery is required. Great news for ultrasonographers and general practitioners alike!