A minimally invasive treatment option offered through the Mizzou Veterinary Health Center Cardiology and Small Animal Internal Medicine Service (SAIM). The patients are seen primarily by the SAIM service, and the procedure is led by the cardiologist, Dr. Anna McManamey.
For clients
For referring veterinarians
We welcome referrals for dogs with suspected or confirmed intrahepatic portosystemic shunts. Early referral allows for comprehensive diagnostic work-up and procedural planning.
If the animal has already had a confirmed diagnosis via computed tomography angiography (CTA) and is on medical therapy, please provide records and the CTA images to Mizzou for measuring and review.
If the patient is suspected to have a hepatic shunt, the case can be worked up by the SAIM service and an internal consultation with Dr. McManamey can take place after the CTA confirms an IHPSS. The cost of an initial workup and CTA is around $2,500-3,000.
**Due to the need for a stent implant, the recommendation is to wait until the patient is at least six months of age to perform the procedure to reduce the chance of implant:host mismatch.** Ideally, a CTA will be performed within three months of the procedure and after six months of age to account for any growth of the animal. The stents come in a variety of sizes and are self-expanding. The stent is selected to be 20% larger than the average diameter of the caudal vena cava as measured in multiple planes on CTA imaging.
