Abstract
BackgroundPortal vein thrombosis (PVT) is a rare presentation in dogs with protein-losing enteropathy (PLE). Rivaroxaban, an oral, selective, direct factor Xa inhibitor, has not been reported to be administrated for canine PVT and the effect is unclear in dogs with PLE.Case presentationAn 11-year-old Yorkshire Terrier presented with moderate ascites. The dog had severe hypoalbuminemia (1.2 g/dL), and a portal vein thrombus was confirmed on computed tomographic angiography (CTA). On endoscopic examination, it became apparent that the hypoalbuminemia was caused by PLE, which was consequent of lymphatic dilation and lymphoplasmacytic enteritis. Therefore, the dog was initially treated with oral administrations of spironolactone and clopidogrel, with dietary fat restriction. However, a follow-up CTA showed no changes in the ascites, thrombus, and portal vein to aorta (PV/Ao) ratio. Therefore, the dog was additionally prescribed rivaroxaban and low-dose prednisolone for the portal vein thrombus and hypoalbuminemia due to lymphoplasmacytic enteritis, respectively. Following the treatment, the PV/Ao ratio decreased because of a decrease in the thrombus and the ascites disappeared completely with an elevation of albumin concentration (1.9 g/dL).ConclusionsThis case report demonstrated that oral administration of rivaroxaban combined with low-dose glucocorticoid was effective management for PVT in a dog with PLE.
Highlights
Portal vein thrombosis (PVT) is a rare presentation in dogs with protein-losing enteropathy (PLE)
This case report demonstrated that oral administration of rivaroxaban combined with low-dose glucocorticoid was effective management for PVT in a dog with PLE
On the two computed tomographic angiography (CTA) images acquired after combined therapy with rivaroxaban and prednisolone (c, d), ascites was not detected and the thrombus size appears to have gradually reduced in the main portal vein
Summary
Portal vein thrombosis (PVT) is a rare presentation in dogs with protein-losing enteropathy (PLE). Conclusions: This case report demonstrated that oral administration of rivaroxaban combined with low-dose glucocorticoid was effective management for PVT in a dog with PLE. This case describes the successful management of PVT due to PLE in a Yorkshire Terrier with the administration of rivaroxaban and low-dose glucocorticoid. Based on the CTA results, the dog was diagnosed with prehepatic PH due to a portal vein thrombus.
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