title: Circumcaval ureter associated with an intrahepatic portosystemic shunt in a dog.
abstract: METHODS
  A 4-month-old Bernese Mountain Dog was examined because of shifting hind limb lameness and lethargy of 2 weeks' duration.
  
  
  RESULTS
  The lameness was attributed to hypertrophic osteodystrophy. Portosystemic shunting was suspected on the basis of low serum albumin concentration and high serum bile acids concentration, and an intrahepatic shunt was identified ultrasono-graphically. Celiotomy was performed, and the shunt was partially closed with a cellophane band. During follow-up ultrasonography 7 months later, dilation of the left renal pelvis and proximal portion of the left ureter was identified. During exploratory celiotomy, the left ureter was found to pass dorsal to the caudal vena cava, and circumcaval ureter was diagnosed.
  
  
  RESULTS
  The ureter was transected, repositioned ventral to the vena cava, and anastomosed. Follow-up ultrasonographic examinations revealed gradual resolution of the hydronephrosis and hydroureter.
  
  
  CONCLUSIONS
  Findings suggest that circumcaval ureter should be considered in the differential diagnosis for hydronephrosis and hydroureter in dogs. Partial obstruction of the middle segment of the ureter on ultrasonograms or contrast radiographs should increase the index of suspicion for this condition.
authors.affiliation: Division of Companion Animal Sciences, Faculty of Veterinary Medicine, University of Glasgow, Glasgow G61 1QH, Scotland.
authors.forename: Ross T
authors.initials: RT
authors.lastname: Doust
authors.forename: Stephen P
authors.initials: SP
authors.lastname: Clarke
authors.forename: Gawain
authors.initials: G
authors.lastname: Hammond
authors.forename: Calum
authors.initials: C
authors.lastname: Paterson
authors.forename: Alison
authors.initials: A
authors.lastname: King
mesh_terms: D000015:Abnormalities, Multiple / Q000601:surgery / Q000662:veterinary*; D000818:Animals; D002476:Cellophane / Q000627:therapeutic use; D004283:Dog Diseases / Q000175:diagnosis* / Q000601:surgery; D004285:Dogs; D005260:Female; D007682:Kidney Pelvis / Q000000981:diagnostic imaging; D007794:Lameness, Animal / Q000209:etiology; D010535:Laparoscopy / Q000379:methods / Q000662:veterinary; D008026:Ligation / Q000379:methods / Q000662:veterinary; D011169:Portal Vein / Q000002:abnormalities* / Q000601:surgery; D016896:Treatment Outcome; D014463:Ultrasonography; D014513:Ureter / Q000002:abnormalities* / Q000000981:diagnostic imaging / Q000601:surgery*
chemical_list: D002476:Cellophane