Effective management of portal vein thrombosis in a dog with protein-losing enteropathy
Portal vein thrombosis is an uncommon presentation in dogs with protein-losing enteropathy. Several management treatments have been attempted but the effects have been unclear in dogs with protein-losing enteropathy.
A case of an 11-year-old Yorkshire Terrier that was previously diagnosed with congenital portosystemic shunt presented with abdominal swelling one month ago. The findings showed severe hypoproteinemia with hypoalbuminemia, hypercholesterolemia, and thrombus in the portal vein was found. An endoscopy-guided intestinal biopsy was performed and the histopathological results revealed intestinal lymphangiectasia lymphoplasmacytic enteritis. This confirmed that the ascites and hypoalbuminemia were due to the protein-losing enteropathy. The dog was first treated with spironolactone and clopidogrel plus a restricted fat diet. But, no changes in the ascites and thrombus were seen. Therefore the dog additionally was given rivaroxaban and low-dose prednisolone as part of the treatment for the portal vein thrombus and lymphoplasmacytic enteritis. Rivaroxaban is a new oral anticoagulant, direct factor Xa inhibitor, and has been effective against thrombotic disorders. After this treatment, the dog showed an improvement, the ascites disappeared and the thrombus decreased in size.
This case report revealed that the combination of oral rivaroxaban and low-dose glucocorticoid was effective in the management of portal vein thrombus.
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