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MRI findings in two West Highland White Terrier dogs with hepatic encephalopathy secondary to portosystemic shunt
  1. Ricardo Fernandes1,
  2. Colin Driver1,
  3. J H Rose1 and
  4. Clare Rusbridge1,2
  1. 1Department of Neurology and Neurosurgery, Fitzpatrick referrals, Godalming, UK
  2. 2School of Veterinary Medicine, University of Surrey, Guildford, UK
  1. Correspondence to Ricardo Fernandes; ricfer82{at}


A portosystemic shunt is an abnormal communication between the portal vascular system and the systemic circulation. A significant number of clinical signs associated with portosystemic shunting result from hepatic encephalopathy (HE); a syndrome encompassing neurological signs such as including changes in behaviour, ataxia, unresponsiveness, pacing, circling, blindness, seizures, coma and death. We present two West Highland White Terrier dogs diagnosed with HE based on clinical signs, bile acid stimulation test and imaging of the abnormal vessel communicating the portal and the systemic circulation. Magnetic resonance sequences of the brain revealed a poorly marginated and diffuse, bilateral and symmetric hyperintense lesions on T2-weighted, fluid attenuation inversion recovery and diffusion-weighted sequences relative to the brain parenchyma including the medial longitudinal fasciculus and reticular formation in the brainstem. No abnormalities were detected on T1-weighted sequences.

  • canine
  • metabolic encephalopathy
  • brainstem
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  • Contributors The cases reported here were originally by the first author who had clinical guidance of the second, third and fourth authors. This manuscript was written by the first author and reviewed by the remaining authors prior submission.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement No additional data are available.

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