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ID:	51167Specialists from Willows worked together to carry out pioneering minimally-invasive liver shunt surgery on a family’s beloved pet dog.

Bertie the cavapoo’s happy demeanour had disguised a potentially life-threatening congenital defect, which was only picked up after specialists at the multidisciplinary Willows Veterinary Centre and Referral Service, in Solihull, examined the puppy.

Bertie had been born with an intrahepatic liver shunt, an abnormality of blood vessels which can lead to diverse symptoms and, in some cases, even prove fatal.
The expert multidisciplinary team at Willows closely monitored Bertie as a pup for a 12-month period until he was fully grown, the point at which the corrective procedure could be carried out.

Chris Shales, an RCVS and European specialist in small animal surgery at Willows discussed Bertie’s abnormality with colleagues in the interventional radiology (IR) service at Willows which included specialists in cardiology (Chris Linney) and internal medicine (Andrew Kent). Following a comprehensive review, the IR service was pleased to accept Bertie for minimally invasive, rather than open, surgery.

Chris Shales said: “Intrahepatic shunts can carry significant risk during the dissection in open surgery, and so in light of the CT scan results of Bertie’s shunt, the decision was made to offer a minimally invasive technique known as Percutaneous trans-venous coil embolisation (PTCE) instead.

“Prior to the PTCE, Bertie underwent a special CT technique to allow our specialist radiology team to assess his vascular anatomy and allow measurement of the vessels running through his liver.

“These measurements were then used to order specialised implants from America, tailored precisely to Bertie’s needs.

“During the procedure, Chris, Andrew and I relied on the excellent care provided by one Willows’ specialist veterinary anaesthetists, Jacques Ferreira, and a team of highly skilled theatre nurses.

“PTCE involves a small skin incision in the neck, over the jugular vein. The equipment is then passed down the jugular, through the heart and into the liver where the abnormal vessel was closed using coils.
“Throughout the procedure, the team used fluoroscopy equipment, which is similar to watching real-time X-rays, to ensure we were operating on the correct vessels within the liver.
“Everything went really well. Bertie made an excellent recovery and was able to return home the following morning.

“Over the next few weeks, he was weaned off his medications and is now doing very well.”

The journey from diagnosis to the successful surgery was a concerning time for Bertie’s owners Dawn and Paul Matthews, from Solihull, however they are now delighted their beloved cavapoo is fully fit and enjoying life.
Paul, 65, revealed: “The first sign of a problem was when he was just a small puppy and we noticed his urine was pink.

“We took him straight to the general practice vets at Willows were they performed a number of tests and scans. First, they discovered some kidney stones, which is unusual in a dog so young, and then they found the real problem.

“The good news was there was a solution, the specialists did, however, advise against carrying out the corrective procedure until Bertie was fully grown, so he spent 12 months on medication and a special diet to manage the condition.”
Dawn, 54, said: “We’d waited 12 months for Bertie to be old enough to have this procedure done and then suddenly it was all sorted in no time.

“It was amazing and we can’t thank Chris Shales and the team at Willows enough. They were simply excellent.”