Case Study: CVC Thrombus

Clinical Snapshot: Caudal Vena Cava Thrombus

Video 1. The right adrenal gland. Note the thickened, irregular, hypoechoic cranial pole of the right adrenal gland.

Video 2. Fanning from the right adrenal gland cranially to view the caudal vena cava. Note the echogenic thrombus within the lumen of the vena cava.

Video 3. Color flow Doppler view of the caudal vena cava. Note the echogenic thrombus in the lumen of the vena cava that interupts flow. Flow is present around the periphery of the thrombus.

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Caudal Vena Cava Thrombus Figure 1
Figure 1

The right adrenal gland. Note the thickened, irregular cranial pole of the right adrenal gland.

Caudal Vena Cava Thrombus Figure 2
Figure 2

A normal right adrenal gland for comparison.

Caudal Vena Cava Thrombus Figure 3
Figure 3

The caudal vena cava just cranial to the right adrenal gland. Note the echogenic thrombus in the lumen.

Caudal Vena Cava Thrombus Figure 4
Figure 4

Still image of color flow Doppler applied over the CVC thrombus. Note the interuption of flow (this is best viewed in video 3).

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Clinical Snapshot

A ten-year-old neutered male Pointer mix dog was presented with an acute history of lateral recumbancy, vertical nystagmus, opisthotonus and an inability to rise. Femoral pulse quality was poor. Intracranial disease, such as thromboembolism or neoplasia was suspected. A CBC and blood chemistry profile was unremarkable. Thoracic radiographs were normal. Abdominal radiographs revealed a mass in the region of the liver. Abdominal ultrasound revealed a liver mass, as well as an abnormal, thickened, irregular, hypoechoic cranial pole of the right adrenal gland (Video 1 & Figure 1). Just cranial to the right adrenal gland, an echogenic thrombus was imaged in the caudal vena cava (Video 2 and Figure 3 ). Color flow Doppler revealed partial occlusion of the caudal vena cava (Video 3 and Figure 4 ). Adrenal hyperplasia, primary neoplasia or metastatic neoplasia with secondary thrombosis of the caudal vena cava and intracranial thromboembolism was suspected. The owners opted for euthanasia. A post mortem exam was not performed.

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