CASE REPORT Veterinary Surgery 28:489-495, 1999 Caudal Vena Cava Obstruction and Ascites in a Cat Treated by Balloon Dilation and Endovascular Stent Placement DAVID HOLT, BVSc, Diplomate ACVS, H. MARK SAUNDERS, VMD, Diplomate ACVR, LILLIAN ARONSON, VMD, Diplomate ACVS, HEATHER PEIKES, VMD, MICHEAL GOLDSCHMIDT, BVSc, Diplomate ACVP, and ZIV J. HASKAL, MD, FSCVIR Objective—To present details of an unusual case of caudal vena caval obstruction and its management in a cat. Study Design—Clinical case report. Study Population—A 15 month old male castrated domestic shorthaired cat. Results—The diagnostic evaluation included the use of digital subtraction angiography and ultrasonography to locate the caudal vena caval obstruction. Treatment initially involved puncture and balloon dilation of the obstructed area of the cava. After reobstruction, the stenotic area was redilated and stented. The cat was euthanatized 4 weeks later because of vomiting, anorexia, and abnormal behavior, presumed to be associated with liver disease. Conclusion and Clinical Relevance—Interventional radiography provided a minimally invasive way to manage this unusual vascular anomaly. ©Copyright 1999 by The American College of Veterinary Surgeons A 15 MONTH OLD male neutered domestic short- haired cat was taken to the referring veterinarian for evaluation of abdominal distension which had developed over the past 2 months. The cat was kept indoors and there was no history of trauma. The cat was eating normally, and was alert and active. The only abnormalities found on physical examination were severe abdominal distension and lumbar muscle wasting. The cat weighed 5.5 kg, which was 1.3 kg more than when it was examined 3 months previously. No hematologic or biochemical abnormalities were detected. Preprandial and 2-hour post-prandial serum bile acid concentrations were normal. Serology for feline leukemia virus (FeLV), feline immunodefi- ciency virus (FIV), and feline infectious peritonitis (FIP) were negative. No abnormalities were seen on thoracic radiographs. Abdominal ultrasonography showed a large amount of peritoneal effusion. The liver lobes were rounded and contained numerous 0.2 to 0.3 cm hyperechoic nodules. The omentum was clumped. Peritoneal fluid obtained during ultrasonog- raphy was interpreted as a modified transudate. The fluid was pale yellow with a specific gravity (SG) of 1.022 and a total protein (TP) of 4.0 g/dL. The fluid red blood cell count (RBC) was 921 cells/L and the nucleated cell count was 65 cells/l. Smears from a centrifuged peritoneal fluid sample contained 46% nondegenerate neutrophils, 39% macrophages, and 15% small mature lymphoctes. No infectious agents or neoplastic cells were seen. A coagulation screen and platelet count were normal. Serology for heartworm was negative. An exploratory laparotomy was performed. A large volume of peritoneal fluid was removed via suction. All organs appeared grossly normal, except the liver, which seemed small and irregular with a thickened capsule. Liver biopsy samples were submitted. His- topathologic sections of the liver revealed dilated From the Department of Clinical Studies (DH, HMS, LA, HP) and Pathobiology (MG), University of Pennsylvania School of Veterinary Medicine, Philadelphia, PA; and the Department of Radiology (ZJH), University of Pennsylvania School of Medicine, Philadelphia, PA. Address reprint requests to David Holt, BVSc, Department of Clinical Studies, University of Pennsylvania School of Veterinary Medicine, 3850 Spruce Street, Philadelphia, PA 19104-6010. ©Copyright 1999 by The American College of Veterinary Surgeons 0161-3499/99/2806-0011$3.00/0 489