Timothy Jorge, Elisa Heacock, Joshua Hargrove, Wilfried Mai
Background
Azygos continuation of the caudal vena cava (CVC) due to segmental aplasia of the prehepatic CVC is a rare congenital anomaly in dogs. Typically incidental, this anomaly may be associated with other malformations or complications such as thrombosis. This case report describes a Doberman puppy with this vascular anomaly, uniquely complicated by thrombophlebitis—a previously unreported presentation.
Methods
A 4.5-month-old female Doberman with chronic gastrointestinal signs and acute systemic symptoms was evaluated using abdominal ultrasonography. Findings prompted euthanasia and postmortem examination, including necropsy and histopathological assessment of the vascular structures. Bacterial culture of the thrombus and infectious disease testing were also performed.
Results
Ultrasound revealed a markedly dilated renal segment of the CVC with mural thickening, echogenic luminal content, and a large thrombus. The prehepatic CVC segment was absent, and an enlarged azygos vein served as the venous conduit. Collateral venous pathways were present in the caudal abdomen. Necropsy confirmed segmental aplasia of the prehepatic CVC with azygos continuation and extensive thrombi in the renal CVC and renal veins. Histopathology revealed fibrinoid necrosis, abscessation, and inflammation consistent with phlebitis. Cultures from the thrombus grew E. coli and Enterococcus faecalis.
Limitations
The case's diagnostic evaluation was limited by the owner's decision to decline CT angiography. The etiology of the thrombophlebitis remained unclear, and the presence of bacteria could not definitively be attributed to infection versus postmortem contamination. The rarity of this presentation limits comparative analysis.
Conclusions
This report documents the first known case of thrombophlebitis complicating azygos continuation of the CVC in a dog. The vascular anomaly likely predisposed the patient to thrombus formation and vascular inflammation. Recognition of this potential complication is important for prognosis and management in similar cases, particularly when thrombotic signs are present in young dogs with suggestive imaging findings.
Ultrasound image. Acquired blood vessels in the caudal retroperitoneum, secondary to thrombosis of the azygos/renal CVC. The urinary bladder is seen just caudal to the anomalous vessels on the right side of the figure.
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