THIS week we wanted to share a rare and interesting condition that we don’t see very often.

George is a four-month-old English bulldog puppy who was referred to our specialist internal medicine department with a history of several days of persistent vomiting and diarrhoea.

His primary care vet had also found ascites (fluid inside his tummy) and suspected a problem with the blood vessels inside his liver.

We performed a CT scan on George using a special dye which highlighted the blood vessels inside his body.

The reason for the huge amount of fluid inside his tummy was that some of the arteries in his liver were wrongly connected to the veins.

This is a very rare condition called a ‘hepatic arteriovenous malformation’ and it caused the pressure inside the veins to become so high that it was damaging his liver, bowel and other organs.

As a result, George’s body was trying to open up lots of additional blood vessels to cope with this, a condition called portosystemic shunting.

Unfortunately, this is a very serious condition and George’s outlook with medications alone was sadly not very good.

Surgery offers the potential to improve signs and liver function in the short-medium term but is not without a high degree of risk.

After discussing all of the options George’s owners felt that surgery was the best chance of giving him a good quality of life again.

Mark, one of our soft tissue surgeons, carried out a procedure to remove the portion of George’s liver that contained the malformations.

In this case it meant removing all of the central part of the liver along with the gall bladder.

George’s anaesthesia was complex and was managed by one of our dedicated soft tissue nurses alongside Toby, our specialist anaesthetist.

George is making a fantastic recovery from surgery - he spent a few days in hospital following surgery and was thrilled to go home once he was feeling better.

He has been back to see us since to have a good fuss and show off his surgical scar!

George will need ongoing medications, but he is now back to being a happy, bouncy, puppy again and we are absolutely delighted for him!