A 5 ½ month old, intact female mixed breed dog was referred to Cornell University Hospital for Animals (CUHA) Internal Medicine service for evaluation of a portosystemic shunt (PSS) that was diagnosed by elevated serum bile acid levels and an abdominal ultrasound. The patient originally presented to the referring veterinarian for altered gait and unresponsiveness, as well as lethargy, post-feeding. On presentation, the patient was bright, alert, and responsive with normal vital parameters. Other than a non-reducible abdominal hernia palpated, the patient had an unremarkable physical exam. A computed tomographic angiogram performed on the patient’s abdomen confirmed a definitive diagnosis of a portocaval shunt with intrahepatic localization. Shunt attenuation by ligation was performed along with an ovariohysterectomy and umbilical hernia repair. Post-operative management included frequent veterinary visits with blood work submissions and medical management. Two months following the procedure, the patient continued to be healthy.