A​ ​4​ ​year​ ​old​ ​female​ ​spayed​ ​Yorkshire​ ​terrier​ ​was​ ​presented​ ​to​ ​Cornell’s​ ​Internal​ ​Medicine Service​ ​for​ ​evaluation​ ​of​ ​bilateral​ ​nephrolithiasis​ ​and​ ​a​ ​possible​ ​portosystemic​ ​shunt.​ ​ She​ ​was initially​ ​presented​ ​to​ ​her​ ​primary​ ​care​ ​veterinarian​ ​for​ ​chronic​ ​intermittent​ ​vomiting​ ​and polydipsia.​ ​ Abdominal​ ​radiographs​ ​disclosed​ ​bilateral​ ​(mineralized)​ ​nephroliths.​ ​ Bloodwork disclosed​ ​reduced​ ​albumin​ ​and​ ​blood​ ​urea​ ​nitrogen​ ​(BUN)​ ​concentrations​ ​and​ ​increased​ ​liver enzyme​ ​activity​ ​(ALT,​ ​AST).​ ​ Pre-​ ​and​ ​post-prandial​ ​bile​ ​acid​ ​concentrations​ ​were​ ​markedly increased.​ ​ Additional​ ​diagnostic​ ​testing​ ​demonstrated​ ​a​ ​subnormal​ ​Protein​ ​C​ ​activity,​ ​(59%, reference​ ​range​ ​75-135%).​ ​​ ​An​ ​abdominal​ ​ultrasound​ ​and​ ​computed​ ​tomographic​ ​angiography (CT-A)​ ​confirmed​ ​a​ ​splenophrenic​ ​portosystemic​ ​shunt.​ ​Shunt​ ​ligation​ ​with​ ​intraoperative portograms​ ​(pre​ ​&​ ​post​ ​portal​ ​vein​ ​attenuation)​ ​and​ ​monitoring​ ​splanchnic​ ​portal​ ​pressure suggested​ ​low​ ​risk​ ​of​ ​post-operative​ ​portal​ ​hypertension​ ​with​ ​complete​ ​shunt​ ​attenuation.​ ​ The splenophrenic​ ​extrahepatic​ ​shunt​ ​was​ ​completely​ ​ligated.​ ​​ ​Staghorn​ ​nephroliths​ ​were​ ​surgically removed​ ​via​ ​bilateral​ ​nephrotomy.​ ​Surgical​ ​treatment​ ​was​ ​successful​ ​with​ ​subsequent normalization​ ​of​ ​liver​ ​enzyme​ ​&​ ​Protein​ ​C​ ​activity​ ​as​ ​well​ ​as​ ​concentrations​ ​of​ ​albumin​ ​and BUN.​ ​The​ ​dog​ ​continues​ ​to​ ​do​ ​well​ ​at​ ​home.