Clinical outcome of congenital extrahepatic portosystemic shunt attenuation in dogs aged five years and older: 17 cases (1992-2005)

J Am Vet Med Assoc. 2008 Mar 1;232(5):722-7. doi: 10.2460/javma.232.5.722.

Abstract

Objective: To assess the outcome of extrahepatic portosystemic shunt (EHPSS) treatment in dogs aged 5 years and older.

Design: Retrospective case series.

Animals: 17 client-owned dogs.

Procedures: Medical records for dogs (> or = 5 years old) that underwent surgical attenuation of an EHPSS (1992 through 2005) were evaluated; data, including clinical signs, clinicopathologic findings, surgical procedure, and outcome, were recorded. Follow-up information was obtained via patient examination or telephone interview with veterinarians and owners.

Results: Dogs (5 to 9 years old [median age, 6.6 years]) had neurologic (n = 12), urinary tract (8), and gastrointestinal tract (6) EHPSS-associated clinical signs. Serum bile acids and ammonia concentrations were abnormal in all evaluated dogs. Treatment of EHPSSs included complete (n = 6 dogs) or partial (2) suture attenuation or ameroid constrictor placement (9). Two dogs died following surgery. Follow-up information (6 to 120 months) was available for 13 dogs. Deaths were attributable to heart failure (n = 1), bacterial hepatitis (2; with pyelonephritis in 1 dog), and unknown causes (3). At a median of 23 and 25 months, serum bile acids concentrations had almost normalized in 5 of 8 dogs and ammonia concentrations were within reference limits in 3 of 5 dogs, respectively; dogs with abnormal liver function test results had no associated clinical signs. Median long-term survival time was 72 months.

Conclusions and clinical relevance: Attenuation of EHPSS in > or = 5-year-old dogs ameliorated signs of liver dysfunction in surviving dogs, although return of normal liver function occurred less frequently than expected.

MeSH terms

  • Age Factors
  • Ammonia
  • Animals
  • Dogs / abnormalities*
  • Dogs / surgery*
  • Female
  • Follow-Up Studies
  • Ligation
  • Male
  • Portal System / abnormalities*
  • Portal System / surgery*
  • Postoperative Complications / epidemiology
  • Postoperative Complications / mortality
  • Postoperative Complications / veterinary
  • Postoperative Period
  • Retrospective Studies
  • Survival Analysis
  • Time Factors
  • Treatment Outcome

Substances

  • Ammonia