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Clinical and clinicopathologic abnormalities in young dogs with acquired and congenital portosystemic shunts: 93 cases (2003–2008)

Fiona H. Adam BVM&S1, Alexander J. German BVSc, PhD2, J. Fraser McConnell BVM&S3, Mary R. Trehy BVetMed4, Nat Whitley BVMS, PhD, DACVIM5, Alison Collings MAVetMB6, Penny J. Watson MAVetMD7, and Rachel D. Burrow BVetMed8
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  • 1 Small Animal Teaching Hospital, University of Liverpool, Neston, Cheshire, CH64 7TE, England.
  • | 2 Small Animal Teaching Hospital, University of Liverpool, Neston, Cheshire, CH64 7TE, England.
  • | 3 Small Animal Teaching Hospital, University of Liverpool, Neston, Cheshire, CH64 7TE, England.
  • | 4 Davies Veterinary Specialists, Higham Gobion, Hertfordshire, SG5 3HR, England.
  • | 5 Davies Veterinary Specialists, Higham Gobion, Hertfordshire, SG5 3HR, England.
  • | 6 Queen's Veterinary School Hospital, University of Cambridge, Cambridge, CB3 0ES, England.
  • | 7 Queen's Veterinary School Hospital, University of Cambridge, Cambridge, CB3 0ES, England.
  • | 8 Small Animal Teaching Hospital, University of Liverpool, Neston, Cheshire, CH64 7TE, England.

Abstract

Objective—To determine whether clinical and clinicopathologic data could assist differentiation of congenital portosystemic shunts (CPSSs) from acquired portosystemic shunts (APSSs) in young dogs.

Design—Retrospective case series.

Animals—Dogs < 30 months of age with CPSSs (n = 62) or APSSs (31).

Procedures—Medical records from 3 referral centers identified 31 dogs with APSSs and 62 dogs with CPSSs diagnosed from July 2003 to July 2008. Signalment, clinical signs, physical examination, and clinicopathological data were recorded, and statistical analyses were performed to determine differences between groups.

Results—Univariable analysis showed APSS patients were older, heavier, and in poorer body condition, compared with CPSS patients. In CPSS patients, diarrhea was less prevalent, and neurologic signs were more prevalent. Ascites was more prevalent in APSS (Fisher exact test; OR, 50.2; 95% confidence interval [CI], 6.2 to 409.7), with no significant difference in albumin concentration between groups. The logistic regression model used to assess clinicopathological parameters showed lower Hct (OR, 1.42 × 10−12; 95% CI, 1.42 × 10−17 to 4.0 × 10−6), higher mean corpuscular volume (OR, 1.27; 95% CI, 1.08 to 1.50), and higher alanine aminotransferase concentrations (OR, 1.005; 95% CI, 1.001 to 1.009) were more likely in APSS patients.

Conclusions and Clinical Relevance—Several clinicopathologic differences between dogs with congenital and acquired shunts were identified; however, assessed alone, these would be unlikely to enable differentiation between the 2 conditions. Awareness of the rarity of ascites in CPSS cases should prompt recognition of a likely diagnosis of APSS, allowing the veterinarian to target further diagnostics and counsel the owner appropriately.

Abstract

Objective—To determine whether clinical and clinicopathologic data could assist differentiation of congenital portosystemic shunts (CPSSs) from acquired portosystemic shunts (APSSs) in young dogs.

Design—Retrospective case series.

Animals—Dogs < 30 months of age with CPSSs (n = 62) or APSSs (31).

Procedures—Medical records from 3 referral centers identified 31 dogs with APSSs and 62 dogs with CPSSs diagnosed from July 2003 to July 2008. Signalment, clinical signs, physical examination, and clinicopathological data were recorded, and statistical analyses were performed to determine differences between groups.

Results—Univariable analysis showed APSS patients were older, heavier, and in poorer body condition, compared with CPSS patients. In CPSS patients, diarrhea was less prevalent, and neurologic signs were more prevalent. Ascites was more prevalent in APSS (Fisher exact test; OR, 50.2; 95% confidence interval [CI], 6.2 to 409.7), with no significant difference in albumin concentration between groups. The logistic regression model used to assess clinicopathological parameters showed lower Hct (OR, 1.42 × 10−12; 95% CI, 1.42 × 10−17 to 4.0 × 10−6), higher mean corpuscular volume (OR, 1.27; 95% CI, 1.08 to 1.50), and higher alanine aminotransferase concentrations (OR, 1.005; 95% CI, 1.001 to 1.009) were more likely in APSS patients.

Conclusions and Clinical Relevance—Several clinicopathologic differences between dogs with congenital and acquired shunts were identified; however, assessed alone, these would be unlikely to enable differentiation between the 2 conditions. Awareness of the rarity of ascites in CPSS cases should prompt recognition of a likely diagnosis of APSS, allowing the veterinarian to target further diagnostics and counsel the owner appropriately.

Contributor Notes

Fiona Adam's present address is North Downs Specialist Referrals, Brewerstreet Dairy Business Park, Brewer St, Bletchingley, Surrey, RH1 4QP, England.

Mary Trehy's present address is Small Animal Teaching Hospital, University of Liverpool, Neston, Cheshire, CH64 7TE, England.

Alison Collings' present address is Anderson Moores Veterinary Specialists, The Granary, Bunstead Barns, Poles Lane, Winchester, Hampshire, SO21 2LL, England.

Dr. German's senior lectureship is funded by Royal Canin.

Presented in abstract form at the British Small Animal Veterinary Association Conference, Birmingham, West Midlands, England, April 2010.

Address correspondence to Ms. Adam (fadam@ndsr.co.uk).