Multiple extrahepatic portosystemic shunts in dogs: 30 cases (1981-1993)
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Objective
To describe the long-term outcome in dogs with naturally developing multiple extrahepatic portosystemic shunts (PSS).
Design
Retrospective case series.
Animals
30 dogs with multiple PSS.
Procedure
Medical records of dogs with multiple PSS were reviewed. Follow-up data were obtained by 1 or more of the following methods: recheck at the veterinary teaching hospital (n = 6) or telephone contact with the referring veterinarian (n = 18) or owner (n = 10). The χ2 or Mann-Whitney rank sum test was used to determine the association of clinical factors with long-term outcome. Survival curves were generated by the Kaplan-Meier product limit method.
Results
Median age at diagnosis was 1 year. Findings on exploratory surgery in 25 dogs included ascites; numerous tortuous vessels connecting the portal vein with systemic veins; a small, misshapen liver; and an enlarged portal vein. The most common lesions on histologic evaluation of hepatic tissue specimens were hepatocellular atrophy, portal vascular duplication, cirrhosis, inflammation, and bile duct proliferation. Twelve dogs were treated surgically with vena caval banding, whereas 13 dogs were treated conservatively with dietary restriction of protein and administration of antibiotics, diuretics, and other drugs. Long-term survival and quality of life were similar in dogs from both treatment groups. Median follow-up interval in dogs that survived hospitalization was 24 months (range, 1 to 54 months).
Clinical Implications
On the basis of these findings, vena caval banding in dogs with multiple PSS is not superior to medical and nutritional treatment. (J Am Vet Med Assoc 1996;208:1849-1854)
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