Multiple extrahepatic portosystemic shunts in dogs: 30 cases (1981-1993)

Harry W. Boothe From the Department of Veterinary Small Animal Medicine and Surgery (Boothe, Howe, Slater) and Veterinary Pathobiology (Edwards), College of Veterinary Medicine, Texas A&M University, College Station, TX 77843.

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 DVM, MS
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Lisa M. Howe From the Department of Veterinary Small Animal Medicine and Surgery (Boothe, Howe, Slater) and Veterinary Pathobiology (Edwards), College of Veterinary Medicine, Texas A&M University, College Station, TX 77843.

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John F. Edwards From the Department of Veterinary Small Animal Medicine and Surgery (Boothe, Howe, Slater) and Veterinary Pathobiology (Edwards), College of Veterinary Medicine, Texas A&M University, College Station, TX 77843.

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Margaret R. Slater From the Department of Veterinary Small Animal Medicine and Surgery (Boothe, Howe, Slater) and Veterinary Pathobiology (Edwards), College of Veterinary Medicine, Texas A&M University, College Station, TX 77843.

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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)

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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