Comparison of survival after surgical or medical treatment in dogs with a congenital portosystemic shunt

Abstract

Both medical and surgical treatment can be used to achieve long-term survival of dogs with CPSS, although results of statistical analysis supported the widely held belief that surgery is preferable to medical treatment. However, the study population consisted of dogs at referral clinics, which suggested that efficacy of medical treatment may have been underestimated. Although surgical intervention was associated with a better chance of long-term survival, medical management provided an acceptable first-line option. Age at examination did not affect survival, which implied that early surgical intervention was not essential. Dogs with CPSS that do not achieve acceptable resolution with medical treatment can subsequently be treated surgically.

Outcomes of cellophane banding or percutaneous transvenous coil embolization of canine intrahepatic portosystemic shunts

“…Hepatic insufficiency can cause a myriad of clinical signs, such as seizures, ataxia, obtundation, anorexia, vomiting, diarrhea, pollakiuria, stranguria, and death . The severity of these signs justifies surgical correction aimed at improving the perfusion of the deprived liver . Surgical techniques are generally classified as extravascular or intravascular and achieve partial or complete attenuation.…”

“…Surgical techniques are generally classified as extravascular or intravascular and achieve partial or complete attenuation. Complete occlusion of CIHPSS is rarely feasible without inducing unacceptable portal hypertension; instead, partial or gradual occlusion techniques have been applied most frequently . Extravascular partial suture ligation was reported most commonly in the veterinary literature through the turn of the 20th century .…”

Prospective evaluation of outcome of dogs with intrahepatic portosystemic shunts treated via percutaneous transvenous coil embolization

“…A myriad of clinical signs occur secondary to IHPSS, but those related to the neurologic, gastrointestinal, and urinary systems are most common . Treatment of IHPSS include medical, surgical, and interventional options . The long‐term implementation of medical management as a sole treatment modality for IHPSS is controversial in cases amenable to surgery or interventional radiology (IR) .…”

Incidence of Postoperative Seizures with and without Levetiracetam Pretreatment in Dogs Undergoing Portosystemic Shunt Attenuation

“…Extrahepatic shunts are frequently observed in small breed dogs, with the Yorkshire Terrier, Maltese, Shih Tzu, Dachshund, and Poodle being the most commonly reported . Surgery is the treatment of choice for CPS, with dogs undergoing vascular attenuation surviving significantly longer than those treated medically …”