Klinisches Bild und Diagnostik des angeborenen portosystemischen Shunts beim Hund

Abstract

Im Gegensatz zum Menschen, bei dem ein erworbener portosystemischer Shunt meist nur sekund?r durch Erkrankungen der Leber auftritt, kommt der portosystemische Shunt beim Hund ?fter angeboren als erworben vor. Die H?ufigkeit der Erkrankung wird kritisch diskutiert. Man geht jedoch von einer erheblichen Dunkelziffer aus, insbesondere weil die Symptome mannigfaltig sind und die Auspr?gung sehr unterschiedlich ist. Die Erkrankung z?hlt zu den beim Hund beschriebenen Erbkrankheiten.

Evaluation of the Blood Neutrophil-to-Lymphocyte Ratio (NLR) as a Diagnostic and Prognostic Biomarker in Dogs with Portosystemic Shunt

“…The results of this study confirm many previously reported aspects of PSSs in dogs. This includes that many dogs with PSSs in our study were purebred dogs, breeds commonly over-represented in studies on PSSs (e.g., Bolonka Zwetna, Yorkshire Terrier, Malteser, and Labrador Retriever), and of very young age [ 1 , 2 , 4 ]. However, some dogs included in our study had a later presentation, supporting the idea that the onset of clinical signs may occur at any age [ 1 ].…”

“…This includes that many dogs with PSSs in our study were purebred dogs, breeds commonly over-represented in studies on PSSs (e.g., Bolonka Zwetna, Yorkshire Terrier, Malteser, and Labrador Retriever), and of very young age [ 1 , 2 , 4 ]. However, some dogs included in our study had a later presentation, supporting the idea that the onset of clinical signs may occur at any age [ 1 ]. The majority of the dogs were diagnosed with an extrahepatic PSS, a more common finding in smaller breeds [ 35 ], which comprised the majority of our study population.…”

“…Portosystemic shunts (PSSs) are acquired or congenital vascular anomalies that can occur in dogs and cats [ 1 , 2 ]. The clinical signs of a PSS result from impaired liver function due to the blood bypassing the liver, connecting the vena porta via an extrahepatic or intrahepatic shunting vessel to the systemic circulation [ 2 ].…”

“…Congenital extrahepatic shunts (ehPSSs) are more common in small breeds, while congenital intrahepatic shunt vessels dominate in larger breeds [ 3 ]. The clinical signs associated with PSSs may occur at any age and include gastrointestinal (GI), urological, and central nervous system signs [ 1 ]. Some cases of PSSs may initially resemble dogs with hypoadrenocorticism (HOC) as both groups of dogs can present with similar clinical signs and overlapping clinicopathologic findings.…”

“…The diagnostic work-up of dogs presenting with a suspected PSS includes routine blood work and measurement of the ammonia concentration, a serum bile acid stimulation test (SBA-ST), urinalysis, abdominal ultrasonography, computed tomography (CT), and/or arterial portography to evaluate the presence and location of the PSS and determine the possibility of surgical attenuation or closure [ 1 , 3 , 4 ]. In dogs that are not candidates for surgical intervention, conservative medical therapy is recommended, which was reported to result in a generally lower quality of life and a shorter median survival time compared to surgical treatment in a previous study [ 5 ].…”