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Konstantinidis AO, Patsikas MN, Papazoglou LG, Adamama-Moraitou KK. Congenital Portosystemic Shunts in Dogs and Cats: Classification, Pathophysiology, Clinical Presentation and Diagnosis. Vet Sci 2023; 10:vetsci10020160. [PMID: 36851464 PMCID: PMC9961057 DOI: 10.3390/vetsci10020160] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 02/07/2023] [Accepted: 02/14/2023] [Indexed: 02/19/2023] Open
Abstract
Congenital portosystemic shunts (CPSS) are abnormal vascular communications between the portal and the systemic circulation, bypassing the hepatic parenchyma and resulting in liver hypoplasia and hepatic insufficiency. Such connections develop in utero and persist postnatally. CPSS are among the two most common congenital vascular anomalies of the liver in small animals, along with primary hypoplasia of the portal vein without portal hypertension (PHPV without PH). CPSS can be extrahepatic (ECPSS), most commonly diagnosed in small and toy breed dogs and cats, or intrahepatic (ICPSS), most commonly seen in large breed dogs. Single ECPSS is the most common type encountered in both dogs and cats. Clinical signs of CPSS are non-specific and may wax and wane, while laboratory findings can raise clinical suspicion for CPSS, but they are also not specific. Definitive diagnosis will be established by evaluation of liver function tests, such as determination of fasting plasma ammonia (FA) levels, and pre- and postprandial serum bile acids concentrations, and diagnostic imaging. The purpose of this article is to review the definition, classification, pathogenesis, clinical presentation, and diagnosis of CPSS in dogs and cats, highlighted by the authors' clinical experience.
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Affiliation(s)
- Alexandros O. Konstantinidis
- Companion Animal Clinic (Medicine Unit), School of Veterinary Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54627 Thessaloniki, Greece
- Correspondence:
| | - Michail N. Patsikas
- Laboratory of Diagnostic Imaging, School of Veterinary Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54627 Thessaloniki, Greece
| | - Lysimachos G. Papazoglou
- Companion Animal Clinic (Surgery and Obstetrics Unit), School of Veterinary Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54627 Thessaloniki, Greece
| | - Katerina K. Adamama-Moraitou
- Companion Animal Clinic (Medicine Unit), School of Veterinary Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54627 Thessaloniki, Greece
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Wilson S, Culp WTN, Wisner ER, Cissell DD, Finn JP, Zwingenberger AL. Ferumoxytol-enhanced magnetic resonance angiography provides comparable vascular conspicuity to CT angiography in dogs with intrahepatic portosystemic shunts. Vet Radiol Ultrasound 2021; 62:463-470. [PMID: 33634935 DOI: 10.1111/vru.12963] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 01/08/2021] [Accepted: 01/10/2021] [Indexed: 11/26/2022] Open
Abstract
Computed tomography angiography (CTA) is currently the gold standard imaging modality for anatomically characterizing canine hepatic vascular anomalies; with conventional, gadolinium-enhanced MR angiography being less frequently utilized. However, both imaging modalities are limited by a brief, first pass peak of contrast medium in the vasculature that necessitates precisely timed image acquisition. A long-acting purely intravascular magnetic resonance imaging (MRI) contrast agent, ferumoxytol, offers the potential to reduce complexity of magnetic resonance angiography (MRA) protocol planning by ensuring diagnostic contrast medium concentration in all the vessels that are targeted for imaging. Aims of this prospective, pilot, methods comparison study were to develop an optimized MRA protocol using ferumoxytol in dogs with hepatic vascular anomalies, perform a dose escalation trial to compare image quality with four-dose regimens of ferumoxytol, and compare accuracy of vascular anatomic depiction based on the gold standard of CTA. Six dogs (10.7-36.1 kg) with portosystemic shunts (four intrahepatic left divisional shunts and two intrahepatic right divisional shunts) were recruited for inclusion in the study. A dose-escalation trial was performed to compare image quality at four incremental dose levels of ferumoxytol (1, 2, 3, and 4 mg/kg) and to compare the accuracy of vascular anatomic detection to CTA. Ferumoxytol contrast-enhanced MRA (CE-MRA) at 4 mg/kg provided similar conspicuity of normal and abnormal vasculature compared to CTA with a minimal decrease in spatial resolution. Findings indicated that ferumoxytol holds promise for comprehensive, single breath hold CE-MRA of all abdominal vessels in dogs with portosystemic shunts. Background information provided in this study can be used to support development of other future applications such as intracranial and cardiac MRA, real-time imaging, flow quantification, and potentially sedated MRI imaging.
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Affiliation(s)
- Sabrina Wilson
- Department of Surgical and Radiological Sciences, University of California Davis, School of Veterinary Medicine, Davis, California, USA
| | - William T N Culp
- Department of Surgical and Radiological Sciences, University of California Davis, School of Veterinary Medicine, Davis, California, USA
| | - Erik R Wisner
- Department of Surgical and Radiological Sciences, University of California Davis, School of Veterinary Medicine, Davis, California, USA
| | - Derek D Cissell
- Department of Surgical and Radiological Sciences, University of California Davis, School of Veterinary Medicine, Davis, California, USA
| | - J Paul Finn
- Diagnostic Cardiovascular Imaging Research Laboratory, Department of Radiology, David Geffen School of Medicine, University of California Los Angeles, School of Medicine, Davis, California, USA
| | - Allison L Zwingenberger
- Department of Surgical and Radiological Sciences, University of California Davis, School of Veterinary Medicine, Davis, California, USA
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Plested MJ, Zwingenberger AL, Brockman DJ, Hecht S, Secrest S, Culp WTN, Drees R. Canine intrahepatic portosystemic shunt insertion into the systemic circulation is commonly through primary hepatic veins as assessed with CT angiography. Vet Radiol Ultrasound 2020; 61:519-530. [PMID: 32663370 DOI: 10.1111/vru.12892] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Revised: 03/15/2020] [Accepted: 04/27/2020] [Indexed: 02/06/2023] Open
Abstract
Congenital intrahepatic portosystemic shunts (IHPSS) in dogs are traditionally classified as right, left, or central divisional. There are few descriptive studies regarding the variation of IHPSS within these categories. This multicenter, analytical, cross-sectional study aimed to describe a large series of dogs with CT angiography (CTA) of IHPSS, hypothesizing that there would be variation to the existing classification. Ninety CTA studies were assessed for IHPSS type, insertion, and the relationship of the insertion to the primary hepatic veins. Ninety-two percent of IHPSS inserted into a primary hepatic vein (HV) or phrenic vein, 8% inserted directly into the ventral aspect of the intrahepatic caudal vena cava. The most common IHPSS type was a single right divisional (44%), including those inserting via the right lateral HV or the caudate HV. Left divisional IHPSS (33%) inserted into the left HV or left phrenic vein. Central divisional IHPSS (13%) inserted into the quadrate HV, central HV, dorsal right medial HV, or directly into the ventral aspect of the intrahepatic caudal vena cava. Multiple sites of insertion were seen in 9% of dogs. Within left, central, and right divisional types, further subclassifications can therefore commonly be defined based on the hepatic veins with which the shunting vessel communicates. Relating IHPSS morphology to the receiving primary HV could make IHPSS categorization more consistent and may influence the type and method of IHPSS attenuation recommended.
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Affiliation(s)
- Mark J Plested
- Department of Clinical Sciences and Services, Royal Veterinary College, University of London, North Mymms, Hertfordshire, UK
| | - Allison L Zwingenberger
- Department of Surgical and Radiological Sciences, Davis, School of Veterinary Medicine, University of California, Davis, California, USA
| | - Daniel J Brockman
- Department of Clinical Sciences and Services, Royal Veterinary College, University of London, North Mymms, Hertfordshire, UK
| | - Silke Hecht
- Department of Small Animal Clinical Sciences, University of Tennessee, Knoxville, Tennessee, USA
| | - Scott Secrest
- Department of Veterinary Biosciences and Diagnostic Imaging, University of Georgia College of Veterinary Medicine, Athens, Georgia, USA
| | - William T N Culp
- Department of Small Animal Clinical Sciences, University of Tennessee, Knoxville, Tennessee, USA
| | - Randi Drees
- Department of Clinical Sciences and Services, Royal Veterinary College, University of London, North Mymms, Hertfordshire, UK
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Plested MJ, Drees R. Survey of surgical specialists' content preferences in radiology reports for extrahepatic portosystemic shunts. Vet Radiol Ultrasound 2019; 60:316-322. [PMID: 30851002 DOI: 10.1111/vru.12730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Revised: 12/06/2018] [Accepted: 01/10/2019] [Indexed: 11/30/2022] Open
Abstract
The aim of this prospective, survey study was to assess the opinions of specialist surgeons as to the preferred content, nomenclature, and classification of extrahepatic portosystemic shunts for inclusion in radiology reports. A link to an online survey was sent by email to members of the European College of Veterinary Surgeons and the Association of Veterinary Soft Tissue Surgeons, and was made available on the American College of Veterinary Surgeons web forum and Facebook page. There were 93 respondents (survey sent to over 2500 email addresses and made available in two online locations). Most respondents agreed that they both review the images themselves (87/92, 95%) and read the radiology report (82/92, 89%) prior to surgery. Most respondents believed that the radiology report should contain a detailed anatomic description of the insertion (83/92, 90%), origin (54/91, 59%), and course (70/92, 76%) of the shunt, as well as a measure of the diameter of the shunting vessel at its insertion (54/92, 59%). Most respondents (70/90, 78%) disagreed that a brief description of shunt type, such as portocaval or portophrenic, was sufficient. Respondents were undecided regarding the use of an alphanumeric classification system (36/92, 39% agree; 32/92, 35% disagree). There was agreement that details of the presence or absence of urolithiasis (91/93, 98%), renomegaly (54/93, 58%), and peritoneal fluid (72/92, 78%) should be included in the report. The results of this study will help to guide reporting radiologists in providing descriptions of extrahepatic portosystemic shunts that include information most preferred by the recipient surgeons.
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Affiliation(s)
- Mark J Plested
- Department of Clinical Sciences and Services, The Royal Veterinary College, University of London, North Mymms, UK
| | - Randi Drees
- Department of Clinical Sciences and Services, The Royal Veterinary College, University of London, North Mymms, UK
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Bertolini G. Anomalies of the Portal Venous System in Dogs and Cats as Seen on Multidetector-Row Computed Tomography: An Overview and Systematization Proposal. Vet Sci 2019; 6:vetsci6010010. [PMID: 30678218 PMCID: PMC6466037 DOI: 10.3390/vetsci6010010] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Revised: 01/13/2019] [Accepted: 01/16/2019] [Indexed: 01/01/2023] Open
Abstract
This article offers an overview of congenital and acquired vascular anomalies involving the portal venous system in dogs and cats, as determined by multidetector-row computed tomography angiography. Congenital absence of the portal vein, portal vein hypoplasia, portal vein thrombosis and portal collaterals are described. Portal collaterals are further discussed as high- and low-flow connections and categorized in hepatic arterioportal malformation, arteriovenous fistula, end-to-side and side-to-side congenital portosystemic shunts, acquired portosystemic shunts, cavoportal and porto-portal collaterals. Knowledge of different portal system anomalies helps understand the underlying physiopathological mechanism and is essential for surgical and interventional approaches.
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Affiliation(s)
- Giovanna Bertolini
- San Marco Veterinary Clinic and Laboratory, via dell'Industria 3, 35030 Veggiano, Padova, Italy.
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Culp WTN, Griffin MA. Interventional Radiology Management of Vascular Malformations: Portosystemic Shunts and Vascular Fistulae/Malformations. Vet Clin North Am Small Anim Pract 2018; 48:781-795. [PMID: 29933944 DOI: 10.1016/j.cvsm.2018.05.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Vascular malformations are abnormal connections between blood vessels that can have various endothelial characteristics. Although uncommon, these malformations can present challenging diagnostic and therapeutic scenarios. The use of interventional radiology techniques in the management of various vascular malformations is an attractive option because of the ability to treat these malformations at the most appropriate anatomic location and in the most effective manner. Techniques such as coil embolization of intrahepatic portosystemic shunts and liquid embolization of arteriovenous fistulae/malformations have shown tremendous potential as treatments for these challenging diseases.
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Affiliation(s)
- William T N Culp
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California-Davis, One Shields Avenue, Davis, CA 95616, USA.
| | - Maureen A Griffin
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California-Davis, One Shields Avenue, Davis, CA 95616, USA
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Aarsvold S, Solano M, Garcia-Lopez J. Magnetic resonance imaging following regional limb perfusion of gadolinium contrast medium in 26 horses. Equine Vet J 2018; 50:649-657. [PMID: 29417635 DOI: 10.1111/evj.12818] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2017] [Revised: 12/13/2017] [Accepted: 01/26/2018] [Indexed: 01/27/2023]
Abstract
BACKGROUND Systemic administration of gadolinium contrast medium is common in small animals to increase lesion conspicuity and determine vascularisation of lesions identified with magnetic resonance imaging (MRI); however, the large volume required for systemic administration limits its use in horses. OBJECTIVES The purpose of this study was to assess the feasibility of administering a low dose of contrast medium via venous regional limb perfusion. STUDY DESIGN Prospective clinical study. METHODS Distal limbs of 26 horses (one limb per horse) were imaged with MRI before and after administration of 5 mL of gadopentetate dimeglumine (Magnevist® ) diluted with 5 mL of physiological saline via a palmar/plantar digital vein with a tourniquet in place at the level of the mid aspect of the third metacarpal/metatarsal bone. Commonly assessed structures of the equine distal limb were examined for normal and abnormal contrast enhancement. RESULTS Twenty-five of 26 horses had adequate contrast enhancement of their distal limb. The lack of adequate contrast enhancement in one limb was likely associated with failure of the tourniquet. No adverse reactions were identified in any horse. One hundred thirty-two lesions were detected, of which, 69 contrast enhanced. Twelve lesions were detected exclusively following contrast enhancement. MAIN LIMITATIONS Case numbers and lesion variability yielded insufficient data to perform statistical analyses. Histopathology was not performed on sound horses to determine if the imaged structures were normal. CONCLUSIONS Regional limb perfusion is a feasible method to administer gadolinium contrast material to the equine distal limb for MRI. The enhancement pattern of the equine distal limb in sound horses is described. Contrast enhanced MRI of the distal equine limb helps to further characterise lesions identified with precontrast images, including adhesions and deep digital flexor tendinopathy. Contrast enhanced MRI also aids in identification of additional lesions, such as neovascularisation.
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Affiliation(s)
- S Aarsvold
- Department of Clinical Sciences, Cummings School of Veterinary Medicine at Tufts University, North Grafton, Massachusetts, USA
| | - M Solano
- Department of Clinical Sciences, Cummings School of Veterinary Medicine at Tufts University, North Grafton, Massachusetts, USA
| | - J Garcia-Lopez
- Department of Clinical Sciences, Cummings School of Veterinary Medicine at Tufts University, North Grafton, Massachusetts, USA
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Parry AT, White RN. Comparison of computed tomographic angiography and intraoperative mesenteric portovenography for extrahepatic portosystemic shunts. J Small Anim Pract 2016; 58:49-55. [DOI: 10.1111/jsap.12596] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2016] [Revised: 07/28/2016] [Accepted: 08/31/2016] [Indexed: 12/24/2022]
Affiliation(s)
- A. T. Parry
- Willows Referral Service; Solihull West Midlands B90 4NH
| | - R. N. White
- School of Veterinary Medicine and Science; University of Nottingham, Sutton Bonington Campus; Leicestershire LE12 5RD
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White RN, Parry AT. Morphology of congenital portosystemic shunts involving the left colic vein in dogs and cats. J Small Anim Pract 2016; 57:247-54. [DOI: 10.1111/jsap.12454] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2015] [Revised: 01/11/2016] [Accepted: 01/22/2016] [Indexed: 12/31/2022]
Affiliation(s)
- R. N. White
- School of Veterinary Medicine and Science; University of Nottingham; Sutton Bonington Campus Leicestershire LE12 5RD
| | - A. T. Parry
- Willows Referral Service; Highlands Road, Shirley Solihull West Midlands B90 4NH
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White RN, Parry AT. Morphology of splenocaval congenital portosystemic shunts in dogs and cats. J Small Anim Pract 2015; 57:28-32. [PMID: 26563977 DOI: 10.1111/jsap.12414] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2015] [Revised: 09/01/2015] [Accepted: 09/23/2015] [Indexed: 01/21/2023]
Affiliation(s)
- R. N. White
- Willows Referral Service, Shirley; Solihull West Midlands B90 4NH
| | - A. T. Parry
- Willows Referral Service, Shirley; Solihull West Midlands B90 4NH
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Parry AT, White RN. Portal vein anatomy in the dog: comparison between computed tomographic angiography (CTA) and intraoperative mesenteric portovenography (IOMP). J Small Anim Pract 2015; 56:657-61. [DOI: 10.1111/jsap.12392] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2015] [Revised: 05/18/2015] [Accepted: 06/26/2015] [Indexed: 02/02/2023]
Affiliation(s)
- A. T. Parry
- Department of Clinical Sciences and Services; The Royal Veterinary College, University of London; North Mymms Herts AL9 7TA
| | - R. N. White
- Willows Referral Service; Highlands Road, Shirley Solihull West Midlands B90 4NH
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Thieman Mankin KM. Current Concepts in Congenital Portosystemic Shunts. Vet Clin North Am Small Anim Pract 2015; 45:477-87. [DOI: 10.1016/j.cvsm.2015.01.008] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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White RN, Parry AT. Morphology of congenital portosystemic shunts involving the right gastric vein in dogs. J Small Anim Pract 2015; 56:430-40. [PMID: 25871881 DOI: 10.1111/jsap.12355] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2014] [Revised: 01/28/2015] [Accepted: 02/18/2015] [Indexed: 12/12/2022]
Affiliation(s)
- R. N. White
- Willows Referral Service; Highlands Road, Shirley Solihull West Midlands B90 4NH
| | - A. T. Parry
- Willows Referral Service; Highlands Road, Shirley Solihull West Midlands B90 4NH
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Marks AL, Hecht S, Stokes JE, Conklin GA, Deanna KH. Effects of gadoxetate disodium (Eovist(®)) contrast on magnetic resonance imaging characteristics of the liver in clinically healthy dogs. Vet Radiol Ultrasound 2015; 55:286-91. [PMID: 24945024 DOI: 10.1111/vru.12116] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Gadoxetate disodium (Gd-EOB-DTPA; gadolinium-ethoxybenzyl-diethylene triamine penta-acetic acid) is a newly developed paramagnetic contrast agent reported to have a high specificity for the hepatobiliary system in humans. The purpose of this prospective study was to describe effects of Gd-EOB-DTPA contrast administration on MRI characteristics of the liver in eight clinically healthy dogs. Precontrast dorsal and transverse T1-weighted spin echo, T2-weighted fast spin echo, and transverse T1-weighted 3D gradient echo (VIBE; volume-interpolated body examination) pulse sequences were acquired for each dog. Dogs were assigned to four groups based on contrast dose administered (0.0125 mmol/kg or 0.025 mmol/kg), and pulse sequences acquired after contrast administration (T1-weighted spin echo and T1-weighted 3D gradient echo). Liver signal intensity ratios were calculated and compared between the two contrast dose groups and two postcontrast pulse sequence groups using ANOVA. No adverse effects of contrast administration were observed. All dogs exhibited homogeneous contrast enhancement of the liver with no statistical difference in enhancement between the two different contrast doses. Contrast enhancement in all dogs peaked between 1 and 10 min after intravenous injection. There was a significant difference in mean signal intensity ratios between sequences (P = 0.035) but not between doses (P = 0.421). Postcontrast signal intensities of the liver parenchyma were significantly higher for the T1-weighted 3D gradient echo images when compared to the T1-weighted spin echo sequences. Findings indicated that Gd-EOB-DTPA contrast administration is safe in healthy dogs and causes homogeneous enhancement of the liver that is more pronounced in T1-weighted 3D gradient echo MRI pulse sequences.
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Weisse C, Berent AC, Todd K, Solomon JA, Cope C. Endovascular evaluation and treatment of intrahepatic portosystemic shunts in dogs: 100 cases (2001-2011). J Am Vet Med Assoc 2014; 244:78-94. [PMID: 24344856 DOI: 10.2460/javma.244.1.78] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To evaluate short- and long-term outcome following endovascular treatment of intrahepatic portosystemic shunts in dogs. DESIGN Retrospective case series. ANIMALS 100 dogs. PROCEDURES All patients had angiographic evaluation with or without endovascular shunt attenuation. The medical records were reviewed for pertinent data, complications, outcome, and survival time. RESULTS 95 dogs with congenital intrahepatic portosystemic shunts received 111 procedures (83% [79/95] had 1 treatment, and 17% [16/95] had > 1 treatment; 5 dogs had no treatment because of excessive portal venous pressure-central venous pressure gradients). Angiography identified 38 right, 33 left, and 19 central divisional single shunts (n = 90) and 10 complex or multiple shunts. Partial shunt attenuation was performed in 92 dogs by means of caval stent placement and insertion of thrombogenic coils within the shunt, and 3 had complete acute shunt occlusion. Major intraoperative complications (3/111 [3%]) included temporary severe portal hypertension in 2 dogs and gastrointestinal hemorrhage in 1 dog. Major postoperative (< 1 week after surgery) complications (14/111 [13%]) included seizures or hepatoencephalopathy (7/111 [6%]), cardiac arrest (2/111 [2%]), jugular site bleeding (2/111 [2%]), pneumonia (1/111 [1%]), suspected portal hypertension (1/111 [1%]), and acute death (1/111 [1%]). Median follow-up time was 958 days (range, 0 to 3,411 days). Median survival time for treated dogs was 2,204 days (range, 0 to 3,411 days). Outcome was considered excellent (57/86 [66%]) or fair (13/86 [15%]) in 70 of 86 (81%) treated dogs. CONCLUSIONS AND CLINICAL RELEVANCE Results suggested that endovascular treatment of intrahepatic shunts in dogs may result in lower morbidity and mortality rates, with similar success rates, compared with previously reported outcomes for open surgical procedures. Gastrointestinal ulceration was a common finding among this population of dogs, and lifelong gastroprotectant medications are now recommended.
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Affiliation(s)
- Chick Weisse
- Department of Diagnostic Imaging and Interventional Radiology, The Animal Medical Center, 510 E 62nd St, New York, NY 10065
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Carlton PF, Hammond G. Bipartite portosystemic shunt with single insertion: a rare congenital vascular anomaly in a dog. VETERINARY RECORD CASE REPORTS 2014. [DOI: 10.1136/vetreccr-2014-000132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
| | - Gawain Hammond
- Small Animal HospitalGlasgow UniversityGlasgowStrathclydeG61 1QHUK
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De Rycke LM, Kromhout KJ, van Bree HJ, Bosmans T, Gielen IM. Computed Tomography Atlas of the Normal Cranial Canine Abdominal Vasculature Enhanced by Dual-phase Angiography. Anat Histol Embryol 2013; 43:413-22. [DOI: 10.1111/ahe.12090] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2013] [Accepted: 09/04/2013] [Indexed: 11/30/2022]
Affiliation(s)
- L. M. De Rycke
- Department of Veterinary Medical Imaging and Small Animal Orthopaedics; Faculty of Veterinary Medicine; Ghent University; Merelbeke Belgium
| | - K. J. Kromhout
- Department of Veterinary Medical Imaging and Small Animal Orthopaedics; Faculty of Veterinary Medicine; Ghent University; Merelbeke Belgium
| | - H. J. van Bree
- Department of Veterinary Medical Imaging and Small Animal Orthopaedics; Faculty of Veterinary Medicine; Ghent University; Merelbeke Belgium
| | - T. Bosmans
- Department of Veterinary Medical Imaging and Small Animal Orthopaedics; Faculty of Veterinary Medicine; Ghent University; Merelbeke Belgium
| | - I. M. Gielen
- Department of Veterinary Medical Imaging and Small Animal Orthopaedics; Faculty of Veterinary Medicine; Ghent University; Merelbeke Belgium
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White RN, Parry AT. Morphology of congenital portosystemic shunts emanating from the left gastric vein in dogsand cats. J Small Anim Pract 2013; 54:459-67. [PMID: 23888909 DOI: 10.1111/jsap.12116] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- R. N. White
- Willows Referral Service; Highlands Road, Shirley Solihull West Midlands B90 4NH
| | - A. T. Parry
- Willows Referral Service; Highlands Road, Shirley Solihull West Midlands B90 4NH
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MANSO-DÍAZ G, GARCÍA-REAL MI, CASTELEYN C, SAN-ROMÁN F, TAEYMANS O. Time-of-flight magnetic resonance angiography (TOF-MRA) of the normal equine head. Equine Vet J 2012; 45:187-92. [DOI: 10.1111/j.2042-3306.2012.00621.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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