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Frymus J, Trębacz P, Kurkowska A, Pawlik M, Barteczko A, Barański M, Galanty M. Three-Dimensional Models of Liver Vessels for Navigation during Laparotomic Attenuation of Intrahepatic Portosystemic Shunt in Dogs. Animals (Basel) 2023; 13:2004. [PMID: 37370514 DOI: 10.3390/ani13122004] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2023] [Revised: 06/09/2023] [Accepted: 06/14/2023] [Indexed: 06/29/2023] Open
Abstract
Laparotomic attenuation of an intrahepatic portosystemic shunt (IHPSS) is more difficult than an extrahepatic one, and results in a higher risk of complications because the identification of the aberrant vessel in the liver remains often a challenge. Excessive preparation and traction of the parenchyma results in trauma, bleeding, and prolonged surgery, which is what worsens the prognosis. Therefore, based on computed tomographic angiography, we printed 3-dimensional (3D) individual patient liver models, scaled 1:1, and used them for surgery planning and as a guide during intraoperative identification of the shunt in four dogs with IHPSS. The advantages of the 3D technology are simple and precise planning of the surgery, fast intraoperative identification of the shunt, and low invasive dissection of the liver parenchyma. We conclude that 3D technology can potentially raise the recovery rate. To the best of our knowledge, this was the first application of 3D models in the surgery of canine IHPSS.
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Affiliation(s)
- Jan Frymus
- Department of Small Animal Diseases with Clinic, Institute of Veterinary Medicine, Warsaw University of Life Sciences-SGGW, Nowoursynowska 159c, 02-776 Warsaw, Poland
| | - Piotr Trębacz
- Department of Small Animal Diseases with Clinic, Institute of Veterinary Medicine, Warsaw University of Life Sciences-SGGW, Nowoursynowska 159c, 02-776 Warsaw, Poland
| | - Aleksandra Kurkowska
- CABIOMEDE Sp. z o. o., Kielce Technology Park, Olszewskiego 6, 25-663 Kielce, Poland
| | - Mateusz Pawlik
- CABIOMEDE Sp. z o. o., Kielce Technology Park, Olszewskiego 6, 25-663 Kielce, Poland
| | - Anna Barteczko
- CABIOMEDE Sp. z o. o., Kielce Technology Park, Olszewskiego 6, 25-663 Kielce, Poland
| | - Michał Barański
- Department of Small Animal Diseases with Clinic, Institute of Veterinary Medicine, Warsaw University of Life Sciences-SGGW, Nowoursynowska 159c, 02-776 Warsaw, Poland
| | - Marek Galanty
- Department of Small Animal Diseases with Clinic, Institute of Veterinary Medicine, Warsaw University of Life Sciences-SGGW, Nowoursynowska 159c, 02-776 Warsaw, Poland
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Konstantinidis AO, Adamama-Moraitou KK, Patsikas MN, Papazoglou LG. Congenital Portosystemic Shunts in Dogs and Cats: Treatment, Complications and Prognosis. Vet Sci 2023; 10:vetsci10050346. [PMID: 37235429 DOI: 10.3390/vetsci10050346] [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: 03/13/2023] [Revised: 05/02/2023] [Accepted: 05/10/2023] [Indexed: 05/28/2023] Open
Abstract
Congenital portosystemic shunts (CPSS) are a common vascular anomaly of the liver in dogs and cats. Clinical signs of CPSS are non-specific and may wax and wane, while laboratory findings can raise the clinical suspicion for CPSS, but they are also not specific. Definitive diagnosis will be established by evaluation of liver function tests and diagnostic imaging. The aim of this article is to review the management, both medical and surgical, complications, and prognosis of CPSS in dogs and cats. Attenuation of the CPSS is the treatment of choice and may be performed by open surgical intervention using ameroid ring constrictors, thin film banding, and partial or complete suture ligation or by percutaneous transvenous coil embolization. There is no strong evidence to recommend one surgical technique over another. Medical treatment strategies include administration of non-absorbable disaccharides (i.e., lactulose), antibiotics, and dietary changes, and are indicated for pre-surgical stabilization or when surgical intervention is not feasible. After CPSS attenuation, short- and long-term post-surgical complications may be seen, such as post-operative seizures and recurrence of clinical signs, respectively. Prognosis after surgical attenuation of CPSS is generally favorable for dogs and fair for cats.
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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
| | - Katerina K Adamama-Moraitou
- Companion Animal Clinic (Medicine Unit), School of Veterinary Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54627 Thessaloniki, Greece
| | - 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
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Economu L, Strickland R, Lipscomb VJ. Surgical treatment and outcome of intrahepatic shunts in 12 cats. J Feline Med Surg 2022; 24:e411-e419. [PMID: 35833502 PMCID: PMC10812295 DOI: 10.1177/1098612x221109325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
CASE SERIES SUMMARY The objective of this case series was to describe the presentation, surgical treatment and outcome of a congenital intrahepatic portosystemic shunt (IHPSS) in 12 cats. A retrospective case series of cats undergoing surgical treatment for an IHPSS was undertaken. Signalment, clinical signs, imaging, surgical treatment, complications and short-term outcome (<30 days) were obtained using medical records. Long-term outcome (>1 year after first surgery) was obtained, where possible, using a health-related quality of life owner questionnaire. Seven cats were diagnosed with a left divisional shunt, three with a central divisional shunt and two with a right divisional shunt using intraoperative mesenteric portovenography. Three cats tolerated complete acute suture attenuation, eight cats underwent partial suture attenuation, four of which received complete suture ligation at a second surgery, and one cat underwent partial attenuation with a thin film band. Six cats (50%) developed post-attenuation neurological signs (PANS) after first surgery and two cats (17%) died or were euthanased due to severe PANS. Long-term outcome was available for eight cats (67%), with a median follow-up time of 1743 days (range 364-2228), and was described as excellent in five cats (63%), fair in two cats (25%) and poor in one cat (12%). RELEVANCE AND NOVEL INFORMATION Few papers exist that describe the presentation, intraoperative imaging, treatment and outcome of IHPSSs in cats. This is the first to describe surgical attenuation with a thin film band in a cat with an IHPSS. This case series reports excellent long-term outcomes in a majority of surgically treated cats with IHPSS.
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Affiliation(s)
- Lavinia Economu
- Queen Mother Hospital for Animals, Royal Veterinary College, University of London, Hatfield, UK
| | - Rhiannon Strickland
- Queen Mother Hospital for Animals, Royal Veterinary College, University of London, Hatfield, UK
| | - Vicky J Lipscomb
- Queen Mother Hospital for Animals, Royal Veterinary College, University of London, Hatfield, UK
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Toom M, Saunders JH, Duchateau L, Serrano G, De Rooster H, Devriendt N, Stock E. Shear wave elastography measurements in dogs treated surgically for congenital extrahepatic portosystemic shunts. Front Vet Sci 2022; 9:991148. [PMID: 36225793 PMCID: PMC9549120 DOI: 10.3389/fvets.2022.991148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Accepted: 08/31/2022] [Indexed: 11/13/2022] Open
Abstract
Assessing the postoperative surgical success of congenital extrahepatic portosystemic shunt (EHPSS) attenuation can be challenging and involve invasive imaging methods. Elastography is an ultrasound technique that allows qualitative and quantitative estimation of tissue stiffness and has extensively been used in people with liver disease. In recent years, increased interest in this technique has developed in veterinary medicine due to its non-invasive nature, availability, and low cost. The objective of this study was to compare liver stiffness values between dogs with closed EHPSS and those with multiple acquired portosystemic shunts (MAPSS) after gradual surgical attenuation and to assess whether shear wave elastography could be used to determine EHPSS closure. As a secondary objective, measurements obtained from both intercostal and subxiphoidal views were compared. Mean values for the average, median, and maximum two-dimensional shear wave velocities (2D SWV) for the closed EHPSS were 2.88 +/−0.11 m/s; 2.83 +/−0.11 m/s; and 3.75 +/−0.16 m/s, respectively. In the MAPSS dogs, mean values for the average, median, and maximum 2D SWV were 2.77 +/– 0.17 m/s; 2.71 +/– 0.17 m/s; and 3.66 +/−0.24 m/s, respectively. No significant differences in 2D SWV were present between dogs with closed EHPSS and those with MAPSS (P = 0.33; P = 0.33; P = 0.42, respectively). When assessing potential differences between intercostal and subxiphoidal 2D SWV measurements, no effect was observed for the average and median 2D SWV (P = 0.06; P = 0.07, respectively). Yet, a significant difference was identified for the maximum 2D SWV between intercostal 4.00 +/−0.20 m/s and subxiphoidal 3.41 +/−0.17 m/s measurements (P = 0.02). The relevance of this finding is uncertain as many other studies about liver elastography only report mean and not maximum values.
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Affiliation(s)
- Merle Toom
- Department of Morphology, Imaging, Orthopedics, Rehabilitation and Nutrition, Faculty of Veterinary Medicine, Merelbeke, Belgium
- *Correspondence: Merle Toom
| | - Jimmy H. Saunders
- Department of Morphology, Imaging, Orthopedics, Rehabilitation and Nutrition, Faculty of Veterinary Medicine, Merelbeke, Belgium
| | - Luc Duchateau
- Department of Veterinary and Biosciences, Faculty of Veterinary Medicine, Merelbeke, Belgium
| | - Goncalo Serrano
- Department of Small Animals, Faculty of Veterinary Medicine, Merelbeke, Belgium
| | - Hilde De Rooster
- Department of Small Animals, Faculty of Veterinary Medicine, Merelbeke, Belgium
| | - Nausikaa Devriendt
- Department of Small Animals, Faculty of Veterinary Medicine, Merelbeke, Belgium
| | - Emmelie Stock
- Department of Morphology, Imaging, Orthopedics, Rehabilitation and Nutrition, Faculty of Veterinary Medicine, Merelbeke, Belgium
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Sunlight C, Weisse C, Berent A, Tozier E. Protein C and comparative biochemical changes in dogs treated with percutaneous transvenous coil embolization of congenital intrahepatic portosystemic shunts. Vet Surg 2021; 51:125-135. [PMID: 34596252 DOI: 10.1111/vsu.13719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Revised: 08/05/2021] [Accepted: 08/25/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To evaluate protein C (PC) activity after intrahepatic portosystemic shunt (IHPSS) percutaneous transvenous coil embolization (PTCE) in dogs; to identify if PC is associated with clinical status after intervention, and to compare PC with standard biochemical values. STUDY DESIGN Retrospective case series. ANIMALS Forty-seven client-owned dogs with IHPSS undergoing PTCE. METHODS Records were reviewed for preoperative and postoperative PC, hematocrit (HCT), mean corpuscular volume (MCV), albumin (ALB), and blood urea nitrogen (BUN). Ultimate clinical status was classified as excellent, fair, or poor, based on ongoing medical management and the presence of clinical signs. Intrahepatic portosystemic shunt was considered to be completely or incompletely occluded intraoperatively based on angiography. RESULTS Postoperative PC activity increased in 37/47 (78.7%) dogs with a mean increase of 38.7% ± 2.1%. Ultimate postoperative clinical status was excellent in 16/43 (37.2%), fair in 19/43 (44.2%), and poor in 8/43 dogs (18.6%). No association was detected between preoperative PC (46.8% ± 1.8%) and ultimate clinical status but mean postoperative PC (75.7% ± 1.4%), HCT, MCV, ALB, and BUN were higher in dogs with excellent clinical status. Postoperative PC activity was higher when shunts were completely occluded (96.3% ± 10.9%), which was a finding associated with excellent status. CONCLUSION Postoperative, but not preoperative, PC activity was higher in dogs with better ultimate clinical status. Similar trends were noted in standard hematological and biochemical values. Complete occlusion of shunts was associated with a higher postoperative PC and superior ultimate clinical status. CLINICAL SIGNIFICANCE Postoperative PC may provide valuable information about the success of PTCE for IHPSS as it relates to the ultimate status and the need for additional procedures.
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Affiliation(s)
| | | | | | - Eric Tozier
- Lamb Consulting, West Saint Paul, Minnesota, USA
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Pavlova E, Gold RM, Tolbert MK, Lidbury JA. Medical conditions associated with gastroduodenal ulceration or erosion in 168 dogs: 2008-2018. J Vet Intern Med 2021; 35:2697-2704. [PMID: 34596276 PMCID: PMC8692196 DOI: 10.1111/jvim.16275] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 09/14/2021] [Accepted: 09/15/2021] [Indexed: 12/17/2022] Open
Abstract
Background Many medical conditions are thought to cause gastroduodenal ulceration or erosion (GUE) in dogs. However, evidence for the association between many of these conditions and GUE in dogs is lacking. Objective To identify medical conditions associated with GUE in dogs. Animals One hundred and sixty‐eight dogs with GUE and 168 randomly selected control dogs without evidence of GUE identified on necropsy between January 2008 and September 2018. Methods Patient signalment, blood urea nitrogen (BUN) and serum creatinine concentrations, recently administered ulcerogenic drugs, as well as necropsy findings were recorded. The association between these findings and presence of GUE was assessed by univariable and multivariable analysis. Results In the final multivariable model, the following factors were associated with GUE: Nonsteroidal anti‐inflammatory drug (NSAID) administration (odds ratio [OR], 6.3; 95% confidence interval [CI], 2.3‐17.4; P = .0004), glucocorticoid administration (OR, 3.0; 95% CI, 1.5‐5.9; P = .001), gastrointestinal neoplasia (OR, 13.5; 95% CI, 1.7‐108.0; P = .01) and gastrointestinal mechanical disease (foreign bodies, gastric dilatation, and volvulus; OR, 4.8; 95% CI, 1.2‐19.7; P = .03). Additionally, working dog breeds were predisposed to GUE compared to mixed breed dogs (OR, 2.8; 95% CI, 1.1‐7.4; P = .04). Insufficient clinical data was available to either support or refute a role of other putative risk factors evaluated. Conclusion and Clinical Importance Administration of NSAID or glucocorticoid and gastrointestinal neoplasia or mechanical disease were associated with GUE in dogs. The potential predisposition of working breed dogs for GUE requires further investigation.
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Affiliation(s)
- Elena Pavlova
- Department of Small Animal Clinical Sciences, Texas A&M University College of Veterinary Medicine and Biomedical Sciences, College Station, Texas, USA
| | - Randi M Gold
- Department of Small Animal Clinical Sciences, Texas A&M University College of Veterinary Medicine and Biomedical Sciences, College Station, Texas, USA
| | - M Katherine Tolbert
- Department of Small Animal Clinical Sciences, Texas A&M University College of Veterinary Medicine and Biomedical Sciences, College Station, Texas, USA
| | - Jonathan A Lidbury
- Department of Small Animal Clinical Sciences, Texas A&M University College of Veterinary Medicine and Biomedical Sciences, College Station, Texas, USA
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Mullins RA, Escribano Carrera A, Anderson DM, Billet JP, Brissot H, Broome C, de Rooster H, Kirby BM, Pratschke KM, Tivers MS, White RN, Yool DA, Youmans KR. Postattenuation neurologic signs after surgical attenuation of congenital portosystemic shunts in dogs: A review. Vet Surg 2021; 51:23-33. [PMID: 34585759 DOI: 10.1111/vsu.13729] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 02/26/2021] [Accepted: 03/18/2021] [Indexed: 11/27/2022]
Abstract
The development of postattenuation neurologic signs (PANS) is a poorly understood and potentially devastating complication after surgical attenuation of congenital portosystemic shunts in dogs. Postattenuation neurologic signs include seizures but also more subtle neurologic signs such as depression, behavioral changes, tremors, and twitching. They most commonly occur within 7 days postoperatively and are typically unrelated to hyperammonemia, hypoglycemia, or electrolyte disturbances. This narrative review summarizes the findings of 50 publications from 1988-2020 that report occurrence of PANS. While most published reports included only dogs affected by postattenuation seizures (PAS), others included dogs with any form of PANS. Overall, PANS (including PAS) affected 1.6%-27.3% of dogs, whereas incidence of PAS ranged from 0%-18.2%. The etiology of PANS remains unknown; however, several theories have been proposed. Risk factors include preoperative hepatic encephalopathy, increasing age, and possibly certain breeds and extrahepatic shunt morphology. There is increasing evidence that prophylactic antiepileptic drugs do not prevent PANS. Treatment is centered around controlling neurologic signs with antiepileptic drugs and providing supportive intensive care. The 30-day survival rate in studies that included a minimum of four dogs affected by PANS was 0%-100% (median, 50.0%) and 0%-75.0% (median, 37.5%) for those with PAS. Mortality associated with PANS was typically related to occurrence of generalized seizure activity. Prognostic factors positively associated with short-term survival included having a history of preoperative seizures and development of focal seizures only. If affected dogs survived to discharge, survival for several years was possible, and the majority of neurologic signs manifested as part of the phenomenon of PANS appeared to resolve.
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Affiliation(s)
- Ronan A Mullins
- Section of Small Animal Clinical Sciences, University College Dublin, Dublin, Ireland
| | | | | | | | | | - Cameron Broome
- Veterinary Referral Hospital, Melbourne, Victoria, Australia
| | - Hilde de Rooster
- Small Animal Department, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - Barbara M Kirby
- Section of Small Animal Clinical Sciences, University College Dublin, Dublin, Ireland
| | - Kathryn M Pratschke
- Veterinary Clinical Services, The Royal (Dick) School of Veterinary Studies and The Roslin Institute, Easter Bush Campus, Midlothian EH25 9RG, UK
| | - Michael S Tivers
- Paragon Veterinary Referrals, Paragon Business Village, Red Hall Crescent, Wakefield, UK
| | - Robert N White
- School of Veterinary Medicine & Science, University of Nottingham, Sutton Bonington Campus, Loughborough, UK
| | - Donald A Yool
- University of Glasgow, School of Veterinary Medicine, Glasgow, UK
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Devriendt N, Serrano G, Paepe D, de Rooster H. Liver function tests in dogs with congenital portosystemic shunts and their potential to determine persistent shunting after surgical attenuation. Vet J 2020; 261:105478. [PMID: 32741493 DOI: 10.1016/j.tvjl.2020.105478] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Revised: 05/24/2020] [Accepted: 05/29/2020] [Indexed: 02/03/2023]
Abstract
Portosystemic shunts (PSS) are congenital or acquired vascular anomalies that cause blood to bypass the liver. Liver function tests, such as fasting ammonia, ammonia tolerance test, and (paired) serum bile acids, are reliable for the diagnosis of PSS in dogs. Surgical attenuation is a common treatment for congenital PSS. Following surgical attenuation, it is useful to evaluate shunt closure. In this critical review, the ability of liver function tests to determine the presence and degree of residual shunting following surgical attenuation of canine PSS is discussed. Despite the availability of several liver function tests, a single rapid, simple, cost-effective, sensitive and specific test to evaluate surgical attenuation of PSS is not available.
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Affiliation(s)
- Nausikaa Devriendt
- Small Animal Department, Faculty of Veterinary Medicine, Ghent University, Salisburylaan 133, 9820 Merelbeke, Belgium.
| | - Gonçalo Serrano
- Small Animal Department, Faculty of Veterinary Medicine, Ghent University, Salisburylaan 133, 9820 Merelbeke, Belgium
| | - Dominique Paepe
- Small Animal Department, Faculty of Veterinary Medicine, Ghent University, Salisburylaan 133, 9820 Merelbeke, Belgium
| | - Hilde de Rooster
- Small Animal Department, Faculty of Veterinary Medicine, Ghent University, Salisburylaan 133, 9820 Merelbeke, Belgium
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Matiasovic M, Chanoit GPA, Meakin LB, Tivers MS. Outcomes of dogs treated for extrahepatic congenital portosystemic shunts with thin film banding or ameroid ring constrictor. Vet Surg 2019; 49:160-171. [PMID: 31270829 DOI: 10.1111/vsu.13273] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Revised: 05/12/2019] [Accepted: 06/02/2019] [Indexed: 01/21/2023]
Abstract
OBJECTIVE To compare the outcomes of dogs treated at a single institution for single extrahepatic congenital portosystemic shunts (CPSS) by thin film banding (TFB) or by placement of an ameroid constrictor (AC). STUDY DESIGN Retrospective case series. ANIMALS Seventy-six client-owned dogs with CPSS treated with TFB (n = 53) or AC (n = 23). METHODS Records were reviewed for signalment, preoperative, intraoperative, and postoperative management and short-term outcomes. Data on second surgeries were reviewed. Long-term outcomes were obtained via an owner-directed health-related quality of life questionnaire. The rates of complications, mortality, and revision surgery were compared between the treatment groups. RESULTS Postoperative complications occurred in 15 (28%) dogs with TFB (9% mortality, n = 5) and 8 (35%) dogs with an AC (4% mortality, n = 1). Long-term follow-up was available in 41 of 56 dogs at a median of 55 months (range, 15-89). Revision surgery for persistent shunting was performed in 14 (29%) dogs treated initially with TFB and in no dogs treated initially with AC (P = .007). Median long-term outcome scores were good in both groups; nine of 14 revision surgeries led to favorable outcomes. CONCLUSION Persistent shunting requiring revision surgery was more common when CPSS were treated with TFB than with an AC, but both treatments achieved favorable long-term outcomes. CLINICAL SIGNIFICANCE Treatment of CPPS by placement of an AC rather than TFB seems more reliable for shunt attenuation and prevention of revision surgeries.
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Affiliation(s)
- Matt Matiasovic
- Bristol Veterinary School, University of Bristol, Langford, United Kingdom
| | | | - Lee B Meakin
- Bristol Veterinary School, University of Bristol, Langford, United Kingdom
| | - Mickey S Tivers
- Bristol Veterinary School, University of Bristol, Langford, United Kingdom
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Bristow P, Lipscomb V, Kummeling A, Packer R, Gerrits H, Homan K, Ortiz V, Newson K, Tivers M. Health-related quality of life following surgical attenuation of congenital portosystemic shunts versus healthy controls. J Small Anim Pract 2018; 60:21-26. [PMID: 30251431 DOI: 10.1111/jsap.12927] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2016] [Revised: 08/09/2018] [Accepted: 08/13/2018] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To design a health-related quality of life questionnaire for dogs with congenital portosystemic shunts, use it in a cohort of dogs treated with suture attenuation and compare results with those obtained from a healthy control cohort. MATERIALS AND METHODS Data were collected from the hospital records of dogs treated with suture ligation of an intrahepatic or extrahepatic congenital portosystemic shunt at two referral centres. Owners were asked to complete a questionnaire assessing their dog's health-related quality of life preoperatively (retrospectively) and at the time of follow-up. Owners of control dogs also completed the questionnaire. RESULTS One hundred and twenty-eight dogs with congenital portosystemic shunts and 131 control dogs were recruited. Median follow-up time was 64 months (range 19.7 to 157.2). The median long-term health-related quality of life score was excellent for both intrahepatic and extrahpatic shunt cases and similar to that of control dogs. The long-term portosystemic shunt clinical sign scores for both intrahepatic and extrahepatic congenital portosystemic shunt dogs were significantly worse than the those of the control group. CLINICAL SIGNIFICANCE Suture attenuation of congenitial portosystemic shunts is associated with an excellent health-related quality of life score at long-term follow-up.
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Affiliation(s)
- P Bristow
- Department of Veterinary Clinical Sciences, Royal Veterinary College, Hatfield, Herts, AL9 7TA, UK
| | - V Lipscomb
- Department of Veterinary Clinical Sciences, Royal Veterinary College, Hatfield, Herts, AL9 7TA, UK
| | - A Kummeling
- Faculty of Veterinary Medicine, Clinical Sciences of Companion Animals, Utrecht University, Utrecht, 3508, The Netherlands
| | - R Packer
- Department of Veterinary Clinical Sciences, Royal Veterinary College, Hatfield, Herts, AL9 7TA, UK
| | - H Gerrits
- Faculty of Veterinary Medicine, Clinical Sciences of Companion Animals, Utrecht University, Utrecht, 3508, The Netherlands
| | - K Homan
- Faculty of Veterinary Medicine, Clinical Sciences of Companion Animals, Utrecht University, Utrecht, 3508, The Netherlands
| | - V Ortiz
- Department of Veterinary Clinical Sciences, Royal Veterinary College, Hatfield, Herts, AL9 7TA, UK
| | - K Newson
- Department of Veterinary Clinical Sciences, Royal Veterinary College, Hatfield, Herts, AL9 7TA, UK
| | - M Tivers
- Department of Veterinary Clinical Sciences, Royal Veterinary College, Hatfield, Herts, AL9 7TA, UK
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