Outcomes of ameroid ring vs cellophane banding for dog liver shunts

Abstract

OBJECTIVE: To compare outcomes and identify prognostic factors in dogs with single congenital extrahepatic portosystemic shunt (CEHPSS) gradually attenuated with an ameroid ring constrictor (ARC) or cellophane banding (CB). STUDY DESIGN: Retrospective, multi-institutional study. ANIMALS: Forty-nine dogs with CEHPSS (n&#x2009;=&#x2009;23 for ARC; n&#x2009;=&#x2009;26 for CB). METHODS: Medical records of dogs with CEHPSS treated by ARC or CB were reviewed for postoperative (<1 month), midterm (1-6 months), and long-term (> 6 months) outcomes. Data were evaluated to detect factors associated with postoperative complications, residual shunting, and long-term outcome. RESULTS: Postoperative complication rates did not differ between ARC (26.1%) and CB (23.1%, P&#x2009;=&#x2009;.89) and were negatively associated with body weight (P&#x2009;=&#x2009;.03). Overall, postoperative mortality was low (2.0%). Clinical long-term outcome was excellent in 45.0% and 39.1% and good in 55.0% and 60.9% of dogs after ARC and CB, respectively. Suspected residual shunting rate upon abdominal ultrasonography was greater after CB (31.6%) than after ARC (0%). CONCLUSION: ARC and CB were both effective for attenuation of CEHPSS, resulting in good to excellent outcomes with low morbidity and mortality. Residual shunting was suspected in a higher proportion of dogs treated with CB on the basis of abdominal ultrasonography results. However, further prospective randomized studies must be conducted with validated evaluation methods to verify this assumption.