Peer-reviewed veterinary case report
Older dogs with congenital liver shunts live longer after surgery
By Wallace, Mandy L et al.·Published in Journal of the American Veterinary Medical Association·2022·Department of Small Animal Medicine and Surgery, United States·View original on PubMed →
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Original publication title: Dogs ≥ five years of age at the time of congenital extrahepatic portosystemic shunt diagnosis have better long-term outcomes with surgical attenuation than with medical management alone.
- Species:
- dog
Plain-English summary
A study found that dogs aged 5 years or older diagnosed with congenital extrahepatic portosystemic shunts (EHPSS) had much better outcomes when treated with surgery rather than just medication. The dogs that underwent surgery lived an average of nearly 11 years, while those managed with medication alone survived about 3.5 years. Additionally, fewer dogs who had surgery continued to show symptoms or needed ongoing treatment after a year compared to those on medical management. Overall, surgery proved to be a more effective option for older dogs with this condition.
People also search for: dog portosystemic shunt surgery · EHPSS treatment options · older dog liver shunt prognosis
Abstract
OBJECTIVE: To determine the outcome in dogs diagnosed with congenital extrahepatic portosystemic shunts (EHPSS) at ≥ 5 years of age treated with medical management only (M) or with surgical attenuation (S). The hypothesis was that dogs undergoing surgical attenuation would have a longer survival time than dogs undergoing medical management only. ANIMALS: 351 dogs definitively diagnosed with EHPSS at ≥ 5 years of age. PROCEDURES: Medical records from 2009 to 2019 at 16 veterinary teaching hospitals were evaluated. Data collected included signalment, clinical signs at diagnosis, clinicopathologic data, surgical and medical treatments, shunt morphology, clinical signs and medical treatments at 6 to 12 months after diagnosis, and survival time. RESULTS: 351 dogs (M, 119 [33.9%]; S, 232 [66.1%]) were included in the study. Survival time was longer with surgery than medical management (hazard ratio, 4.2; M, 3.4 years; S, 10.9 years). Continued clinical signs at 6 to 12 months after diagnosis were more common with medical management (M, 40% [33/88]; S, 14% [21/155]). Continued medical treatments at 6 to 12 months after diagnosis were more common in the medical management group (M, 78% [69/88]; S, 34% [53/155]). Perioperative mortality rate was 7.3%. CLINICAL RELEVANCE: Dogs diagnosed at ≥ 5 years of age with EHPSS have significantly better survival times and fewer clinical signs with surgical attenuation, compared with medical management. Older dogs have similar surgical mortality rates to dogs of all ages after surgical EHPSS attenuation.
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Search related cases →Original publication on PubMed: https://pubmed.ncbi.nlm.nih.gov/35201999/