Ulcers and erosions in dogs with liver shunts before and after coil

Abstract

OBJECTIVE: To describe the syndrome of suspected gastroduodenal ulceration/erosion (GUE) in dogs with intrahepatic portosystemic shunts (IHPSS) before and after percutaneous transvenous coil embolization (PTCE). METHODS: In a multi-institutional, retrospective case series, medical records from 7 specialty hospitals were reviewed to identify dogs with IHPSS diagnosed with suspected GUE prior to or following PTCE from July 31, 2013, to August 1, 2023. Eleven client-owned dogs were divided into 2 groups based on ulcer grade as determined by the Veterinary Cooperative Oncology Group-Common Terminology Criteria for Adverse Events guidelines for gastric ulceration. Factors were evaluated for association with GUE severity. RESULTS: At the time of GUE diagnosis, the median age and weight of dogs were 20 months (range, 2 to 48 months) and 20.9 kg (range, 6.6 to 36.5 kg). Five and 6 dogs were diagnosed with suspected GUE before and after PTCE, respectively. High- and low-grade suspected GUEs were diagnosed in 6 and 5 dogs, respectively. Common clinical signs included vomiting with or without hematemesis (n = 8), lethargy (7), and inappetence (6). Dogs were receiving omeprazole (n = 2) and a steroid (1) or NSAID (5) at the time of suspected GUE diagnosis. No dogs receiving an NSAID were concurrently being treated with omeprazole. No factors evaluated were significantly associated with increased severity of suspected GUE. CONCLUSIONS: Dogs with IHPSS experience GUE despite prophylactic medical management and treatment via PTCE. CLINICAL RELEVANCE: Cautious use of medications associated with GUE should be considered in dogs with IHPSS. The pathophysiology of GUE in dogs with IHPSS remains incompletely understood.