Peer-reviewed veterinary case report
Portosystemic shunts in pets - diagnosis and treatment options
By Winkler, James T et al.·Published in Journal of the American Animal Hospital Association·2003·Department of Clinical Sciences, United States·View original on PubMed →
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Original publication title: Portosystemic shunts: diagnosis, prognosis, and treatment of 64 cases (1993-2001).
Plain-English summary
A review of 64 pets diagnosed with portosystemic shunts, a serious liver condition, found that tests measuring bile acids in the blood were more effective than blood ammonia tests for diagnosis. Surgery to correct these shunts had varying success rates: 8.7% of pets with extrahepatic shunts (outside the liver) and 20% with intrahepatic shunts (inside the liver) did not survive the procedure. While some pets showed improvement, none had normal bile acid levels after surgery, indicating ongoing liver issues. The type of surgical method used also affected recovery, with partial ligation having higher long-term complication rates.
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Abstract
Cases diagnosed with portosystemic shunting between the years 1993 and 2001 were reviewed. Sensitivities of screening tests and abdominal ultrasonographic evaluation for the detection of portosystemic shunting were evaluated. Prognosis for surgically treated shunts was also evaluated. Results indicated that both paired serum bile acids and blood ammonia levels were useful screening tests for portosystemic shunting. However, paired bile acid tests were significantly more sensitive than blood ammonia levels. Overall postoperative mortality rates for extrahepatic shunts and intrahepatic shunts were 8.7% and 20%, respectively. Postoperative mortality rates were slightly higher for animals treated with partial ligation when compared to those treated with ameroid ring placement, although this did not reach statistical significance. Long-term complication rates for animals with single extrahepatic portosystemic shunts treated with complete ligation, ameroid ring placement, and partial ligation alone were 9%, 15.4%, and 42%, respectively. Animals >2 years of age with extrahepatic shunts had almost identical postoperative mortality and long-term complication rates as animals < or = 2 years of age. No animal in this study had paired bile acid samples within the reference range postoperatively, indicating continued abnormal liver function after surgery.
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Search related cases →Original publication on PubMed: https://pubmed.ncbi.nlm.nih.gov/12617545/