Peer-reviewed veterinary case report
Portocaval venograft surgery to control portal hypertension in dogs
By Kyles, Andrew E et al.·Published in Veterinary surgery : VS·2004·Department of Surgical and Radiological Sciences, United States·View original on PubMed →
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Original publication title: Re-evaluation of a portocaval venograft without an ameroid constrictor as a method for controlling portal hypertension after occlusion of intrahepatic portocaval shunts in dogs.
- Species:
- dog
Plain-English summary
A group of seven dogs with a serious liver condition called intrahepatic portosystemic shunts (PSS) underwent surgery to manage their portal hypertension (high blood pressure in the liver). After the procedure, five of the dogs experienced various complications, including abdominal swelling and bleeding, and sadly, six of them either died or had to be euthanized due to severe symptoms. Only one dog recovered completely and was doing well 33 months later. This study suggests that using a specific type of surgical graft without a constrictor may not be safe, as it could lead to dangerous complications related to portal hypertension.
People also search for: dog portal hypertension treatment · intrahepatic portosystemic shunt surgery risks · dog liver disease symptoms
Abstract
OBJECTIVE: To evaluate the use of a portocaval venograft without an ameroid constrictor in the surgical management of intrahepatic portosystemic shunts (PSS). STUDY DESIGN: Prospective clinical study. ANIMALS: Seven dogs with intrahepatic PSS. METHODS: Portal pressure was measured after temporary suture occlusion of the intrahepatic PSS. In dogs with an increase in portal pressure > or =8 mm Hg or signs of portal hypertension, a single extrahepatic portocaval shunt was created using a jugular vein. Clinical outcome and complications were recorded. RESULTS: The mean (+/-SD) portal pressure increased from 5.9+/-1.6 to 17.9+/-4.1 mm Hg with PSS occlusion. There were no intraoperative complications and, after creation of the portocaval shunt, the intrahepatic PSS could be completely ligated in all dogs. The final portal pressure was 9.6+/-1.9 mm Hg. Complications developed during postoperative hospitalization in 5 dogs and included incisional discharge (4 dogs), ascites (3), ventricular premature contractions (2), and melena, bloody diarrhea, neurologic signs, coagulopathy, and aspiration pneumonia (each in 1 dog). Six dogs died or were euthanatized with clinical signs related to depression, inappetance, abdominal pain, vomiting, melena, and abdominal distention, with a median survival of 82 days (range, 20-990 days). One dog was clinically normal at 33 months after surgery. CONCLUSIONS: Clinical signs observed in 6 dogs after surgery were consistent with portal hypertension. Use of a portocaval venograft without an ameroid constrictor may reduce the likelihood of hepatic vascular development, thereby increasing the risk of life-threatening portal hypertension should the venograft suddenly occlude. CLINICAL RELEVANCE: Use of a portocaval venograft without an ameroid constrictor to control portal hypertension after ligation of an intrahepatic PSS cannot be recommended.
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Search related cases →Original publication on PubMed: https://pubmed.ncbi.nlm.nih.gov/15659026/