Hidden gut lining damage in dogs with liver blood vessel shunts

Abstract

OBJECTIVE: To determine the prevalence and severity of gastrointestinal mucosal lesions in dogs with intrahepatic portosystemic shunts (IHPSS), and to compare the prevalence and severity of gastrointestinal mucosal lesions in dogs with IHPSS before and after treatment with percutaneous transvenous coil embolization (PTCE) based on capsule endoscopy (CE). METHODS: A prospective clinical trial was performed from June 1, 2020, to March 1, 2022. Ten client-owned dogs diagnosed with IHPSS by use of CT angiography were included. Dogs were administered a capsule endoscopy device prior to and 1 month following PTCE. Outcomes compared before and after PTCE included gastrointestinal mucosal lesions as observed via CE, serum biochemistry changes, and client-reported clinical metrology data. RESULTS: All dogs underwent pre- and postprocedure CE without adverse events. Six and 5 dogs each had gastric and intestinal mucosal lesions on pre-PTCE CE images, whereas 8 and 4 dogs each had gastric and intestinal mucosal lesions after PTCE. Six of 7 dogs with pre-PTCE lesions had post-PTCE lesions, and 3 of 4 dogs without pre-PTCE lesions had post-PTCE lesions. There was no significant difference in mucosal severity scores of gastric or small intestinal segments before PTCE or 1 month after PTCE. There was significant improvement in owner-reported symptom assessment scores 1 month after PTCE compared to before PTCE. CONCLUSIONS: Abnormalities of the gastric and small intestinal mucosal surface were common on the basis of CE images within this population of dogs with IHPSS. Severity of mucosal lesions was not associated with PTCE treatment short-term. CLINICAL RELEVANCE: Dogs with IHPSS prior to and following PTCE may require ongoing management for subclinical gastrointestinal lesions. Further investigation to understand clinical relevance of these lesions is indicated.