Adam Fiona H, German Alexander J, McConnell J Fraser, Trehy Mary R, Whitley Nat, Collings Alison, Watson Penny J, Burrow Rachel D
Small Animal Teaching Hospital, University of Liverpool, Neston, Cheshire, England.
J Am Vet Med Assoc. 2012 Sep 15;241(6):760-5. doi: 10.2460/javma.241.6.760.
To determine whether clinical and clinicopathologic data could assist differentiation of congenital portosystemic shunts (CPSSs) from acquired portosystemic shunts (APSSs) in young dogs.
Retrospective case series.
Dogs < 30 months of age with CPSSs (n = 62) or APSSs (31).
Medical records from 3 referral centers identified 31 dogs with APSSs and 62 dogs with CPSSs diagnosed from July 2003 to July 2008. Signalment, clinical signs, physical examination, and clinicopathological data were recorded, and statistical analyses were performed to determine differences between groups.
Univariable analysis showed APSS patients were older, heavier, and in poorer body condition, compared with CPSS patients. In CPSS patients, diarrhea was less prevalent, and neurologic signs were more prevalent. Ascites was more prevalent in APSS (Fisher exact test; OR, 50.2; 95% confidence interval [CI], 6.2 to 409.7), with no significant difference in albumin concentration between groups. The logistic regression model used to assess clinicopathological parameters showed lower Hct (OR, 1.42 × 10(-12); 95% CI, 1.42 × 10(-17) to 4.0 × 10(-6)), higher mean corpuscular volume (OR, 1.27; 95% CI, 1.08 to 1.50), and higher alanine aminotransferase concentrations (OR, 1.005; 95% CI, 1.001 to 1.009) were more likely in APSS patients.
Several clinicopathologic differences between dogs with congenital and acquired shunts were identified; however, assessed alone, these would be unlikely to enable differentiation between the 2 conditions. Awareness of the rarity of ascites in CPSS cases should prompt recognition of a likely diagnosis of APSS, allowing the veterinarian to target further diagnostics and counsel the owner appropriately.
确定临床和临床病理数据是否有助于区分幼犬的先天性门体分流（CPSS）和后天性门体分流（APSS）。
回顾性病例系列研究。
年龄小于30个月的患有CPSS（n = 62）或APSS（31）的犬。
来自3个转诊中心的病历记录了2003年7月至2008年7月期间诊断出的31只患有APSS的犬和62只患有CPSS的犬。记录了信号、临床症状、体格检查和临床病理数据，并进行了统计分析以确定组间差异。
单变量分析显示，与CPSS患犬相比，APSS患犬年龄更大、体重更重且身体状况更差。在CPSS患犬中，腹泻的发生率较低，而神经症状的发生率较高。腹水在APSS中更为常见（Fisher精确检验；OR，50.2；95%置信区间[CI]，6.2至409.7），两组间白蛋白浓度无显著差异。用于评估临床病理参数的逻辑回归模型显示，APSS患犬更可能出现较低的血细胞比容（OR，1.42×10⁻¹²；95%CI，1.42×10⁻¹⁷至4.0×10⁻⁶）、较高的平均红细胞体积（OR，1.27；95%CI，1.08至1.50）和较高的丙氨酸转氨酶浓度（OR，1.005；95%CI，1.001至1.009）。
确定了先天性和后天性分流犬之间的一些临床病理差异；然而，单独评估这些差异不太可能区分这两种情况。认识到CPSS病例中腹水的罕见性应促使对APSS可能诊断的认识，使兽医能够针对性地进行进一步诊断并适当地向主人提供咨询。
