Konstantinidis Alexandros O, Patsikas Michail N, Papazoglou Lysimachos G, Adamama-Moraitou Katerina K
Companion Animal Clinic (Medicine Unit), School of Veterinary Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54627 Thessaloniki, Greece.
Laboratory of Diagnostic Imaging, School of Veterinary Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54627 Thessaloniki, Greece.
Vet Sci. 2023 Feb 17;10(2):160. doi: 10.3390/vetsci10020160.
Congenital portosystemic shunts (CPSS) are abnormal vascular communications between the portal and the systemic circulation, bypassing the hepatic parenchyma and resulting in liver hypoplasia and hepatic insufficiency. Such connections develop in utero and persist postnatally. CPSS are among the two most common congenital vascular anomalies of the liver in small animals, along with primary hypoplasia of the portal vein without portal hypertension (PHPV without PH). CPSS can be extrahepatic (ECPSS), most commonly diagnosed in small and toy breed dogs and cats, or intrahepatic (ICPSS), most commonly seen in large breed dogs. Single ECPSS is the most common type encountered in both dogs and cats. Clinical signs of CPSS are non-specific and may wax and wane, while laboratory findings can raise clinical suspicion for CPSS, but they are also not specific. Definitive diagnosis will be established by evaluation of liver function tests, such as determination of fasting plasma ammonia (FA) levels, and pre- and postprandial serum bile acids concentrations, and diagnostic imaging. The purpose of this article is to review the definition, classification, pathogenesis, clinical presentation, and diagnosis of CPSS in dogs and cats, highlighted by the authors' clinical experience.
先天性门体分流（CPSS）是门静脉与体循环之间的异常血管连接，绕过肝实质，导致肝脏发育不全和肝功能不全。这种连接在子宫内形成并在出生后持续存在。CPSS是小动物肝脏中两种最常见的先天性血管异常之一，另一种是门静脉原发性发育不全且无门静脉高压（无门静脉高压的门静脉发育不全，PHPV无PH）。CPSS可以是肝外的（ECPSS），最常见于小型和玩具型犬猫，也可以是肝内的（ICPSS），最常见于大型犬。单一ECPSS是犬猫中最常见的类型。CPSS的临床症状不具特异性，可能时轻时重，而实验室检查结果可增加对CPSS的临床怀疑，但也不具特异性。通过评估肝功能检查，如测定空腹血浆氨（FA）水平、餐前和餐后血清胆汁酸浓度以及诊断性影像学检查来确诊。本文旨在结合作者的临床经验，对犬猫CPSS的定义、分类、发病机制、临床表现和诊断进行综述。
