Spies Kate, Ogden Jessica, Sterman Allyson, Davidson Jackie, Scharf Valery, Reyes Bianca, Luther Jill Kristine, Martin Libby, Kudej Raymond, Stockman Tiffany, Gallaher Hayley Maloof-Jones, Buote Nicole J, Smith Meghan, Ciepluch Brittany, Amore Riley, Sherman Alec H, Wallace Mandy L
Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Purdue University, West Lafayette, Indiana, USA.
Department of Small Animal Clinical Sciences, College of Veterinary Medicine & Biomedical Sciences, Texas A&M University, College Station, Texas, USA.
Vet Surg. 2024 Feb;53(2):277-286. doi: 10.1111/vsu.14040. Epub 2023 Oct 16.
To describe demographics, clinical presentation, shunt anatomy, clinical progression, and complications in large dogs ≥15 kg with single extrahepatic portosystemic shunts (EHPSS) treated with or without surgery.
Multicenter retrospective (10 university hospitals, one private referral institution).
Dogs ≥15 kg (n = 63).
Medical records of dogs ≥15 kg diagnosed with EHPSS between January 01, 2005 and December 31, 2020 were reviewed. Dogs had a minimum follow-up of 90 days. Signalment, clinical signs, diagnostics, shunt anatomy, treatment interventions, and perioperative complications were assessed.
Median age was 21.9 months (IQR: 9-36.8). The breed most represented was the Golden retriever (17/63 dogs). Portocaval (17/63) and splenocaval (15/63) shunt configurations were most common. Portal vein hypoplasia was noted in 18 imaging reports. Of the surgically treated dogs, 14/45 (35.6%) had short-term complications, and 3/45 (6.7%) had shunt-related deaths. Medical management was discontinued in 15/40 and reduced in 9/40 of surviving dogs who had surgical attenuation. All medically managed, nonattenuated dogs (18/18) were maintained on their original shunt-related medication regimens.
Clinical presentation of dogs ≥15 kg with extrahepatic portosystemic shunts was similar to the more commonly reported small breed dogs. Surgical management of single EHPSS in large dogs ≥15 kg had similar clinical short-term outcomes as small breed dogs.
Clinicians should be aware that large breed dogs with EHPSS share similar characteristics and clinical outcomes to small breed dogs. The significance of the presence of a hypoplastic portal vein warrants further research. Surgical treatment is a viable option for large breed dogs with EHPSS.
描述体重≥15千克的大型犬单发性肝外门体分流（EHPSS）接受或未接受手术治疗时的人口统计学特征、临床表现、分流解剖结构、临床进展及并发症情况。
多中心回顾性研究（10所大学医院，1家私立转诊机构）。
体重≥15千克的犬（n = 63）。
回顾2005年1月1日至2020年12月31日期间诊断为EHPSS的体重≥15千克犬的病历。犬的随访时间至少为90天。评估品种特征、临床症状、诊断、分流解剖结构、治疗干预措施及围手术期并发症。
中位年龄为21.9个月（四分位间距：9 - 36.8）。最具代表性的品种是金毛寻回犬（17/63只犬）。门腔分流（17/63）和脾腔分流（15/63）的构型最为常见。18份影像学报告中发现门静脉发育不全。在接受手术治疗的犬中，14/45（35.6%）出现短期并发症，3/45（6.7%）因分流相关死亡。在存活且接受手术减流的犬中，15/40停止了药物治疗，9/40减少了药物用量。所有接受药物治疗且未减流的犬（18/18）维持原有的分流相关药物治疗方案。
体重≥15千克的大型犬肝外门体分流的临床表现与更常见报道的小型犬相似。体重≥15千克的大型犬单发性EHPSS的手术治疗短期临床结果与小型犬相似。
临床医生应意识到患有EHPSS的大型犬与小型犬具有相似的特征和临床结果。门静脉发育不全的意义值得进一步研究。手术治疗是患有EHPSS的大型犬的可行选择。
