Swieton Natalie, Weisse Chick, Zwingenberger Allison L, Vilaplana Grosso Frederico R, Carroll Kenneth A, Scharf Valery F, Asano Kazushi, Wallace Mandy L, Arai Shiori, Lipscomb Victoria J, Amato Nicole S, Davidson Jacqueline R, Aly Ali M
Interventional Radiology and Endoscopy Service, Schwarzman Animal Medical Center, New York, New York, USA.
Department of Surgical & Radiological Sciences, School of Veterinary Medicine, University of California, Davis, California, USA.
Vet Surg. 2025 Feb;54(2):297-310. doi: 10.1111/vsu.14183. Epub 2024 Oct 30.
To assess outcomes of dogs with side-to-side portocaval extrahepatic portosystemic shunts (PC-EHPSS) and poor portal perfusion to the liver treated with medical management alone (MM) or surgical attenuation (SA).
Multi-institutional retrospective study.
A total of 21 dogs with PC-EHPSS (14/21 MM and 7/21 SA).
Medical records were reviewed, and data was collected on dogs <12 kg with PC-EHPSS treated with MM or SA between June 2008 to June 2021. Signalment, clinical signs, postoperative complications, bloodwork values, long-term clinical outcome, survival, and owner reported quality of life were recorded.
Of 21 dogs included, 10 were mixed breeds and 14 were females. Median age at time of presenting clinical signs was 163 days. At final follow-up examination (median 1119 days), all SA and 6/14 MM dogs were alive, with a median survival time of 2138 days following treatment onset. In surviving MM dogs, outcome was fair in 3/6 and poor in 3/6. In SA dogs with long-term follow-up, outcome was fair in 5/6, and poor in 1/6. A greater proportion of SA dogs had improved bloodwork parameter values at final follow-up examination, and the mean relative change in final bloodwork values was higher when compared to MM dogs.
These findings demonstrate that SA has improved clinical outcomes to MM for PC-EHPSS; however, SA clinical outcomes appear worse than those previously reported for other EHPSS.
This information may have implications for expected outcomes in other EHPSS subtypes associated with severely diminished portal perfusion.
评估经单纯药物治疗（MM）或手术减流（SA）治疗的患有侧-侧肝外门体分流（PC-EHPSS）且肝脏门静脉灌注不良的犬的预后情况。
多机构回顾性研究。
共有21只患有PC-EHPSS的犬（14/21接受MM治疗，7/21接受SA治疗）。
回顾病历，并收集2008年6月至2021年6月期间接受MM或SA治疗的体重<12 kg的患有PC-EHPSS的犬的数据。记录品种、临床症状、术后并发症、血液检查值、长期临床结局、生存率以及主人报告的生活质量。
纳入的21只犬中，10只为混血品种，14只为雌性。出现临床症状时的中位年龄为163天。在末次随访检查时（中位时间为1119天），所有接受SA治疗的犬和6/14接受MM治疗的犬存活，治疗开始后的中位生存时间为2138天。在存活的接受MM治疗的犬中，3/6结局为一般，3/6结局较差。在接受长期随访的接受SA治疗的犬中，5/6结局为一般，1/6结局较差。在末次随访检查时，接受SA治疗的犬中有更大比例的血液检查参数值得到改善，与接受MM治疗的犬相比，最终血液检查值的平均相对变化更高。
这些发现表明，对于PC-EHPSS，SA治疗的临床结局优于MM治疗；然而，SA治疗的临床结局似乎比先前报道的其他EHPSS的结局更差。
该信息可能对与门静脉灌注严重减少相关的其他EHPSS亚型的预期结局有影响。
