Long-Term Results of Complete and Partial Ligation of Congenital Portosystemic Shunts in Dogs |
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| Authors: | HEIDI A HOTTINGER DVM RICHARD WALSHAW BVMS Diplomate ACVS JOE G HAUPTMAN DVM MS Diplomate ACVS |
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| Institution: | Department of Small Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, MI. |
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| Abstract: | The medical records of 65 dogs that underwent complete or partial ligation of a single congenital portosystemic shunt (CPSS) were reviewed to determine the long-term clinical results. Information retrieved from the records included age at surgery, preligation (baseline) portal pressure, postligation portal pressure, change in portal pressure from baseline, complete or partial occlusion of the shunting vessel and fasting, and 2-hour postprandial bile acids from the preoperative, early postoperative (PO), and greater than 1 year PO time periods. A clinical rating score derived from a follow-up examination greater than 1 year PO was assigned to each dog. Of the 56 dogs that survived the perioperative period, 29 (52%) had complete and 27 (48%) had partial ligations. Age at surgery, pre- and postligation portal pressure, change in portal pressure from baseline and serum bile acid concentrations were not related to long-term clinical outcome. Clinical rating scores were significantly greater for dogs with partial CPSS ligations compared with dogs with complete ligations, indicating a less favorable clinical outcome for partial ligations. Fasting and 2-hour postprandial bile acid values at both PO time intervals were significantly greater in partial versus complete ligation groups. Follow-up information for more than 1 year was available on 18 of 29 dogs (62%) with complete ligations. All were clinically normal. Of 27 dogs with partial ligations, 11 dogs (41%) developed recurrence of clinical signs resulting in presentation to the university or referring veterinarian for additional surgery, medical management, or euthanasia. Only three dogs with partial CPSS ligation (11%) were clinically normal. Another nine dogs (33%) were operated on again before the possible development of clinical signs and four dogs (15%) were unavailable for follow-up. It was concluded that partial ligation of CPSS is associated with a greater recurrance of clinical signs and patient morbidity than complete ligation. |
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