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Review
. 2023 May 12;10(5):346.
doi: 10.3390/vetsci10050346.

Congenital Portosystemic Shunts in Dogs and Cats: Treatment, Complications and Prognosis

Alexandros O Konstantinidis  1 , Katerina K Adamama-Moraitou  1 , Michail N Patsikas  2 , Lysimachos G Papazoglou  3
Affiliations
Review

Congenital Portosystemic Shunts in Dogs and Cats: Treatment, Complications and Prognosis

Alexandros O Konstantinidis et al. Vet Sci. .

Abstract

Congenital portosystemic shunts (CPSS) are a common vascular anomaly of the liver in dogs and cats. Clinical signs of CPSS are non-specific and may wax and wane, while laboratory findings can raise the clinical suspicion for CPSS, but they are also not specific. Definitive diagnosis will be established by evaluation of liver function tests and diagnostic imaging. The aim of this article is to review the management, both medical and surgical, complications, and prognosis of CPSS in dogs and cats. Attenuation of the CPSS is the treatment of choice and may be performed by open surgical intervention using ameroid ring constrictors, thin film banding, and partial or complete suture ligation or by percutaneous transvenous coil embolization. There is no strong evidence to recommend one surgical technique over another. Medical treatment strategies include administration of non-absorbable disaccharides (i.e., lactulose), antibiotics, and dietary changes, and are indicated for pre-surgical stabilization or when surgical intervention is not feasible. After CPSS attenuation, short- and long-term post-surgical complications may be seen, such as post-operative seizures and recurrence of clinical signs, respectively. Prognosis after surgical attenuation of CPSS is generally favorable for dogs and fair for cats.

Keywords: attenuation; canine; complications; feline; portosystemic shunt; prognosis; treatment.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Intraoperative measurement of portal pressure through a mesenteric vein catherization (arrow) during an intrahepatic shunt attenuation in a dog.
Figure 2
Figure 2
(A): A portocaval shunt is evident over a right angle forceps. (B): An ameroid constrictor was placed around the shunt for attenuation.
Figure 3
Figure 3
(A): Intrahepatic portosystemic shunt of the caudate lobe creating an aneurism within the hepatic paranchyma (arrow). (B): Ameroid constrictor placed around the right portal branch that supplies the caudate lobe.
Figure 4
Figure 4
(A): A right divisional portosystemic shunt (asterisk) is visualized. (B): A thin film (arrow) was placed around the shunt. A polypropylene suture that was placed around the shunt to facilitate easier thin film placement was removed prior to celiotomy closure.
Figure 5
Figure 5
Multiple acquired shunts (arrows) that developed following a portocaval shunt attenuation using an ameroid constrictor.
See this image and copyright information in PMC

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