PORTOSYSTEMIC SHUNTS: MANAGING COMPLICATIONS

摘要

In dogs with extrahepatic (EH) portosystemic shunts (PSS), many surgeons prefer methods of gradual occlusion to avoid the need for a second surgery, since most dogs cannot undergo acute complete ligation. Brunson et al (CVJ 2016) reported an overall short term survival of 93.5% after gradual attenuation (cellophane band or ameroid constrictor placement) of EHPSS in dogs. The most common cause of death was postoperative seizures. One and 2 year survival rates were 90.3% and 88.7%; having a CT angiogram immediately before surgery did not increase mortality rates. Two other deaths were caused by cardiac arrest of unknown etiology. Falls et al (Vet Surg 2013) reported a short term (<1 month) mortality rate of 7.3% after EHPSS occlusion with an ameroid constrictor. Mortality was not related to age or presence of neurologic signs. Long term, 17% of dogs died because of causes related to EHPSS (median overall survival, 12.8 years). At long term follow up, 92% had no clinical signs.