Sohee Bae, William T N Culp, Allison L Zwingenberger
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Data collected included signalment, clinical signs, preoperative and postoperative clinicopathologic values, diagnostic imaging findings, surgical details, and short- and long-term postoperative follow-up information.</p><p><strong>Results: </strong>7 client-owned dogs diagnosed with congenital EHPSS and suspected portal vein atresia on CTA that underwent surgical exploration at the William R. Pritchard Veterinary Medical Teaching Hospital at the University of California-Davis from 2010 to 2022 were identified. Surgical attenuation of the EHPSS was successfully performed in 6 of 7 dogs. Intraoperative mesenteric portovenography (IOMP) and/or clinical indicators (eg, absence of visceral congestion) were used to determine suitability for attenuation. In 2 dogs, IOMP was performed, which revealed intrahepatic portal vasculature only after temporary EHPSS occlusion. Postoperative clinicopathologic values and clinical signs were favorable in all 6 dogs that underwent attenuation, with no long-term complications reported. The numeric scoring scale applied to CTA did not appear to influence intraoperative decision-making.</p><p><strong>Conclusions: </strong>Surgical attenuation of EHPSS in dogs with absent portal branches on CTA may be associated with favorable long-term follow-up, when supported by intraoperative findings.</p><p><strong>Clinical relevance: </strong>These findings highlight the limitations of CTA alone in preoperative decision-making for these complex cases and support the use of dynamic evaluation, such as IOMP, in guiding treatment strategies.</p>","PeriodicalId":7754,"journal":{"name":"American journal of veterinary research","volume":" ","pages":"1-6"},"PeriodicalIF":1.4000,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Dogs with congenital extrahepatic shunts and absent portal vasculature noted on computed tomographic angiography can successfully undergo surgical attenuation.\",\"authors\":\"Sohee Bae, William T N Culp, Allison L Zwingenberger\",\"doi\":\"10.2460/ajvr.25.04.0146\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>To evaluate the clinical outcomes of dogs with a single congenital extrahepatic portosystemic shunt (EHPSS), in which portal vein atresia (PVA) was considered a differential diagnosis based on CT angiography (CTA), and that underwent surgical exploration.</p><p><strong>Methods: </strong>Medical records were retrospectively reviewed for dogs with a single congenital EHPSS and absent portal vein branches on CTA. 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引用次数: 0
摘要
目的：评价单纯性先天性肝外门静脉分流（EHPSS）犬的临床疗效，其中门静脉闭锁（PVA）被认为是基于CT血管造影（CTA）的鉴别诊断，并进行手术探查。方法：回顾性分析单纯性先天性EHPSS和门静脉分支缺失犬的CTA病历。收集的数据包括信号、临床体征、术前和术后临床病理值、诊断成像结果、手术细节以及术后短期和长期随访信息。结果：2010年至2022年在加州大学戴维斯分校William R. Pritchard兽医教学医院进行手术探查的7只客户犬被诊断为先天性EHPSS并在CTA上疑似门静脉闭锁。7只狗中有6只成功地进行了EHPSS的手术衰减。术中肠系膜门静脉造影（IOMP）和/或临床指标（如内脏充血的缺失）被用来确定衰减的适宜性。在2只狗中，IOMP显示只有在暂时阻断EHPSS后才有肝内门静脉血管。6只衰减犬术后临床病理指标和临床体征均良好，无长期并发症报道。应用于CTA的数字评分量表似乎不影响术中决策。结论：当术中发现支持时，CTA门静脉分支缺失犬的EHPSS手术衰减可能与良好的长期随访有关。临床意义：这些发现强调了CTA在这些复杂病例的术前决策中的局限性，并支持使用动态评估，如IOMP，来指导治疗策略。
Dogs with congenital extrahepatic shunts and absent portal vasculature noted on computed tomographic angiography can successfully undergo surgical attenuation.
Objective: To evaluate the clinical outcomes of dogs with a single congenital extrahepatic portosystemic shunt (EHPSS), in which portal vein atresia (PVA) was considered a differential diagnosis based on CT angiography (CTA), and that underwent surgical exploration.
Methods: Medical records were retrospectively reviewed for dogs with a single congenital EHPSS and absent portal vein branches on CTA. Data collected included signalment, clinical signs, preoperative and postoperative clinicopathologic values, diagnostic imaging findings, surgical details, and short- and long-term postoperative follow-up information.
Results: 7 client-owned dogs diagnosed with congenital EHPSS and suspected portal vein atresia on CTA that underwent surgical exploration at the William R. Pritchard Veterinary Medical Teaching Hospital at the University of California-Davis from 2010 to 2022 were identified. Surgical attenuation of the EHPSS was successfully performed in 6 of 7 dogs. Intraoperative mesenteric portovenography (IOMP) and/or clinical indicators (eg, absence of visceral congestion) were used to determine suitability for attenuation. In 2 dogs, IOMP was performed, which revealed intrahepatic portal vasculature only after temporary EHPSS occlusion. Postoperative clinicopathologic values and clinical signs were favorable in all 6 dogs that underwent attenuation, with no long-term complications reported. The numeric scoring scale applied to CTA did not appear to influence intraoperative decision-making.
Conclusions: Surgical attenuation of EHPSS in dogs with absent portal branches on CTA may be associated with favorable long-term follow-up, when supported by intraoperative findings.
Clinical relevance: These findings highlight the limitations of CTA alone in preoperative decision-making for these complex cases and support the use of dynamic evaluation, such as IOMP, in guiding treatment strategies.
期刊介绍：
The American Journal of Veterinary Research supports the collaborative exchange of information between researchers and clinicians by publishing novel research findings that bridge the gulf between basic research and clinical practice or that help to translate laboratory research and preclinical studies to the development of clinical trials and clinical practice. The journal welcomes submission of high-quality original studies and review articles in a wide range of scientific fields, including anatomy, anesthesiology, animal welfare, behavior, epidemiology, genetics, heredity, infectious disease, molecular biology, oncology, pharmacology, pathogenic mechanisms, physiology, surgery, theriogenology, toxicology, and vaccinology. Species of interest include production animals, companion animals, equids, exotic animals, birds, reptiles, and wild and marine animals. Reports of laboratory animal studies and studies involving the use of animals as experimental models of human diseases are considered only when the study results are of demonstrable benefit to the species used in the research or to another species of veterinary interest. Other fields of interest or animals species are not necessarily excluded from consideration, but such reports must focus on novel research findings. Submitted papers must make an original and substantial contribution to the veterinary medicine knowledge base; preliminary studies are not appropriate.
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