Association of portovenographic findings with outcome in dogs receiving surgical treatment for single congenital portosystemic shunts: 45 cases (2000-2004).
OBJECTIVE
To determine whether hepatic portal vascularity, as assessed by intraoperative mesenteric portovenography (IMP), is related to outcome in dogs undergoing attenuation of single congenital portosystemic shunts (CPSSs).


METHODS
Retrospective case series.


METHODS
45 dogs, each with a single CPSS, in which IMP was performed before and after temporary complete occlusion of the shunting vessel and that underwent complete (17 dogs) or partial (28 dogs) CPSS attenuation (surgery 1).


METHODS
Medical records were reviewed for signalment, clinical history, and bile acids stimulation test results. Intrahepatic portal vessel (IPV) opacification in pre- and postocclusion portovenograms was graded to determine whether the degree of opacification was correlated with the degree of shunt attenuation, clinical or biochemical factors, or long-term clinical outcome. In 17 of 28 dogs that had partial CPSS attenuation, these procedures were subsequently repeated (surgery 2) to achieve complete (14 dogs) or further partial (3 dogs) CPSS attenuation.


RESULTS
Compared with preattenuation findings, IPV opacification increased significantly after partial or complete CPSS attenuation. The degree of IPV opacification before and after CPSS occlusion (surgery 1) was greater in dogs that tolerated complete versus partial CPSS attenuation and was correlated positively with age. The degree of IPV opacification following CPSS occlusion (surgery 1) was maximal in all dogs without encephalopathy and was correlated negatively with follow-up preprandial serum bile acids concentrations and positively with clinical improvement.


CONCLUSIONS
Data suggest that IMP can be used to assess changes in IPV blood flow and help predict outcome following attenuation of single CPSSs in dogs.
Lee
Karla C L
KC
Department of Veterinary Clinical Sciences, The Royal Veterinary College, University of London, North Mymms, Hertfordshire AL9 7TA, UK.
Lipscomb
Victoria J
VJ
Lamb
Christopher R
CR
Gregory
Susan P
SP
Guitian
Javier
J
Brockman
Daniel J
DJ
D000818:Animals; D004283:Dog Diseases / Q000000981:diagnostic imaging* / Q000601:surgery; D004285:Dogs; D005260:Female; D006975:Hypertension, Portal / Q000000981:diagnostic imaging / Q000601:surgery / Q000662:veterinary; D008297:Male; D010690:Phlebography / Q000379:methods / Q000662:veterinary*; D011168:Portal System / Q000002:abnormalities / Q000000981:diagnostic imaging / Q000601:surgery; D011169:Portal Vein / Q000002:abnormalities* / Q000000981:diagnostic imaging / Q000601:surgery; D011172:Portography / Q000379:methods / Q000662:veterinary*; D012189:Retrospective Studies; D016896:Treatment Outcome