Outcome associated with use of a percutaneously controlled hydraulic occluder for treatment of dogs with intrahepatic portosystemic shunts.
OBJECTIVE
To evaluate efficacy of a hydraulic occluder (HO) used for treatment of dogs with an intrahepatic portosystemic shunt (IHPSS).


METHODS
Prospective study.


METHODS
10 dogs with an IHPSS.


METHODS
Serum biochemical and postprandial bile acids (PPBA) analyses and transcolonic scintigraphy were performed before surgery. Laparotomy was performed, and an uninflated HO was placed around the portal vein branch leading to the IHPSS. After surgery, 0.9% NaCl solution was injected into subcutaneous injection ports at 2, 4, 6, and 8 weeks to achieve staged occlusion of the HO. Serum biochemical analyses, PPBA analysis, and scintigraphy were performed 2 weeks after occlusion. Serum biochemical analyses were repeated 1 year after surgery.


RESULTS
Implant revision was required in 3 dogs because of rupture of the HO (n = 2) or detachment of the actuating tubing (1). Serum biochemical values and clinical signs improved in all dogs after surgery. Six of 10 dogs had PPBA concentration within reference range 2 weeks after occlusion, and 2 additional dogs had concentrations within reference range at 1 year. Only 5 of 10 dogs had complete resolution of portosystemic shunting 2 weeks after occlusion. Two dogs were lost to follow-up, and 8 dogs remained alive with no recurrence of clinical signs at a median of 22 months after surgery.


CONCLUSIONS
Use of the HO appeared to be an effective method for surgical treatment for dogs with IHPSS, although problems with implant reliability indicate a need for modifications in design and manufacturing.
Adin
Christopher A
CA
Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL 32610, USA.
Sereda
Colin W
CW
Thompson
Margaret S
MS
Wheeler
Jason L
JL
Archer
Linda L
LL
D000818:Animals; D001774:Blood Chemical Analysis / Q000662:veterinary; D001783:Blood Flow Velocity / Q000662:veterinary; D003250:Constriction; D004283:Dog Diseases / Q000151:congenital / Q000601:surgery*; D004285:Dogs; D011168:Portal System / Q000002:abnormalities* / Q000601:surgery*; D011169:Portal Vein / Q000002:abnormalities / Q000601:surgery; D011446:Prospective Studies; D016896:Treatment Outcome