title: Clinical outcome of congenital extrahepatic portosystemic shunt attenuation in dogs aged five years and older: 17 cases (1992-2005).
abstract: OBJECTIVE
  To assess the outcome of extrahepatic portosystemic shunt (EHPSS) treatment in dogs aged 5 years and older.
  
  
  METHODS
  Retrospective case series.
  
  
  METHODS
  17 client-owned dogs.
  
  
  METHODS
  Medical records for dogs (> or = 5 years old) that underwent surgical attenuation of an EHPSS (1992 through 2005) were evaluated; data, including clinical signs, clinicopathologic findings, surgical procedure, and outcome, were recorded. Follow-up information was obtained via patient examination or telephone interview with veterinarians and owners.
  
  
  RESULTS
  Dogs (5 to 9 years old [median age, 6.6 years]) had neurologic (n = 12), urinary tract (8), and gastrointestinal tract (6) EHPSS-associated clinical signs. Serum bile acids and ammonia concentrations were abnormal in all evaluated dogs. Treatment of EHPSSs included complete (n = 6 dogs) or partial (2) suture attenuation or ameroid constrictor placement (9). Two dogs died following surgery. Follow-up information (6 to 120 months) was available for 13 dogs. Deaths were attributable to heart failure (n = 1), bacterial hepatitis (2; with pyelonephritis in 1 dog), and unknown causes (3). At a median of 23 and 25 months, serum bile acids concentrations had almost normalized in 5 of 8 dogs and ammonia concentrations were within reference limits in 3 of 5 dogs, respectively; dogs with abnormal liver function test results had no associated clinical signs. Median long-term survival time was 72 months.
  
  
  CONCLUSIONS
  Attenuation of EHPSS in > or = 5-year-old dogs ameliorated signs of liver dysfunction in surviving dogs, although return of normal liver function occurred less frequently than expected.
authors.affiliation: Department of Clinical Studies, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA 19104-6010, USA.
authors.forename: Deanna R
authors.initials: DR
authors.lastname: Worley
authors.forename: David E
authors.initials: DE
authors.lastname: Holt
mesh_terms: D000367:Age Factors; D000641:Ammonia; D000818:Animals; D004285:Dogs / Q000002:abnormalities* / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D008026:Ligation; D008297:Male; D011168:Portal System / Q000002:abnormalities* / Q000601:surgery*; D011183:Postoperative Complications / Q000453:epidemiology / Q000401:mortality / Q000662:veterinary; D011184:Postoperative Period; D012189:Retrospective Studies; D016019:Survival Analysis; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000641:Ammonia