title: Attenuation of congenital portosystemic shunt reduces inflammation in dogs.
abstract: Liver disease is a major cause of morbidity and mortality. One of the most significant complications in patients with liver disease is the development of neurological disturbances, termed hepatic encephalopathy. The pathogenesis of hepatic encephalopathy is incompletely understood, which has resulted in the development of a wide range of experimental models. Congenital portosystemic shunt is one of the most common congenital disorders diagnosed in client owned dogs. Our recent studies have demonstrated that the pathophysiology of canine hepatic encephalopathy is very similar to human hepatic encephalopathy, which provides strong support for the use of dogs with a congenital portosystemic shunt as a naturally occurring model of human hepatic encephalopathy. Specifically, we have demonstrated an important role for ammonia and inflammation in the development of hepatic encephalopathy in dogs with a congenital portosystemic shunt. Despite the apparent importance of inflammation in driving hepatic encephalopathy in dogs, it is unclear whether inflammation resolves following the successful treatment of liver disease. We hypothesized that haematological and biochemical evidence of inflammation, as gauged by neutrophil, lymphocyte and monocyte concentrations together with C-reactive protein concentrations, would decrease following successful treatment of congenital portosystemic shunts in dogs. One hundred and forty dogs with a congenital portosystemic shunt were enrolled into the study. We found that the proportion of dogs with a monocyte concentration above the reference range was significantly greater in dogs with hepatic encephalopathy at time of initial diagnosis. Importantly, neutrophil and monocyte concentrations significantly decreased following surgical congenital portosystemic shunt attenuation. We also found a significant decrease in C-reactive protein concentrations following surgical attenuation of congenital portosystemic shunts. Our study demonstrates that haematological and biochemical indices of inflammation reduce following successful treatment of the underlying liver disorder.
authors: Department of Veterinary Clinical Sciences, Royal Veterinary College, Hatfield, Hertfordshire, United Kingdom.
authors: Michael S
authors: MS
authors: Tivers
authors: Royal (Dick) School of Veterinary Studies and The Roslin Institute, The University of Edinburgh, Roslin, Midlothian, United Kingdom.
authors: Ian
authors: I
authors: Handel
authors: Royal (Dick) School of Veterinary Studies and The Roslin Institute, The University of Edinburgh, Roslin, Midlothian, United Kingdom.
authors: Adam G
authors: AG
authors: Gow
authors: Department of Veterinary Clinical Sciences, Royal Veterinary College, Hatfield, Hertfordshire, United Kingdom.
authors: Victoria J
authors: VJ
authors: Lipscomb
authors: UCL Institute for Liver and Digestive Health, UCL Medical School, London, United Kingdom.
authors: Rajiv
authors: R
authors: Jalan
authors: Royal (Dick) School of Veterinary Studies and The Roslin Institute, The University of Edinburgh, Roslin, Midlothian, United Kingdom; MRC Centre for Inflammation Research, University of Edinburgh, Edinburgh, United Kingdom.
authors: Richard J
authors: RJ
authors: Mellanby
mesh_terms: D000818:Animals; D002097:C-Reactive Protein / Q000032:analysis; D004195:Disease Models, Animal; D004283:Dog Diseases / Q000151:congenital / Q000209:etiology / Q000473:pathology*; D004285:Dogs; D005260:Female; D006501:Hepatic Encephalopathy / Q000151:congenital / Q000209:etiology / Q000473:pathology*; D006801:Humans; D007249:Inflammation / Q000378:metabolism / Q000473:pathology*; D008214:Lymphocytes / Q000166:cytology; D008297:Male; D009000:Monocytes / Q000166:cytology; D009504:Neutrophils / Q000166:cytology; D011170:Portasystemic Shunt, Surgical
chemical_list: D002097:C-Reactive Protein