The surgical attenuation of an intrahepatic portosystemic shunt in 45 dogs is described. Twenty-nine (64 per cent) had left divisional shunts consistent with a patent ductus venosus (PDV), 15 (33 per cent) had central divisional shunts and one had a right divisional shunt. In the dogs with a PDV, the shunt vessel could be most easily manipulated at a posthepatic site, whereas in those with central and right divisional shunts the manipulation could be more easily made intrahepatically but sometimes involved demanding intravascular surgical techniques. Eight dogs (18 per cent) died during the surgery or shortly afterwards. Of the 37 dogs surviving longer term, 28 (76 per cent) became clinically normal and required no medication or diet control. In a further three animals the shunt was ligated completely only during a second surgical procedure. The remaining six dogs were euthanased because of clinical signs of encephalopathy which were either surgically or medically uncontrollable.
The case records of 36 cats and dogs undergoing surgical correction of a single extrahepatic portosystemic shunt were reviewed. In 12 animals, the shunt was fully ligated during the first surgical procedure, while, in the remaining 24, the shunting vessel could only be partially ligated. Assessment of serum bile acid concentrations demonstrated complete shunt occlusion in 15 of these latter 24 animals (63 per cent) between one and six months postoperatively. Ten animals (28 per cent) had persistently high serum bile acid concentrations postoperatively. Portovenogram findings in these individuals revealed six that demonstrated shunting solely through the original vessel; In five of these, full shunt attenuation was achieved at second surgery. Further shunt manipulation was not possible in the sixth case due to extensive adhesion formation. In the remaining four animals with raised bile acid concentrations, the portovenogram demonstrated shunting through the original vessel as well as the development of multiple acquired shunts.
A retrospective study of the use of intraoperative mesenteric portovenography (IOMP) in the surgical management of congenital portosystemic shunts in 100 dogs and cats was performed. Each portovenogram was scored using a subjective visual analogue scale (VAS) and was assessed for the presence of portal atresia or hypoplasia. VAS scores and portal hypoplasia assessments were obtained for portovenogram images obtained for each animal both before shunt manipulation (preligation) and following the temporary, complete ligation of the vessel (postligation). In each patient, surgical records were reviewed to ascertain the degree of shunt attenuation that was achieved at surgery. Hepatic portal vasculature was significantly different on postligation compared with preligation IOMP. Sixty-two percent of animals had apparent portal hypoplasia or atresia on their preligation IOMP. The majority of these (81%) had an improvement in portal vasculature on postligation IOMP. It was concluded that both preligation and postligation IOMP provided valuable information regarding the morphology of congenital portosystemic shunts. An accurate assessment of an animal's portal vasculature could only be made following the interpretation of a postligation portovenogram, and these findings significantly influenced the surgical management of the patient. Although individuals with high postligation VAS scores were more likely to achieve full shunt attenuation at surgery, there was no quantifiable relationship between IOMP findings and the degree of shunt attenuation achieved.
A case of hypertrophic osteopathy secondary to a pulmonary spindle cell sarcoma is described. The 9-year-old male cat presented with a 1-month history of decreased appetite, decreased activity and progressive lameness with swelling and pain of all four limbs. Thoracic radiographs showed a soft tissue opaque mass in the left caudal lung lobe. Radiographs of all limbs showed extensive periosteal new bone formation of uniform opacity demonstrating a 'palisading' pattern. The lung mass was removed at exploratory thoracotomy; histopathological examination diagnosed a low-grade spindle cell sarcoma. Prior to surgery, the cat had a non-specific conjunctivitis that resolved spontaneously following lobectomy raising the possibility of a paraneoplastic association. The lameness also resolved; six months after surgery, the periosteal palisading of new bone on the long bones had remodelled, and there was no evidence of pulmonary metastases.
The common hepatic artery in 10 healthy adult beagles, 20 healthy pups (13 Deerhounds and seven Irish Wolfhounds), and seven dogs with either a congenital or acquired hepatic disorder was examined by duplex-Doppler ultrasonography. Peak systolic velocity (Vs), resistive index (RI), pulse rate, angle of insonation, and sample volume depth were recorded. Measurements in Beagles were made after a 24 h fast and repeated 2 h after feeding. The mean Vs and RI in fasted Beagles were 1.5 m/s (range 1.1-2.3 m/s) and 0.68 (range 0.62-0.74), respectively. Postprandially, there were no significant differences in any of these variables. Mean Vs and RI were lower in pups: 1.0 m/s (range 0.8-1.3 m/s) and 0.59 (range 0.46-0.65), respectively (P < .001). Two dogs with congenital arterioportal fistula had higher mean Vs (P < .001) and lower mean RI (P < .05) than normal pups. No significant differences were detected between normal Beagles, three dogs with portal vein thrombosis, and two dogs with acquired hepatic insufficiency. Differences in measured hepatic blood flow in dogs of different age or breed will complicate diagnostic use of hepatic arterial Doppler measurements.
CMPA should be suspected when there is regurgitation and pyrexia associated with a mass or enlargement in the caudal mediastinum. CMPA appears to have a good prognosis after aggressive surgical therapy.
Two cases of benign unilateral ureteric flbroepithelial polyps in the dog are reported. The polyps were located in the proximal and distal ureter, respectively, and in each case resulted in obstruction of urine outflow and hydronephrosis. The microscopic appearance of both polyps was of a spindle cell matrix with an overlying transitional epithelium.
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