Objective: To compare the outcomes of dogs treated for single extrahepatic congenital portosystemic shunts (CPSS) by thin film banding (TFB) or placement of an ameroid constrictor (AC) at a single institution. Study design: Retrospective case series. Animals: 76 client owned dogs with CPSS treated with TFB (n=53) or AC (n=23). Methods: Records were reviewed for signalment, pre-, intra-and postoperative management and short-term outcomes. Data on second surgeries were reviewed. Long-term outcomes were obtained by use of an owner-directed health related quality of life questionnaire. The rates of complications, mortality, and revision surgery were compared between the treatment groups. Results: Postoperative complications occurred in 15 dogs with TFB (28%) (9% mortality, n=5) and 8 with AC (35%) (4% mortality, n=1) dogs. Long-term follow up was available in 41/56 dogs at a median of 53 (15-88) months. Revision surgery for persistent shunting was performed in 14 (29%) dogs treated initially with TFB, and no dogs treated initially with AC (P=0.007). Median long-term outcome scores were good in both groups. 9/14 revision surgeries led to favorable outcomes. Conclusions: Persistent shunting requiring revision surgery was more common when CPSS were treated with TFB than AC but both treatments achieved favorable long-term outcomes. Clinical significance: Treatment of CPPS by placement of an AC rather than a TFB seems more reliable for shunt attenuation and prevention of revision surgeries.
GASTRIC dilation‐volvulus syndrome (GDVs) comprises acute gastric dilation (GD), acute gastric dilation‐volvulus (GDV) and chronic gastric volvulus. This article, the first of two reviewing the management of GDVs in dogs, discusses the pathogenesis, pathophysiology, diagnosis and stabilisation of GDV. An article in the next issue will describe surgical and postoperative
GASTRIC dilation–volvulus (GDV) is a challenging but rewarding condition to treat. Appropriate decision making and management can help to achieve a success rate of up to 95 per cent in cases uncomplicated by gastric necrosis. This article, the second of two reviewing the management of canine gastric dilation–volvulus syndrome (GDVs), describes the surgical and postoperative management of GDVs in dogs. An article in the February issue (In Practice, volume 31, pp 66-69) discussed the diagnosis and initial stabilisation of patients with GDVs.
Background: Congenital portosystemic shunt (cPSS) is one of the most common congenital disorders diagnosed in dogs. Hepatic encephalopathy (HE) is a frequent complication in dogs with a cPSS and is a major cause of morbidity and mortality. Despite HE been a major cause of morbidity in dogs with a cPSS, little is known about the cellular changes that occur in the central nervous system of dogs with a cPSS. Objectives: The objective of this study was to characterise the histological changes in the cerebral cortex and cerebellum of dogs with cPSS with particular emphasis on astrocyte morphology. Methods: Eight dogs with a confirmed cPSS were included in the study. Results: Six dogs had substantial numbers of Alzheimer type II astrocytes and all cases had increased immunoreactivity for glial fibrillary acidic protein in the cerebral cortex, even if there were minimal other morphological changes. Conclusions: This study demonstrates that dogs with a cPSS have marked cellular changes in the cerebral cortex and cerebellum. The cellular changes that occur in the cerebral cortex and cerebellum of dogs with spontaneously arising HE are similar to changes which occur in humans with HE, further validating dogs with a cPSS as a good model for human HE.
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