Objectives To design a health‐related quality of life questionnaire for dogs with congenital portosystemic shunts, use it in a cohort of dogs treated with suture attenuation and compare results with those obtained from a healthy control cohort. Materials and Methods Data were collected from the hospital records of dogs treated with suture ligation of an intrahepatic or extrahepatic congenital portosystemic shunt at two referral centres. Owners were asked to complete a questionnaire assessing their dog's health‐related quality of life preoperatively (retrospectively) and at the time of follow‐up. Owners of control dogs also completed the questionnaire. Results One hundred and twenty‐eight dogs with congenital portosystemic shunts and 131 control dogs were recruited. Median follow‐up time was 64 months (range 19.7 to 157.2). The median long‐term health‐related quality of life score was excellent for both intrahepatic and extrahpatic shunt cases and similar to that of control dogs. The long‐term portosystemic shunt clinical sign scores for both intrahepatic and extrahepatic congenital portosystemic shunt dogs were significantly worse than the those of the control group. Clinical Significance Suture attenuation of congenitial portosystemic shunts is associated with an excellent health‐related quality of life score at long‐term follow‐up.

CLP and HDCP may both be used successfully to achieve pancarpal arthrodesis. Adjunctive external coaptation does not appear to have a measurable clinical benefit but is associated with morbidity.

The results suggest that in dogs treated with complete suture ligation mild increases in serum bile acids are not clinically relevant if there are no physical examination abnormalities, a normal body condition score and no relapse in clinical signs.

Staged suture ligation resulted in a high proportion of complete attenuation and reduced persistent shunting compared with a single surgery. Repeat surgery was associated with fewer complications than the first surgery. The proportion of dogs with an excellent outcome was greater for those that had complete attenuation in one or two surgeries compared with those with persistent shunting.

Although closed active suction drains can be used with low risk of major complications, they lead to a high rate of infection in clean surgeries in dogs. It is recommended that such drains are kept in place for the shortest time possible and that strict asepsis is adhered to both during placement and management.