Endovascular evaluation and treatment of intrahepatic portosystemic shunts in dogs: 100 cases (2001–2011)

Weisse, Chick; Berent, Allyson; Todd, Kimberly L.; Solomon, Jeffrey A.; Cope, Constantin

doi:10.2460/javma.244.1.78

Cited by 65 publications

(172 citation statements)

References 36 publications

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“…, Weisse et al . ). Based on the current published literature there appears to be a discrepancy in objective measures of outcome (biochemical changes) versus subjective outcome (owner perceived improvement).…”

Section: Introductionmentioning

confidence: 97%

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Health‐related quality of life following surgical attenuation of congenital portosystemic shunts versus healthy controls

Bristow

Lipscomb

Kummeling

et al. 2018

J of Small Animal Practice

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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.

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Section: Introductionmentioning

confidence: 97%

“…, Weisse et al . , Winkler et al 2014). Most studies assessing biochemical parameters as an outcome measure do not show a return to normal reference values (Lawrence et al 1992, Hunt & Hughes , Bristow et al .…”

Section: Introductionmentioning

confidence: 99%

Health‐related quality of life following surgical attenuation of congenital portosystemic shunts versus healthy controls

Bristow

Lipscomb

Kummeling

et al. 2018

J of Small Animal Practice

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“…Whilst the sample size in this study is small, it does suggest that the cats with prolonged PT and aPTT tests prior to surgery are not at increased risk of developing a clinical perioperative bleeding complication. There are reports of dogs with CPSS suffering serious or fatal postoperative haemorrhage, [13][14][15]30 but overt bleeding is overall an uncommon complication in animals with a CPSS, severe liver disease or failure. 1,3,5,8,31 One possible theory for why many of these animals do not become hypocoagulable is that the pro-coagulant system is not affected in isolation.…”

Section: Discussionmentioning

confidence: 99%

“…1,3,4,9,12,13 Incidences of haemorrhage, as a result of coagulopathy, in dogs undergoing surgery for CPSS attenuation have been documented but are rare in the literature. [13][14][15] The red blood cell parameters for cats with CPSS are reported in four studies including 130 cats in total with 25-54% having a microcytosis, and 0-15% being anaemic, [16][17][18][19] In one study, 33% of cats had microcytosis without a concurrent anaemia. 19 There is less information regarding coagulation parameters in cats with a CPSS with, to the authors' knowledge, only one study reporting the haematology and coagulation parameters of a series of six cats with portal vein thrombosis, three of which were ultimately diagnosed with CPSS.…”

Section: Introductionmentioning

confidence: 99%

Haematology and coagulation profiles in cats with congenital portosystemic shunts

Tzounos

Tivers

Adamantos

et al. 2017

Journal of Feline Medicine and Surgery

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General rightsThis document is made available in accordance with publisher policies. Please cite only the published version using the reference above. Full terms of use are available: http://www.bristol.ac.uk/pure/about/ebr-terms Results: Fourty-two cats were included. Thirty-six cats (87.5%) had an extrahepatic CPSS and six (14.3%) had an intrahepatic CPSS. Pre-operatively, mean cell volume (MCV) and mean cell haemoglobin (MCH) were below the reference interval in 32 (76.2%) and 31 (73.8%) cats respectively. Red blood cell count (RBC) and mean cell haemoglobin concentration (MCHC) were above the reference interval in 10 (23.8%) and eight (19.1%) cats respectively. Postoperatively, there were significant increases in HCT (P = 0.044), MCV (P = 0.008) and MCH (P = 0.002). Despite the significant increase in MCV post-operatively, the median MCV post-operatively was below the reference interval indicating persistence of microcytosis. Preoperatively, PT was above the upper reference interval in 14 cats (87.5%), and aPTT was above the upper reference interval in 11 cats (68.7%). No cat demonstrated a peri-operative clinical bleeding complication. Haematology and Coagulation Profiles in Cats with Congenital Portosystemic Shunts Conclusions:Cats with a CPSS are likely to present with a microcytosis, but rarely present with anaemia, leukocytosis or thrombocytopenia. Surgical attenuation of the CPSS results in a significant increase in the HCT and MCV. Coagulation profiles in cats with a CPSS are likely to be prolonged, irrespective of shunt type, but do not appear to be associated with an increased risk of clinical bleeding.MANUSCRIPT

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“…To our knowledge, the histological characteristics of the gastrointestinal tract of dogs with portal hypertension have not been well described. However, gastroduodenal ulceration has been reported to be a complication of various hepatic diseases in dogs . Hypergastrinemia does not appear to be common in dogs with CH, and thus, mechanisms other than gastric hyperacidity are likely to be important.…”

Section: Consequences Of Hepatic Fibrosismentioning

confidence: 99%

Hepatic Fibrosis in Dogs

Eulenberg

Lidbury

2017

Veterinary Internal Medicne

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Hepatic fibrosis is commonly diagnosed in dogs, often as a sequela to chronic hepatitis (CH). The development of fibrosis is a crucial event in the progression of hepatic disease that is of prognostic value. The pathophysiology of hepatic fibrosis in human patients and rodent models has been studied extensively. Although less is known about this process in dogs, evidence suggests that fibrogenic mechanisms are similar between species and that activation of hepatic stellate cells is a key step. Diagnosis and staging of hepatic fibrosis in dogs requires histopathological examination of a liver biopsy specimen. However, performing a liver biopsy is invasive and assessment of fibrotic stage is complicated by the absence of a universally accepted staging scheme in veterinary medicine. Serum biomarkers that can discriminate among different fibrosis stages are used in human patients, but such markers must be more completely evaluated in dogs before clinical use. When successful treatment of its underlying cause is feasible, reversal of hepatic fibrosis has been shown to be possible in rodent models and human patients. Reversal of fibrosis has not been well documented in dogs, but successful treatment of CH is possible. In human medicine, better understanding of the pathomechanisms of hepatic fibrosis is leading to the development of novel treatment strategies. In time, these may be applied to dogs. This article comparatively reviews the pathogenesis of hepatic fibrosis, its diagnosis, and its treatment in dogs.

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Endovascular evaluation and treatment of intrahepatic portosystemic shunts in dogs: 100 cases (2001–2011)

Cited by 65 publications

References 36 publications

Health‐related quality of life following surgical attenuation of congenital portosystemic shunts versus healthy controls

Health‐related quality of life following surgical attenuation of congenital portosystemic shunts versus healthy controls

Haematology and coagulation profiles in cats with congenital portosystemic shunts

Hepatic Fibrosis in Dogs

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