Symptomatic treatment of ascites with a peritoneo‐vesical automated fluid shunt system in a dog

Abstract

A six-year-old Rottweiler with chronic ascites and moderate panhypoproteinaemia that had been treated with large volume paracentesis over several months duration was diagnosed with a large bi-atrial mass and hepatic fibrosis. For palliative treatment, a peritoneo-vesical automated fluid shunt system with an integrated chargeable battery and an integrated computer to control pump function and to transmit data transcutaneously was implanted by coeliotomy. The pump was left in place for 10 weeks, eliminating the need for further paracentesis during this time. At the end of this period, no ascites was discernible and serum protein concentrations had returned to their respective reference intervals. As a complication, decubitus with skin perforation had developed above the pump. Besides palliative treatment of chronic refractory ascites, this pump may have application in other conditions characterised by chronic cavity effusion or in peritoneal dialysis.

Peritoneo-Vesical Shunt: A Feasible Therapeutic Alternative for Refractory Ascites in the Low-Income Setting

“…Clinically relevant ascites in patients with cirrhosis is initially managed with dietary sodium and fluid restriction, although most patients will require oral diuretic therapy [21]. Treatment options for patients with diuretic-resistant ascites include optimization of medical therapy, liver transplantation, therapeutic paracentesis, transjugular intrahepatic portosystemic shunt (TIPS) and other invasive treatments, such as Leveen peritoneovenous shunts or surgical portosystemic shunts [21][22][23][24][25], Venzin et al [25] reported the use of a peritoneo-vesical automated shunt system with a pump implanted in a dog with refractory ascites. The system was effective for 10 weeks, but a skin perforation developed over the pump Bellot et al [26] reported in 2013 the first non-randomized clinical trial using an automated pump system for cirrhosis-related refractory ascites in 40 patients with a 6-month follow-up.…”