A mattress suture with pledgets can partially occlude intrahepatic shunts in 23 dogs: evaluation of long-term survival.

Abstract

To explore the differences in outcomes between dogs with intrahepatic portosystemic shunts (IHPSSs) partially occluded with a mattress suture with pledgets or attenuated with cellophane banding. 74 dogs with IHPSSs were included in this retrospective study. Medical records between January 2000 and February 2020 were evaluated for information on dogs undergoing laparotomy with cellophane banding (group C) or mattress suture with pledgets (group P) for treatment of IHPSSs, including specific outcomes of survival time, persistence of clinical signs, and necessity of continued medical management. Primary veterinarians and owners were contacted for long-term follow-up. 51 dogs were entered in group C and 23 in group P. The duration of surgery was 154.6 minutes (136.3 to 170 minutes) for group C and 154.9 minutes (128.9 to 180.9 minutes) for group P. The short-term mortality rate was 2% for group C and 4% for group P. Dogs in group C had a median survival time of 3,537 days, while dogs in group P had a median survival time of 2,141 days. In the long term, dogs in group P received more medications than dogs in group C, but the distribution of the quality-of-life score was not different. Mattress suture with pledgets can be used as an alternative to cellophane banding. For dogs with IHPSSs where full surgical dissection for placement of cellophane band is not possible, partial occlusion of the shunt with a mattress suture with pledgets is a viable option with acceptable long-term outcomes.