Abstract

The objective of the study was to evaluate the clinical and laboratory outcome after the surgical treatment of a single congenital extrahepatic portosystemic shunt using an ameroid constrictor. Patient medical records were reviewed in retrospect. Data on the signalment, clinical signs, preoperative bile acid stimulation test and ammonia concentration were recorded. The surgical treatment success rate was evaluated by mortality in the perioperative and short-term postoperative period and by the long-term clinical outcome. Bile acid stimulation test and ammonia concentration were also analysed 2–3 days, 4–6 weeks, and 6–8 weeks postoperatively. No patient died in the selected periods. The long-term clinical outcome was excellent in 15 out of 20 patients, good in 3 out of 20 patients and poor in 2 out of 20 patients. Preprandial bile acid concentration was elevated in 96.00%, postprandial bile acid concentration in 100.00% and ammonia concentration in 80.95% of patients preoperatively. A significant decrease was found in postprandial bile acid and ammonia 2–3 days postoperatively and in preprandial bile acid 4–6 weeks postoperatively. A significant decrease in liver function parameters in days post operation indicates a rapid restoration of hepatic function. The surgical treatment of a single extrahepatic portosystemic shunt using an ameroid constrictor is a successful method of treatment for this type of portosystemic shunt, with as much as 75.00% of the patients having an excellent long-term clinical outcome.

Highlights

  • The objective of the study was to evaluate the clinical and laboratory outcome after the surgical treatment of a single congenital extrahepatic portosystemic shunt using an ameroid constrictor

  • The retrospective study was conducted by reviewing medical records of dogs with Single congenital extrahepatic portosystemic shunt (SEHPSS) that underwent surgical treatment using an ameroid constrictor at the Department of Surgery & Orthopaedics at the Small Animal Clinic, Faculty of Veterinary Medicine, University of Veterinary and Pharmaceutical Sciences Brno, Czech Republic, from January 2013 to July 2017

  • With our study, zero mortality after thr surgical treatment of SEHPSS using an ameroid constrictor was described by Bright et al (2006), who used the ameroid constrictor for surgical treatment of intrahepatic Portosystemic shunt (PSS) in nine dogs and one cat

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Summary

Introduction

The objective of the study was to evaluate the clinical and laboratory outcome after the surgical treatment of a single congenital extrahepatic portosystemic shunt using an ameroid constrictor. The surgical treatment of a single extrahepatic portosystemic shunt using an ameroid constrictor is a successful method of treatment for this type of portosystemic shunt, with as much as 75.00% of the patients having an excellent long-term clinical outcome. Plasma or serum ammonia concentration sensitivity in detecting PSS is 85.00–98.00% and the specificity is 86.00% (Gerritzen-Bruning et al 2006; Ruland et al 2010) Assessment of these two parameters can be used for diagnosing PSS, and for the postoperative monitoring of patients. The second aim of the study was to evaluate changes in plasma BA and ammonia concentrations before and after surgery of SEHPSS using an ameroid constrictor

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