Comparative outcomes between ameroid ring constrictor and cellophane banding for treatment of single congenital extrahepatic portosystemic shunts in 49 dogs (1998-2012).

Abstract

To compare outcomes and identify prognostic factors in dogs with single congenital extrahepatic portosystemic shunt (CEHPSS) gradually attenuated with an ameroid ring constrictor (ARC) or cellophane banding (CB). Retrospective, multi-institutional study. Forty-nine dogs with CEHPSS (n = 23 for ARC; n = 26 for CB). Medical records of dogs with CEHPSS treated by ARC or CB were reviewed for postoperative (<1 month), midterm (1-6 months), and long-term (> 6 months) outcomes. Data were evaluated to detect factors associated with postoperative complications, residual shunting, and long-term outcome. Postoperative complication rates did not differ between ARC (26.1%) and CB (23.1%, P = .89) and were negatively associated with body weight (P = .03). Overall, postoperative mortality was low (2.0%). Clinical long-term outcome was excellent in 45.0% and 39.1% and good in 55.0% and 60.9% of dogs after ARC and CB, respectively. Suspected residual shunting rate upon abdominal ultrasonography was greater after CB (31.6%) than after ARC (0%). ARC and CB were both effective for attenuation of CEHPSS, resulting in good to excellent outcomes with low morbidity and mortality. Residual shunting was suspected in a higher proportion of dogs treated with CB on the basis of abdominal ultrasonography results. However, further prospective randomized studies must be conducted with validated evaluation methods to verify this assumption.