Abstract
BackgroundDeficiencies in vitamin A and D and disorders in the vitamin B complex are often present in people with chronic liver diseases. So far, the serum concentrations of these vitamins have not yet been studied in dogs with congenital extrahepatic portosystemic shunts (EHPSS), who also have some degree of liver dysfunction. The objective was to assess serum vitamin concentrations in dogs with EHPSS from diagnosis to complete closure. A prospective cohort study was performed using ten client-owned dogs with EHPSS, closed after gradual surgical attenuation. Serum concentrations of vitamin A, 25-hydroxyvitamin D, folic acid, cobalamin and methylmalonic acid (MMA) were measured at diagnosis prior to institution of medical therapy, prior to surgery, and three months after gradual attenuation and complete closure of the EHPSS.ResultsAt diagnosis, median serum concentrations of vitamin A, 25-hydroxyvitamin D and folic acid were 18.2 μg/dL (8.8 - 79.5 μg/dL), 51.8 ng/mL (19.4 - 109.0 ng/mL), and 8.1 μg/L (5.2 - 14.5 μg/L), respectively, which increased significantly postoperatively (88.3 μg/dL (51.6 - 182.2 μg/dL, P=0.005), 89.6 ng/mL (49.3 - >150.0 ng/mL, P =0.005), and 14.8 μg/L (11.5 - 17.7 μg/L, P <0.001), respectively). Median serum cobalamin concentrations were 735.5 ng/L (470 - 1388 ng/L) at diagnosis and did not significantly decrease postoperatively (P =0.122). Both at diagnosis and three months postoperatively 7/10 dogs had hypercobalaminemia.ConclusionsSerum concentrations of vitamin A, 25-hydroxyvitamin D and folic acid significantly increase after surgical attenuation. Nevertheless, persistent hypercobalaminemia is suggestive of ongoing liver dysfunction, despite successful surgery.
Highlights
Deficiencies in vitamin A and D and disorders in the vitamin B complex are often present in people with chronic liver diseases
The current study found that the majority of dogs with EHPPS had low serum vitamin A concentrations and hypercobalaminemia at presentation, whereas serum methylmalonic acid (MMA) concentrations were variable at diagnosis
This study showed that folate remained within normal limits, whereas cobalamin was above the upper reference value in the majority of dogs at all time points
Summary
Deficiencies in vitamin A and D and disorders in the vitamin B complex are often present in people with chronic liver diseases. The serum concentrations of these vitamins have not yet been studied in dogs with congenital extrahepatic portosystemic shunts (EHPSS), who have some degree of liver dysfunction. Serum concentrations of vitamin A, 25-hydroxyvitamin D, folic acid, cobalamin and methylmalonic acid (MMA) were measured at diagnosis prior to institution of medical therapy, prior to surgery, and three months after gradual attenuation and complete closure of the EHPSS. Experimental rats in which a portocaval shunt was experimentally created had a 25% decrease in serum vitamin A concentrations compared to sham-operated rats 48 days after surgery [14]. Rats in which portocaval shunts were created have a decreased concentration of cytochrome P450 due to hypoperfusion, causing liver dysfunction [16]. One study analyzed vitamin C plasma concentrations in dogs with extrahepatic PSS (EHPSS). This can most likely be explained because of sufficient dietary uptake
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
