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Long‐term outcome after surgical ameroid ring constrictor placement for treatment of single extrahepatic portosystemic shunts in dogs
Author(s) -
Falls Emily L.,
Milovancev Milan,
Hunt Geraldine B.,
Daniel Leticia,
Mehl Margo L.,
Schmiedt Chad W.
Publication year - 2013
Publication title -
veterinary surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.652
H-Index - 79
eISSN - 1532-950X
pISSN - 0161-3499
DOI - 10.1111/j.1532-950x.2013.12072.x
Subject(s) - medicine , perioperative , surgery , retrospective cohort study , portosystemic shunt , survival analysis , medical record , survival rate , portal hypertension , cirrhosis
Objective To report long‐term clinical outcome in dogs treated for single congenital extrahepatic portosystemic shunt (CEHPSS) with a ameroid ring constrictor (ARC) and to identify perioperative variables associated with outcome. Study Design Retrospective, multi‐institutional study. Animals Dogs (n = 206) with CEHPSS. Methods Medical records of dogs with CEHPSS treated by ARC were reviewed for perioperative and short‐term (<1 month) data. Long‐term follow‐up information was obtained by telephone interview with referring veterinarians and/or owners. Kaplan–Meier analysis was used to estimate median survival time. Factors associated with short‐term survival, outcome grade, and total survival time were identified. Results Fifteen dogs died <1 month after ARC placement. Follow‐up data were obtained for 112 of 191 dogs that survived >1 month; median follow was 54 months (range, 1–175 months) and 103 (92%) dogs had no clinical signs. Estimated median survival time was 152 months. Variables significantly associated with short‐term survival included being intact and a low total white blood cell (WBC) count. Variables significantly associated with a successful outcome included having surgery later in the study period and negative postoperative nuclear scintigraphy. In the long‐term survival analyses, intact dogs and those with higher WBC counts and occlusion pressures and lower bile acid concentrations were more likely to survive. Conclusions Dogs with CEHPSS treated by ARC generally have a good prognosis and prolonged postoperative survival.