New perspectives on the development of extrahepatic portosystemic shunts

White, Robert N.; Shales, Chris; Parry, Andrew

Abstract

Objective: To develop a hypothesis for the developmental modality of extrahepatic portosystemic shunts.
Methods: A retrospective review of a series of dogs and cats managed for congenital portosystemic shunts. Using these data a hypothesis for the role of preferential venous blood flow in the development of common extrahepatic PSSs was postulated. In addition, an online literature search was used to retrieve peer-reviewed data describing the detailed anatomy of shunts in dogs and cats. A systematic review of these data was used as a preliminary test of the hypothesis.
Results: In total 50 dogs and 10 cats met the inclusion criteria revealing five common and distinct shunt types. In the dog, these were spleno-caval, left gastro-phrenic, left gastro-azygos and those involving the right gastric vein. The online search confirmed that these were responsible for 94% of extrahepatic shunts described in this species. In the cat, the four shunt types observed were spleno-caval, left gastro-phrenic, left gastro-caval and left gastro-azygos. Excluding the left gastro-azygos, which from the online search was not described in the cat, the spleno-caval, left gastro-phrenic and left gastro-caval were responsible for 92% of extrahepatic shunts in this species. These data were used to develop, propose and provisionally test a hypothesis for the development of extrahepatic portosystemic shunts.
Clinical Significance: We hypothesise that it is the presence of preferential blood flow that influences the subsequent formation of one of a number of defined and consistent congenital extrahepatic portosystemic shunts in dogs and cats.

Citation

White, R. N., Shales, C., & Parry, A. (in press). New perspectives on the development of extrahepatic portosystemic shunts. Journal of Small Animal Practice, 58(12), https://doi.org/10.1111/jsap.12728

• Journal Article Type: Article
• Acceptance Date: Jul 26, 2017
• Online Publication Date: Sep 5, 2017
• Deposit Date: Aug 2, 2017
• Publicly Available Date: Sep 6, 2018
• Journal: Journal of Small Animal Practice
• Print ISSN: 0022-4510
• Electronic ISSN: 1748-5827
• Publisher: Wiley
• Peer Reviewed: Peer Reviewed
• Volume: 58
• Issue: 12
• DOI: https://doi.org/10.1111/jsap.12728
• Keywords: Soft tissue, Cardiovascular, Portosystemic shunt
• Public URL: https://nottingham-repository.worktribe.com/output/880995
• Publisher URL: http://onlinelibrary.wiley.com/doi/10.1111/jsap.12728/abstract
• Additional Information: This is the peer reviewed version of the following article: White, R. N., Shales, C. and Parry, A. T. (2017), New perspectives on the development of extrahepatic portosystemic shunts. J Small Anim Pract. doi:10.1111/jsap.12728, which has been published in final form at http://onlinelibrary.wiley.com/doi/10.1111/jsap.12728/abstract;jsessionid=75B11D4120738C5B4422578C4F55B17E.f03t03. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving.
• Contract Date: Aug 2, 2017