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New perspectives on the development of extrahepatic portosystemic shunts

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

Authors

ROB WHITE Rob.White@nottingham.ac.uk
Professor of Practice

Chris Shales

Andrew Parry



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 http://eprints.nottingham.ac.uk/id/eprint/44593
Publisher URL http://onlinelibrary.wiley.com/doi/10.1111/jsap.12728/abstract
Copyright Statement Copyright information regarding this work can be found at the following address: http://eprints.nottingh.../end_user_agreement.pdf
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.wi...422578C4F55B17E.f03t03. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving.

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Copyright Statement
Copyright information regarding this work can be found at the following address: http://eprints.nottingham.ac.uk/end_user_agreement.pdf





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