Surgical treatment of intrahepatic portosystemic shunts in 45 dogs.

The surgical attenuation of an intrahepatic portosystemic shunt in 45 dogs is described. Twenty-nine (64 per cent) had left divisional shunts consistent with a patent ductus venosus (PDV), 15 (33 per cent) had central divisional shunts and one had a right divisional shunt. In the dogs with a PDV, the shunt vessel could be most easily manipulated at a posthepatic site, whereas in those with central and right divisional shunts the manipulation could be more easily made intrahepatically but sometimes involved demanding intravascular surgical techniques. Eight dogs (18 per cent) died during the surgery or shortly afterwards. Of the 37 dogs surviving longer term, 28 (76 per cent) became clinically normal and required no medication or diet control. In a further three animals the shunt was ligated completely only during a second surgical procedure. The remaining six dogs were euthanased because of clinical signs of encephalopathy which were either surgically or medically uncontrollable.