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Companion Animal Practice
Decision making in the management of portosystemic shunts
  1. Penny Watson

    Penny Watson graduated from Cambridge in 1989. She spent four years in mixed practice before returning to Cambridge veterinary school to take up a Waltham residency in clinical nutrition. She holds RCVS certificates in veterinary radiology and small animal medicine. Her interests include all aspects of internal medicine, particularly cardiology, gastroenterology and clinical nutrition, and she has an active research interest in the medical management of portosystemic shunts.

Abstract

PORTOSYSTEMIC shunts are abnormal vascular communications allowing some of the portal blood draining the stomach, intestines, pancreas and spleen to bypass the liver and directly enter the systemic circulation. They may be congenital anomalies of portal venous drainage or acquired secondary to portal hypertension. They are relatively common in dogs and are also occasionally seen in cats, horses, cows and pigs. A shunt may be suspected in an animal with a suggestive history, clinical appearance and blood test results. Definitive diagnosis is more difficult, relying on demonstration of shunting and/or visualisation of the shunting vessel(s) with ultrasound, contrast radiography, gamma-scintigraphy or directly at laparotomy. Management decisions depend on a definitive diagnosis and also present a challenge as several factors, including the type of shunt and the age at presentation, will influence whether an animal is managed surgically or medically.

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