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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