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Surgical and Interventional Radiographic Treatment of Dogs with Hepatic Arteriovenous Fistulae

Authors

  • GUILLAUME CHANOIT DVM, MS, Diplomate ECVS,

    1. Department of Small Animal Surgery, National Veterinary School of Lyon, Lyon, France
    2. Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, CA
    3. Section of Small Animal Surgery, Department of Clinical Studies, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA
    4. Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC
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  • ANDREW E. KYLES BVMS, PhD, Diplomate ACVS,

    1. Department of Small Animal Surgery, National Veterinary School of Lyon, Lyon, France
    2. Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, CA
    3. Section of Small Animal Surgery, Department of Clinical Studies, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA
    4. Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC
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  • CHICK WEISSE VMD, Diplomate ACVS,

    1. Department of Small Animal Surgery, National Veterinary School of Lyon, Lyon, France
    2. Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, CA
    3. Section of Small Animal Surgery, Department of Clinical Studies, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA
    4. Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC
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  • ELIZABETH M. HARDIE DVM, PhD, Diplomate ACVS

    1. Department of Small Animal Surgery, National Veterinary School of Lyon, Lyon, France
    2. Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, CA
    3. Section of Small Animal Surgery, Department of Clinical Studies, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA
    4. Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC
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  • Presented in part at the 15th Annual Symposium of the American College of Veterinary Surgeons, San Diego, CA, October 2005 and the 15th Annual Scientific Meeting of the European College of Veterinary Surgeons, Seville, Spain, June 2006.

Address reprint requests to Elizabeth M. Hardie, DVM, PhD Diplomate ACVS, Department of Companion Animal and Special Species Medicine, College of Veterinary Medicine, North Carolina State University, Raleigh, NC 27606. E-mail: lizette_hardie@ncsu.edu.

Abstract

Objective— To report outcome after surgical and interventional radiographic treatment of hepatic arteriovenous fistulae (HAVF) in dogs.

Study Design— Retrospective study.

Animals— Dogs (n=20) with HAVF.

Methods— Medical records of dogs with HAVF were reviewed. Referring veterinarians and owners were contacted by telephone. History, clinical signs, biochemical and hematologic variables, ultrasonographic and angiographic findings, surgical findings, techniques used to correct the HAVF, survival time, and clinical follow-up were recorded.

Results— Canine HAVF often appeared to be an arteriovenous malformation rather than a single fistula. Multiple extrahepatic portosystemic shunts were identified in 19 dogs. Surgery (lobectomy or ligation of the nutrient artery) and/or interventional radiology (glue embolization of the abnormal arterial vessels) was performed in 17 dogs. Thirteen dogs were treated by surgery alone, 4 dogs by glue embolization alone, and 1 dog by glue embolization and surgery. Three dogs treated by surgery alone died <1 month later, and 3 dogs were subsequently euthanatized or died because of persistent clinical signs. None of the dogs treated by glue embolization died <1month after the procedure and all were alive, without clinical signs, at follow-up (9–17 months). Overall, 9 of 12 (75%) dogs with long-term follow-up required dietary or medical management of clinical signs.

Conclusion— HAVF-related death occurred less frequently after glue embolization than after surgery.

Clinical Relevance— Glue embolization may be a good alternative to surgery for treatment of certain canine HAVF.

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