Treatment of extrahepatic congenital portosystemic shunts in dogs – what is the evidence base?
Article first published online: 19 NOV 2011
© 2011 British Small Animal Veterinary Association
Journal of Small Animal Practice
Volume 53, Issue 1, pages 3–11, January 2012
How to Cite
Tivers, M. S., Upjohn, M. M., House, A. K., Brockman, D. J. and Lipscomb, V. J. (2012), Treatment of extrahepatic congenital portosystemic shunts in dogs – what is the evidence base?. Journal of Small Animal Practice, 53: 3–11. doi: 10.1111/j.1748-5827.2011.01144.x
- Issue published online: 27 DEC 2011
- Article first published online: 19 NOV 2011
- Accepted: 3 October 2011; Published online: 19 November 2011
A variety of surgical treatments and medical therapies are recommended for dogs with extrahepatic congenital portosystemic shunts (CPSS). The objective of this review was to assess the evidence base for the management of extrahepatic CPSS in dogs. An online bibliographic search was performed in November 2010 to identify articles relating to the question “Which of the treatment options for extrahepatic CPSS in dogs offers the best short- and long-term outcomes?” Articles were assigned a level of evidence based on a modified grading system. Thirty-eight articles were included in the review. Thirty-six articles were classified as grade 4 and two as grade 5. The timings and methods of assessment of short- and long-term outcomes varied widely between studies. One prospective study (grade 4a) showed that surgically treated dogs survived significantly longer than medically treated dogs. Four retrospective studies (grade 4b) compared the outcome of two surgical techniques but there were no statistically significant differences between treatment groups in terms of complications or outcome. The review found that the evidence base for the treatment of extrahepatic CPSS is weak. There is a lack of evidence of short- and long-term outcomes to recommend one treatment over another.