Some promising news regarding correcting portosystemic shunts in dogs comes from U.C. Davis, where Dr. Bill Culp has developed a new, non-invasive way to close intrahepatic shunts, which historically have been difficult to correct surgically.
Until we have a genetic test for this condition, this might provide a reasonable alternative to medical management or euthanasia of liver-shunt puppies.
I asked Dr. Culp for some information on this procedure. Here is his response:
“Intrahepatic portosystemic shunts (IHPSS) are anomalous (abnormal) vascular communications between two of the major blood vessels in the abdomen (the portal vein and the caudal vena cava). The caudal vena cava drains the blood from the legs, kidneys, and adrenal glands, and returns that blood back to the heart. The portal vein drains the blood from the pancreas, spleen and most of the gastrointestinal tract and takes that blood to the liver. When the liver is done detoxifying the blood, the blood is returned to the vena cava and then taken to the heart. When an IHPSS is present, the communication between the portal vein and the caudal vena cava causes the blood to bypass the liver and go directly to the heart without being detoxified. This results in the clinical signs that are often demonstrated with IHPSS.
Historically, IHPSS were corrected by surgical attenuation (closing down of the IHPSS) during an open abdominal procedure. Recently, a new technique called percutaneous transvenous coil embolization (PTCE) has developed that provides a minimally invasive approach for the treatment of IHPSS. This procedure is performed entirely through the jugular vein, thus allowing for the minimally invasive nature. The early results are very promising….Our success rate has been very good so far. We have had no peri-procedural mortality and dogs are able to be weaned off of medical management.”
The SDCA Health & Genetics Committee’s list of recommended health tests includes bile acid testing in order to detect the presence of liver shunts. Breeders should bile-acid test all puppies before they go to their new homes, and if not tested as puppies, adults should be tested before breeding.