Skip to main content
NCBI home page
Wiley - PMC COVID-19 Collection logoLink to Wiley - PMC COVID-19 Collection
. 2006 Feb 10;43(4):171–176. doi: 10.1111/j.1748-5827.2002.tb00052.x

Neurological dysfunction in three dogs and one cat following attenuation of intrahepatic portosystemic shunts

D A Yool 1, B M Kirby 1
PMCID: PMC7166732  PMID: 11996394

Abstract

Neurological dysfunction is an uncommon complication following extrahepatic portosystemic shunt ligation. Three dogs and one cat are described that developed neurological signs within 21 to 42 hours of attenuation of intrahepatic portosystemic shunts. None of these cases had biochemical evidence of hepatic encephalopathy postoperatively. Two dogs died during management of status epilepticus following aspiration of food. One dog died six months postoperatively. The cat had persistent neurological dysfunction at discharge, but was alive and had recovered most of its neurological function at the time of writing, 37 months after surgery. This report demonstrates the potential for animals with intrahepatic portosystemic shunts to develop postoperative neurological signs and highlights the difficulty of managing such cases. Two dogs had both intrahepatic and extrahepatic portosystemic shunts. Large intestinal malrotation (partial situs inversus) may have been linked to the development of a portosystemic shunt in the remaining dog.

References

  1. Aronson, L. R. , Gacad, R. C. , Kaminsky‐Russ, K. , Gregory, C. R. & Mullen, K. D. (1997) Endogenous benzodiazepine activity in the peripheral and portal blood of dogs with congenital portosystemic shunts. Veterinary Surgery 26, 189–194. [DOI] [PubMed] [Google Scholar]
  2. Auer, R. N. & Benviste, H. (1997) Hypoxia and related conditions. In: Greenfields's Neuropathology, Vol 1, 6th edn Eds Graham D. I. and Lantos P. L. Oxford University Press, New York . pp 263–314. [Google Scholar]
  3. Auer, R. N. & Siesjö, B. K. (1988) Biological differences between ischemia, hypoglycemia, and epilepsy. Annals of Neurology 24, 699–707. [DOI] [PubMed] [Google Scholar]
  4. Ewing, G. O. , Suter, P. F. & Bailey, C. S. (1974) Hepatic insufficiency associated with congenital anomalies of the portal veins in dogs. Journal of the American Animal Hospital Association 10, 463–476. [Google Scholar]
  5. Hardie, E. M. , Kornegay, J. N. & Cullen, J. M. (1990) Status epilepticus after ligation of portosystemic shunts. Veterinary Surgery 19, 412–417. [DOI] [PubMed] [Google Scholar]
  6. Heldmann, E. , Holt, D. E. , Brockman, D. J. , Brown, D. C. & Perkowski, S. Z. (1999) Use of propofol to manage seizure activity after surgical treatment of portosystemic shunts. Journal of Small Animal Practice 40, 590–594. [DOI] [PubMed] [Google Scholar]
  7. Honavar, M. & Meldrum, B. S. (1997) Epilepsy. In: Greenfields's Neuropathology, Vol 1, 6th edn Eds Graham D. I. and Lantos P. L. Oxford University Press, New York . pp 931–972. [Google Scholar]
  8. Hunt, G. B. , Bellinger, C. R. , Borg, R. , Youmans, K. R. , Tisdall, P. C. & Malik, R. (1998) Congenital interruption of the portal vein and caudal vena cava in dogs: six case reports and a review of the literature. Veterinary Surgery 27, 203–215. [DOI] [PubMed] [Google Scholar]
  9. Hunt, G. B. & Hughes, J. (1999) Outcomes after extrahepatic portosystemic shunt ligation in 49 dogs. Australian Veterinary Journal 77, 303–307. [DOI] [PubMed] [Google Scholar]
  10. Johnson, C. A. , Armstrong, P. J. & Hauptman, J. G. (1987) Congenital portosystemic shunts in dogs: 46 cases (1979–1986). Journal of the American Veterinary Medical Association 191, 1478–1483. [PubMed] [Google Scholar]
  11. Komtebedde, J. , Forsyth, S. F. , Breznock, E. M. & Koblik, P. D. (1991) Intrahepatic portosystemic venous anomaly in the dog: perioperative management and complications. Veterinary Surgery 20, 37–42. [DOI] [PubMed] [Google Scholar]
  12. Lawrence, D. , Bellah, J. R. & Diaz, R. (1992) Results of surgical management of portosystemic shunts in dogs: 20 cases (1985–1990). Journal of the American Veterinary Medical Association 201, 1750–1753. [PubMed] [Google Scholar]
  13. Levy, J. K. , Bunch, S. E. & Komtebedde, J. (1995) Gastrointestinal disorders. In: Kirk's Current Veterinary Therapy XII, Small Animal Practice. Ed Bongura J. D. W. B. Saunders, Philadelphia . pp 743–749. [Google Scholar]
  14. Matushek, K. J. , Bjorling, D. & Mathews, K. (1990) Generalised motor seizures after portosystemic shunt ligation in dogs: five cases (1981–1988). Journal of the American Veterinary Medical Association 196, 2014–2017. [PubMed] [Google Scholar]
  15. Meyer, H. P. , Rothuizen, J. , van Sluijs, F. J. , Voorhout, G. & van den Brom, W. E. (1999) Progressive remission of portosystemic shunting in 23 dogs after partial closure of congenital portosystemic shunts. Veterinary Record 144, 333–337. [DOI] [PubMed] [Google Scholar]
  16. Sadanaga, K. & Schulman, A. (1987) An unusual portosystemic shunt in a dog. Journal of the American Veterinary Medical Association 190, 549–551. [PubMed] [Google Scholar]
  17. Shiomi, S. , Kuroki, T. , Miyazawa, Y. , Ueda, T. , Nishiguchi, S. , Seki, S. , Kobayashi, K. & Ochi, H. (1993) Results of surgery for portacaval shunt in a patient with situs inversus diagnosed and evaluated by per rectal portal scintigraphy. Journal of Nuclear Medicine 34, 301–302. [PubMed] [Google Scholar]
  18. Tisdall, P. L. C. , Hunt, G. B. , Youmans, K. R. & Malik, R. (2000) Neurological dysfunction in dogs following attenuation of congenital extrahepatic portosystemic shunts. Journal of Small Animal Practice 41, 539–546. [DOI] [PubMed] [Google Scholar]
  19. van Gundy, T. E. , Boothe, H. W. & Wolf, A. (1990) Results of surgical management of feline portosystemic shunts. Journal of the American Animal Hospital Association 26, 55–62. [Google Scholar]
  20. Waterman, A. E. & Hashim, M. A. (1992) Effects of thiopentone and propofol on lower oesophageal sphincter and barrier pressure in the dog. Journal of Small Animal Practice 33, 530–533. [Google Scholar]
  21. White, R. N. , Burton, C. A. & McEvoy, F. J. (1998) Surgical treatment of intrahepatic portosystemic shunts in 45 dogs. Veterinary Record 142, 358–365. [DOI] [PubMed] [Google Scholar]
  22. White, R. N. , Forster‐van Hijfte, M. A. , Petrie, G. , Lamb, C. R. & Hammond, R. A. (1996) Surgical treatment of intrahepatic portosystemic shunts in six cats. Veterinary Record 139, 314–317. [DOI] [PubMed] [Google Scholar]
  23. Wilson, K. , Scrivani, P. V. & Léveillé, R. (1997) What is your diagnosis? Portocaval and portoazygous shunts and microhepatica in a dog. Journal of the American Veterinary Medical Association 211, 415–416. [PubMed] [Google Scholar]

Articles from The Journal of Small Animal Practice are provided here courtesy of Wiley

RESOURCES