Diagnosis and treatment of portosystemic shunts in the cat.

Feline portosystemic shunts (PSSs) are best managed with surgical intervention. To accomplish this task, veterinarians must be able to identify cats in which a PSS is a strong possibility. Cats exhibit clinical signs that are both similar to and different from the signs of PSSs in dogs. Options for imaging feline PSSs include ultrasound, scintigraphy, and contrast radiography. Medical management stabilizes the critical patients in anticipation of surgery and is used for those patients in which surgical correction is not possible. Surgical options for PSS occlusion include techniques for acute vessel ligation or attenuation and for slow vessel occlusion. The prognosis is based on the degree of shunt occlusion and the ability of the liver to adapt to increased hepatic blood flow.

Portosystemic shunts: diagnosis, prognosis, and treatment of 64 cases (1993-2001).

Cases diagnosed with portosystemic shunting between the years 1993 and 2001 were reviewed. Sensitivities of screening tests and abdominal ultrasonographic evaluation for the detection of portosystemic shunting were evaluated. Prognosis for surgically treated shunts was also evaluated. Results indicated that both paired serum bile acids and blood ammonia levels were useful screening tests for portosystemic shunting. However, paired bile acid tests were significantly more sensitive than blood ammonia levels. Overall postoperative mortality rates for extrahepatic shunts and intrahepatic shunts were 8.7% and 20%, respectively. Postoperative mortality rates were slightly higher for animals treated with partial ligation when compared to those treated with ameroid ring placement, although this did not reach statistical significance. Long-term complication rates for animals with single extrahepatic portosystemic shunts treated with complete ligation, ameroid ring placement, and partial ligation alone were 9%, 15.4%, and 42%, respectively. Animals >2 years of age with extrahepatic shunts had almost identical postoperative mortality and long-term complication rates as animals < or = 2 years of age. No animal in this study had paired bile acid samples within the reference range postoperatively, indicating continued abnormal liver function after surgery.

The effect of a porcine-derived small intestinal submucosa product on wounds with exposed bone in dogs.

OBJECTIVE: To determine the effect of a porcine-derived small intestinal submucosa product (PSIS) on healing time, epithelialization, angiogenesis, contraction, and inflammation of wounds with exposed bone on the distal aspect of the limbs of dogs. STUDY DESIGN: Prospective, controlled, experimental study. ANIMAL POPULATION: 10 young adult, purpose-bred, male Beagles. METHODS: Small wounds with exposed bone were created on the lateral aspect of metatarsal V and the medial aspect of metatarsal II on both hindlimbs. Three sheets of PSIS were sutured into the wounds of the treated limb, and the other limb served as a control. On day 10, punch biopsies of the medial metatarsal wounds were collected and were evaluated microscopically after routine hematoxylin and eosin and phosphotungstic acid hematoxylin (PTAH) staining. The lateral metatarsal wounds were evaluated by planimetry and laser Doppler perfusion imaging on days 7, 14, and 21. Time until complete wound healing was also recorded. The level of significance was set at P < or =.05 for all statistical analyses. RESULTS: Laser Doppler perfusion measurements were significantly higher in control wounds on day 7, but no differences were noted on days 14 and 21. No significant differences in planimetric values, histopathologic appearance, or time until complete wound healing were noted among treated and control groups. CONCLUSIONS: No objective differences in healing were noted between control wounds and wounds treated with PSIS. CLINICAL RELEVANCE: There appears to be no contraindication to the use of PSIS on clean wounds with exposed bone on the distal limbs of dogs. However, our objective data provides no evidence that this product affects epithelialization, contraction, or time to complete healing in wounds with exposed bone.