Clinical presentation and short-term outcomes of dogs ≥15 kg with extrahepatic portosystemic shunts

Objective: To describe demographics, clinical presentation, shunt anatomy, clinical progression, and complications in large dogs >= 15 kg with single extrahepatic portosystemic shunts (EHPSS) treated with or without surgery.Study Design: Multicenter retrospective (10 university hospitals, one private referral institution).Animals: Dogs >= 15 kg (n = 63).Methods: Medical records of dogs >= 15 kg diagnosed with EHPSS between January 01, 2005 and December 31, 2020 were reviewed. Dogs had a minimum follow-up of 90 days. Signalment, clinical signs, diagnostics, shunt anatomy, treatment interventions, and perioperative complications were assessed.Results: Median age was 21.9 months (IQR: 9-36.8). The breed most represented was the Golden retriever (17/63 dogs). Portocaval (17/63) and splenocaval (15/63) shunt configurations were most common. Portal vein hypoplasia was noted in 18 imaging reports. Of the surgically treated dogs, 14/45 (35.6%) had short-term complications, and 3/45 (6.7%) had shunt-related deaths. Medical management was discontinued in 15/40 and reduced in 9/40 of surviving dogs who had surgical attenuation. All medically managed, nonattenuated dogs (18/18) were maintained on their original shunt-related medication regimens.Conclusions: Clinical presentation of dogs >= 15 kg with extrahepatic portosystemic shunts was similar to the more commonly reported small breed dogs. Surgical management of single EHPSS in large dogs >= 15 kg had similar clinical short-term outcomes as small breed dogs.