Outcomes of dogs treated for extrahepatic congenital portosystemic shunts with thin film banding or ameroid ring constrictor

Objective: To compare the outcomes of dogs treated at a single institution for single extrahepatic congenital portosystemic shunts (CPSS) by thin film banding (TFB) or by placement of an ameroid constrictor (AC). Study design: Retrospective case series. Animals: Seventy-six client-owned dogs with CPSS treated with TFB (n = 53) or AC (n = 23). Methods: Records were reviewed for signalment, preoperative, intraoperative, and postoperative management and short-term outcomes. Data on second surgeries were reviewed. Long-term outcomes were obtained via an owner-directed health-related quality of life questionnaire. The rates of complications, mortality, and revision surgery were compared between the treatment groups. Results: Postoperative complications occurred in 15 (28%) dogs with TFB (9% mortality, n = 5) and 8 (35%) dogs with an AC (4% mortality, n = 1). Long-term follow-up was available in 41 of 56 dogs at a median of 55 months (range, 15-89). Revision surgery for persistent shunting was performed in 14 (29%) dogs treated initially with TFB and in no dogs treated initially with AC (P =.007). Median long-term outcome scores were good in both groups; nine of 14 revision surgeries led to favorable outcomes. Conclusion: Persistent shunting requiring revision surgery was more common when CPSS were treated with TFB than with an AC, but both treatments achieved favorable long-term outcomes. Clinical significance: Treatment of CPPS by placement of an AC rather than TFB seems more reliable for shunt attenuation and prevention of revision surgeries.