Three-Dimensional Models of Liver Vessels for Navigation during Laparotomic Attenuation of Intrahepatic Portosystemic Shunt in Dogs

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Abstract

Laparotomic attenuation of an intrahepatic portosystemic shunt (IHPSS) is more difficult than an extrahepatic one, and results in a higher risk of complications because the identification of the aberrant vessel in the liver remains often a challenge. Excessive preparation and traction of the parenchyma results in trauma, bleeding, and prolonged surgery, which is what worsens the prognosis. Therefore, based on computed tomographic angiography, we printed 3-dimensional (3D) individual patient liver models, scaled 1:1, and used them for surgery planning and as a guide during intraoperative identification of the shunt in four dogs with IHPSS. The advantages of the 3D technology are simple and precise planning of the surgery, fast intraoperative identification of the shunt, and low invasive dissection of the liver parenchyma. We conclude that 3D technology can potentially raise the recovery rate. To the best of our knowledge, this was the first application of 3D models in the surgery of canine IHPSS.

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Association of breed with the diagnosis of congenital portosystemic shunts in dogs: 2,400 cases (1980-2002).

Karen Tobias, B W Rohrbach (2003)

To determine the annual and overall proportion of diagnoses of congenital portosystemic shunts (CPSS) in dogs and identify breeds at increased risk for CPSS. Retrospective study. 2,400 dogs with CPSS from veterinary teaching hospitals that reported to the Veterinary Medical Database (VMDB) from January 1, 1980 to February 28, 2002. The proportion of diagnoses of CPSS was calculated for all dogs and each breed recorded in the VMDB annually and for the 22.2-year period. Odds ratios and adjusted confidence intervals were calculated for breeds with at least 100 accessions by comparing odds of each breed with a diagnosis of CPSS with that of mixed-breed dogs. Congenital portosystemic shunts were reported in 0.18% of all dogs and 0.05% of mixed-breed dogs. The proportion of diagnoses of CPSS increased from 5 in 10,000 dogs in 1980 to 5 in 1,000 dogs in 2001. Yorkshire Terriers had the greatest total number of diagnoses of CPSS. Thirty-three breeds were significantly more likely to have a diagnosis of CPSS, compared with mixed-breed dogs. The greatest proportions of diagnoses were found in Havanese (3.2%), Yorkshire Terriers (2.9%), Maltese (1.6%), Dandie Dinmont Terriers (1.6%), and Pugs (1.3%). Certain breeds appear to be at increased risk for CPSS, compared with mixed-breed dogs. The increased odds ratios among specific breeds support the hypothesis of a genetic predisposition for CPSS. Clients and veterinarians should consider appropriate diagnostic tests for dogs with clinical signs and those used for breeding from breeds with increased risk of CPSS.

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The application of 3-dimensional printing for preoperative planning in oral and maxillofacial surgery in dogs and cats

Jenna Winer, Frank J. M. Verstraete, Derek Cissell … (2017)

To describe the application of 3-dimensional (3D) printing in advanced oral and maxillofacial surgery (OMFS) and to discuss the benefits of this modality in surgical planning, student and resident training, and client education.

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Hyperammonemia and Systemic Inflammatory Response Syndrome Predicts Presence of Hepatic Encephalopathy in Dogs with Congenital Portosystemic Shunts

Mickey S. Tivers, Ian G. Handel, Adam G. Gow … (2014)

Hepatic encephalopathy (HE) is an important cause of morbidity and mortality in patients with liver disease. The pathogenesis of he is incompletely understood although ammonia and inflammatory cytokines have been implicated as key mediators. To facilitate further mechanistic understanding of the pathogenesis of HE, a large number of animal models have been developed which often involve the surgical creation of an anastomosis between the hepatic portal vein and the caudal vena cava. One of the most common congenital abnormalities in dogs is a congenital portosystemic shunt (cpss), which closely mimics these surgical experimental models of HE. Dogs with a cPSS often have clinical signs which mimic clinical signs observed in humans with HE. Our hypothesis is that the pathogenesis of HE in dogs with a cPSS is similar to humans with HE. The aim of the study was to measure a range of clinical, haematological and biochemical parameters, which have been linked to the development of HE in humans, in dogs with a cPSS and a known HE grade. One hundred and twenty dogs with a cPSS were included in the study and multiple regression analysis of clinical, haematological and biochemical variables revealed that plasma ammonia concentrations and systemic inflammatory response syndrome scores predicted the presence of HE. Our findings further support the notion that the pathogenesis of canine and human HE share many similarities and indicate that dogs with cPSS may be an informative spontaneous model of human HE. Further investigations on dogs with cPSS may allow studies on HE to be undertaken without creating surgical models of HE thereby allowing the number of large animals used in animal experimentation to be reduced.