Clinical presentation, treatment, and outcomes for 15 dogs with two or three congenital extrahepatic portosystemic shunts.

Complete identification and attenuation of all shunts yields favorable M-EHPSS outcomes comparable to single shunt cases.

This multi-institutional retrospective study examined 15 dogs with multiple congenital extrahepatic portosystemic shunts (M-EHPSS), comparing their clinical presentation, treatment, and outcomes to single shunt cases. Miniature Schnauzers comprised 47% of cases, suggesting breed predisposition. Clinical signs and hematologic abnormalities at presentation were comparable to standard EHPSS. Dogs averaged 1451 days old at CT diagnosis. Fourteen of fifteen dogs underwent surgical attenuation; twelve had two shunts and three had three shunts. Seven dogs had incomplete treatment with one shunt left unattenuated due to initial non-detection (particularly left gastro-phrenic shunts), device misplacement, or surgeon preference. At median follow-up of 1253 days, ten dogs survived with 86% achieving good to excellent clinical outcomes. The study demonstrates that M-EHPSS prognosis is comparable to standard EHPSS when all shunts are identified and appropriately treated, emphasizing the importance of thorough preoperative imaging and complete surgical intervention.

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