| Comparison of survival after surgical or medical treatment in dogs with a congenital portosystemic shunt. | |
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MedLine Citation:
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PMID: 20513200 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: To compare survival of dogs with a congenital portosystemic shunt (CPSS) that received medical or surgical treatment. DESIGN: Prospective cohort study. ANIMALS: 126 client-owned dogs with a single CPSS. PROCEDURES: Dogs were examined at 1 of 3 referral clinics, and a single CPSS was diagnosed in each. Dogs received medical or surgical treatment without regard to signalment, clinical signs, or results of hematologic or biochemical analysis. Survival data were analyzed via a Cox regression model. RESULTS: During a median follow-up period of 579 days, 18 of 126 dogs died as a result of CPSS. Dogs treated via surgical intervention survived significantly longer than did those treated medically. Hazard ratio for medical versus surgical treatment of CPSS (for the treatment-only model) was 2.9 (95% confidence interval, 1.1 to 7.2). Age at CPSS diagnosis did not affect survival. CONCLUSIONS AND CLINICAL RELEVANCE: Both medical and surgical treatment can be used to achieve long-term survival of dogs with CPSS, although results of statistical analysis supported the widely held belief that surgery is preferable to medical treatment. However, the study population consisted of dogs at referral clinics, which suggested that efficacy of medical treatment may have been underestimated. Although surgical intervention was associated with a better chance of long-term survival, medical management provided an acceptable first-line option. Age at examination did not affect survival, which implied that early surgical intervention was not essential. Dogs with CPSS that do not achieve acceptable resolution with medical treatment can subsequently be treated surgically. |
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Authors:
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Stephen N Greenhalgh; Mark D Dunning; Trevelyan J McKinley; Mark R Goodfellow; Khama R Kelman; Thurid Freitag; Emma J O'Neill; Ed J Hall; Penny J Watson; Nick D Jeffery |
Publication Detail:
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Type: Clinical Trial; Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Journal of the American Veterinary Medical Association Volume: 236 ISSN: 0003-1488 ISO Abbreviation: J. Am. Vet. Med. Assoc. Publication Date: 2010 Jun |
Date Detail:
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Created Date: 2010-06-01 Completed Date: 2010-06-29 Revised Date: 2010-09-29 |
Medline Journal Info:
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Nlm Unique ID: 7503067 Medline TA: J Am Vet Med Assoc Country: United States |
Other Details:
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Languages: eng Pagination: 1215-20 Citation Subset: IM |
Affiliation:
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Department of Veterinary Medicine, Veterinary School, University of Cambridge, Cambridge, CB3 0ES, England. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Animals Anti-Bacterial Agents / therapeutic use* Diet / veterinary Disaccharides / therapeutic use* Dog Diseases / congenital, mortality, therapy* Dogs Female Liver Diseases / congenital, mortality, therapy, veterinary* Male Portal System / abnormalities*, surgery |
| Chemical | |
Reg. No./Substance:
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0/Anti-Bacterial Agents; 0/Disaccharides |
| Comments/Corrections | |
Comment In:
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J Am Vet Med Assoc. 2010 Sep 15;237(6):624; author reply 624
[PMID:
20839980
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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