Background: Congenital portosystemic shunts (CPSS) are vascular anomalies, allowing portal blood to bypass the hepatic parenchyma, thereby accumulating toxic substances such as ammonia in the systemic circulation resulting in hepatic encephalopathy.Aim: To evaluate the outcome of non-surgically treated dogs with a CPSS.Methods: Case records of 78 dogs with a single congenital CPSS confirmed by ultrasound and/or computed tomography between September 2003 and February 2015 were reviewed. Median age at diagnosis of CPSS in dogs was 10.8 months (range 2-133 months). Non-surgical treatment was started as an adjusted diet (a diet restricted in protein) with or without lactulose. Owners were contacted by telephone to determine survival time and presumed cause of death, if applicable. In addition, a questionnaire was used to retrospectively assess quality of life (QoL) and CPSS scores in 37 dogs before and during non-surgical treatment. Differences between Kaplan-Meier curves were tested by a Log rank test.Results: Overall estimated median survival time (EMST) was 38.5 months (range 1 day - 91 months; 78 dogs). No significant differences between EMSTs were found between dogs with extra- (n = 48) or intrahepatic (n = 29) shunts, nor between treatment with only an adjusted diet, or an adjusted diet combined with lactulose. During non-surgical treatment, significant improvement in perceived QoL and CPSS scores were found (P < 0.01).Conclusion: Our study demonstrated that an overall median EMST of 3.2 years was reached and that owners retrospectively perceived that non-surgical treatment resulted in an improved QoL and clinical performance, irrespective of intrahepatic or extrahepatic CPSS location.

中文翻译：

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先天性门体系统分流犬有或无乳果糖的非手术饮食治疗的结果。

背景：先天性门体系统分流（CPSS）是血管异常，使门静脉血绕过肝实质，从而在全身循环中积聚有毒物质（例如氨）导致肝性脑病。目的：评估未经手术治疗的狗的结局方法：回顾了2003年9月至2015年2月间通过超声和​​/或计算机断层扫描确认的78只单发先天性CPSS狗的病例记录。诊断为狗的CPSS的中位年龄为10.8个月（范围2-133个月）。非手术治疗开始于有或没有乳果糖的调整饮食（蛋白质限制饮食）。通过电话与所有者联系，以确定生存时间和假定的死亡原因（如果适用）。此外，问卷被用于回顾性评估非手术治疗前后37只狗的生活质量（QoL）和CPSS得分。通过对数秩检验检验Kaplan-Meier曲线之间的差异。结果：总体估计中位生存时间（EMST）为38.5个月（范围1天-91个月； 78只狗）。在有额外（n = 48）或肝内（n = 29）分流的狗之间，以及仅调整饮食或调整饮食与乳果糖联合治疗的狗之间，EMST之间无显着差异。在非手术治疗期间，发现感知的QoL和CPSS得分显着提高（P <0.01）。结论：我们的研究表明，总体EMST中位数达到3.2年，并且所有者回顾性地认为非手术治疗导致了改善QoL和临床表现，