Nursing the portosystemic shunt patient
Abstract
A portosystemic shunt (PSS) is any vascular anomaly that allows blood from the hepatic portal circulation to bypass the liver and be delivered directly into the systemic circulation.
The life expectancy of animals that are medically managed is generally reported to be 2 months to 2 years. Fatal liver failure develops after 3 years of age in most dogs that receive only medical treatment, whereas surgical attenuation of shunts is associated with a more favourable long-term prognosis.
The preferred treatment for PSS is complete/partial shunt attenuation which is intended to redirect the portal blood flow through the liver to promote normalisation of the hepatic structure and function.
The nursing of such cases requires a high level of nursing care with a number of individual nursing considerations.
A portosystemic shunt (PSS) is any vascular anomaly that allows blood from the hepatic portal circulation to bypass the liver and be delivered directly into the systemic circulation.
Extrahepatic shunts (EHPSS) are vascular anomalies located outside the hepatic parenchyma. Intrahepatic shunts (IHPSS) are located within the liver. EHPSS may be congenital, usually a single anomalous vessel or acquired, often multiple small vessels. EHPSS account for nearly 63% of single shunts in dogs; they also occur in cats (Fossum, 2007). Acquired extrahepatic shunts (AEHPSS) are typically multiple and represent about 20% of all canine PSS (Fossum 2007). This article will discuss the nursing considerations for patients with EHPSS.
Purebred dogs are at increased risk for PSS. EHPSS are most frequently diagnosed in young (under 1 year of age) toy/miniature breeds dogs such as Yorkshire Terrier, Shih Tzu, Lhasa Apso, Maltese and Bichon Frise (Ettinger, 2010).
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