Intrahepatic Portosystemic Shunts (IHPSS) in a Bernese Mountain Dog

by Nancy P. Melone, Ph.D

“Sophie Tucker” was born in an Ohio puppy-mill.  At three months of age she was rescued from a dog auction by the Bernese Auction Rescue Coalition, Inc.  When the rescue group got her, she was close to death, weighed only 12 lbs. at 12 weeks. Because of her poor condition, no foster home was willing to take her.  She was not adoptable, and without a miracle, she would be dead in a few weeks.  Nancy Melone agreed to take care of her.

Sophie’s clinical symptoms presented as severe and fairly typical of PSS: small body stature, hepatic encephalopathy, intermittent anorexia, anemia, microcytosis, excessive sleeping and lethargy, pica, and diarrhea.  Suspecting a shunt, Nancy took Sophie for her routine exam, and asked Lawrence Gerson, VMD to run bile acid tests, which if high are suggestive of PSS.  The PSS diagnosis was later confirmed with an ultrasound by mobile radiologist Dana Kellerman DVM DACVIM.

Liver shunts (portosystemic shunts) are defects in the portal vein connecting the liver to the rest of the circulatory system. This defect affects many breeds, including Bernese Mountain Dogs. The liver removes toxins, such as ammonia, from the blood; shunts prevent blood from reaching the liver. Consequently, the liver does not develop properly as the puppy grows. In addition, toxins, such as ammonia, bypass the liver and reach the body’s blood circulation, including the brain. Neurological symptoms begin in the first year of life, and without treatment the condition is fatal. Surgery is the only long-term treatment but is not always successful. The work of researchers at Utrecht University and others has shown that portostystemic shunts are most likely inherited.

Sophie was referred to University of Pennsylvania, Ryan Veterinary Hospital, in Philadelphia where she was seen by by Professor Chick Weisse VMD Dipl. ACVS.  Sophie was accepted as a candidate for experimental interventional radiological (IR) surgery.  On November 19, 2004, she underwent coil embolization of her portosystemic shunt at Ryan Veterinary Hospital. Sophie was the 25th dog and the second BMD to have this surgery.  The surgery was successful and by May 2005, she was completely off all medications and prescription foods.


Sophie Tucker at 8 months.

Nancy Melone has prepared a pamphlet on IHPSS that covers the following information:

What is IHPSS?

What are the Symptoms of IHPSS?

How is IHPSS Diagnosed?

What are IHPSS Treatment Options?

bullet    Medical Management
bullet    Traditional Surgery
bullet    Interventional Radiological (IR) Surgery

How Can We Prevent IHPSS?

 If you would like to know more about Sophie’s surgery or to be sent a copy of the information pamphlet described above (free of charge), please contact Nancy Melone
 

 

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