Intrahepatic Portosystemic Shunts
(IHPSS) in a Bernese Mountain Dog
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
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.
Melone has prepared a pamphlet on IHPSS that covers the following
What is IHPSS?
What are the Symptoms of IHPSS?
is IHPSS Diagnosed?
What are IHPSS Treatment Options?