What care is needed for dogs after shunt surgery?
Dogs are kept on a protein-restricted diet for at least 6-8 weeks after surgery. Lactulose can be continued as well, or can be gradually decreased over 2-4 weeks. Most dogs do not need antibiotics unless they have infections in the urine or other sites. The liver will begin to grow as the shunt closes, and will often be normal sized in 2-4 months. To check liver function, blood tests (BUN, albumin, liver enzymes, and bile acids) are usually evaluated at 8-12 weeks after surgery. If these are still abnormal, they are repeated in another 3 months. If they are normal, the diet is gradually switched to an adult maintenance dog food. A scintigraphy can be performed at 3-6 months to confirm that the shunt is closed.
What is the prognosis for dogs after ameroid constrictor placement around a shunt?
Survival rate from the surgery is over 95% for dogs with shunts treated by ameroid constrictor placement, and our long-term prognosis is better with this technique than with most other methods. Many dogs are clinically normal within 4-8 weeks after the surgery. Long term, about 85% of dogs with liver shunts closed with ameroid constrictors do well clinically. About 15% continue to have problems, probably because the tiny blood vessels inside the liver were also abnormal. Usually these dogs develop multiple acquired shunts and must be managed with a protein restricted diet and lactulose for life.
Dr. Karen Tobias is an Associate Professor in Small Animal Surgery at the University of Tennessee College of Veterinary Medicine.
Portosystemic Shunts FAQ
Since the bile acids were redone in August, he is probably okay but dogs that have had surgery can develop acquired shunting. I think this is more common not long after surgery...
Not everyone uses ameroid constrictors either (which would be a mistake not too), so that may change things too.