Shunt Portosistémico Extrahepático Congénito En Pomerania.

Abstract

A portosystemic shunt is defined as an abnormal vascular communication that diverts portal blood flow into the systemic circulation, bypassing the liver and leading to significant metabolic alterations. These shunts may be congenital or acquired and, when present, directly affect hepatic metabolism and the nerological function of the patient. This clinical case describes a male Pomeranian diagnosed with a congenital extrahepatic portosystemic shunt (CEPSS), a vascular anomaly that diverts portal blood flow away from the liver, resulting in significant metabolic and neurological consequences. The patient presented with postprandial neurological signs, including ataxia, disorientation, and tremors, which are characteristic of hepatic encephalopathy secondary to portosystemic diversion. The diagnostic approach included a combination of biochemical tests and contrast-enhanced computed tomography, which confirmed the presence of an anomalous communication between the left gastric vein and the caudal vena cava. Based on this diagnosis, surgical correction was performed using a cellophane band to induce a gradual occlusion of the shunt, allowing controlled adaptation of portal flow and reducing the risk of postoperative portal hypertension. The patient exhibited a favorable short-term recovery with improvement of neurological signs, adequate tolerance to the surgical procedure, and stabilization of digestive function. However, the absence of long-term follow-up limited the evaluation of complete hepatic functional recovery. This case highlights the importance of an early diagnosis, a multimodal diagnostic approach, and progressive surgical attenuation in the successful management of congenital extrahepatic portosystemic shunts in dogs.