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Sunlight et al: Protein C and comparative biochemical changes in dogs treated with percutaneous transvenous coil embolization of congenital intrahepatic portosystemic shunts
Veterinary Surgery 1, 2022

🔍 Key Findings

  • Postoperative Protein C (PC) activity increased in 78.7% of dogs, and was significantly higher in dogs with excellent clinical outcomes.
  • Complete acute shunt occlusion resulted in higher postoperative PC activity (96.3%) and better ultimate clinical outcomes than incomplete occlusion.
  • Preoperative PC was not predictive of clinical status, but postoperative PC was associated with improved outcomes.
  • Standard biochemical markers (HCT, MCV, ALB, BUN) also improved postoperatively, especially in dogs with excellent clinical outcomes.
  • Dogs requiring a second procedure had significantly lower postoperative PC (43.5%) than those not requiring further intervention (78.5%).
  • Repeat procedures improved PC and BUN values, with PC increasing significantly after second intervention (to 69.8%).
  • PC normalization (within reference interval) occurred in 87.5% of dogs with excellent clinical status, compared to only 12.5% in those with poor status.
  • Clinical outcome classification (excellent/fair/poor) correlated with biochemical normalization and lack of need for diet/medications.

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← Articles

Sunlight et al: Protein C and comparative biochemical changes in dogs treated with percutaneous transvenous coil embolization of congenital intrahepatic portosystemic shunts
Veterinary Surgery 1, 2022

🔍 Key Findings

  • Postoperative Protein C (PC) activity increased in 78.7% of dogs, and was significantly higher in dogs with excellent clinical outcomes.
  • Complete acute shunt occlusion resulted in higher postoperative PC activity (96.3%) and better ultimate clinical outcomes than incomplete occlusion.
  • Preoperative PC was not predictive of clinical status, but postoperative PC was associated with improved outcomes.
  • Standard biochemical markers (HCT, MCV, ALB, BUN) also improved postoperatively, especially in dogs with excellent clinical outcomes.
  • Dogs requiring a second procedure had significantly lower postoperative PC (43.5%) than those not requiring further intervention (78.5%).
  • Repeat procedures improved PC and BUN values, with PC increasing significantly after second intervention (to 69.8%).
  • PC normalization (within reference interval) occurred in 87.5% of dogs with excellent clinical status, compared to only 12.5% in those with poor status.
  • Clinical outcome classification (excellent/fair/poor) correlated with biochemical normalization and lack of need for diet/medications.

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Multiple Choice Questions on this study

In Sunlight 2022 et al., on Protein C monitoring, what was the average postoperative Protein C (PC) activity in dogs with excellent clinical outcomes?

A. 42.5% ± 4.8%
B. 58.9% ± 3.1%
C. 75.7% ± 1.4%
D. 96.3% ± 10.9%
E. 69.8% ± 6.9%

Answer: 96.3% ± 10.9%

Explanation: Dogs with excellent clinical status had the highest mean postoperative PC, specifically those with complete acute occlusion.
In Sunlight 2022 et al., on Protein C monitoring, which combination was most associated with “excellent” ultimate clinical status?

A. Low postoperative PC, high BUN, and low MCV
B. Postoperative PC normalization and no shunt medications
C. High preoperative HCT and low ALB
D. Postoperative ALB <2.0 and persistent clinical signs
E. Normal protein diet with lactulose use

Answer: Postoperative PC normalization and no shunt medications

Explanation: All dogs with excellent status had normalized PC and were off shunt medications and low-protein diets.
In Sunlight 2022 et al., on Protein C monitoring, which variable was **not** significantly associated with ultimate clinical status?

A. Postoperative HCT
B. Postoperative PC
C. Postoperative ALB
D. Preoperative PC
E. Postoperative BUN

Answer: Preoperative PC

Explanation: Only postoperative PC correlated with clinical status; preoperative PC was not predictive.
In Sunlight 2022 et al., on Protein C monitoring, what percentage of dogs required a second intervention following PTCE for IHPSS?

A. 13%
B. 22%
C. 28%
D. 34%
E. 47%

Answer: 34%

Explanation: 16 out of 47 dogs (34%) underwent a second procedure, mainly due to recurrence of clinical signs.
In Sunlight 2022 et al., on Protein C monitoring, what was the most common reason for requiring a second PTCE procedure?

A. Residual shunt flow due to missed diagnosis
B. Portal hypertension
C. Compression and contraction of previously placed coils
D. Coagulopathy and bleeding
E. Portal vein thrombosis

Answer: Compression and contraction of previously placed coils

Explanation: This was the most frequent finding at repeat venography in dogs needing second procedures.

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