Changes

==Treatment==

==Treatment==

In animals with acquired PSS, the underlying cause should be treated and HE should be managed as described [[Hepatic Encephalopathy|here]]. '''Acquired shunts should never be ligated''' as they occur as a compensatory response to portal hypertension and ligation would increase portal pressure.

In animals with acquired PSS, the underlying cause should be treated and [[Hepatic Encephalopathy|hepatic encephalopathy should be managed]]. '''Acquired shunts should never be ligated''' as they occur as a compensatory response to portal hypertension and ligation would increase portal pressure.

Animals affected by congenital PSS may be managed either medically or surgically but a recent study has shown that those undergoing surgical ligation of the shunting vessel have a longer median survival time<ref>Greenhalgh SN, Dunning MD, McKinley TJ, Goodfellow MR, Kelman KR, Freitag T, O'Neill EJ, Hall EJ, Watson PJ, Jeffery ND '''Comparison of survival after surgical or medical treatment in dogs with a congenital portosystemic shunt.''' ''J Am Vet Med Assoc. 2010 Jun 1;236(11):1215-20.''</ref>.  Medical management is often employed in those animals that show few clinical signs on presentations, are older or which have a shunt that is not amenable to ligation.   

Animals affected by congenital PSS may be managed either medically or surgically but a recent study has shown that those undergoing surgical ligation of the shunting vessel have a longer median survival time<ref>Greenhalgh SN, Dunning MD, McKinley TJ, Goodfellow MR, Kelman KR, Freitag T, O'Neill EJ, Hall EJ, Watson PJ, Jeffery ND '''Comparison of survival after surgical or medical treatment in dogs with a congenital portosystemic shunt.''' ''J Am Vet Med Assoc. 2010 Jun 1;236(11):1215-20.''</ref>.  Medical management is often employed in those animals that show few clinical signs on presentations, are older or which have a shunt that is not amenable to ligation.