Diagnosis and treatment of portosystemic shunts in the cat

Feline portosystemic shunts (PSSs) are best managed with surgical intervention. To accomplish this task, veterinarians must be able to identify cats in which a PSS is a strong possibility. Cats exhibit clinical signs that are both similar to and different from the signs of PSSs in dogs. Options for imaging feline PSSs include ultrasound, scintigraphy, and contrast radiography. Medical management stabilizes the critical patients in anticipation of surgery and is used for those patients in which surgical correction is not possible. Surgical options for PSS occlusion include techniques for acute vessel ligation or attenuation and for slow vessel occlusion. The prognosis is based on the degree of shunt occlusion and the ability of the liver to adapt to increased hepatic blood flow.