Measuring Splenic Pulp Pressure in the Evaluation of Portal Hypertension in Dogs
Portal hypertension is a complication of diseases that obstruct portal blood flow, such as primary hepatic diseases and primary vascular disorders. However, the direct measurement of portal pressure is invasive and impractical clinically. This study evaluated the adequacy of splenic pulp pressure (SPP) measurement under laparoscopy in dogs.
Six healthy dogs and 46 dogs with congenital portosystemic shunts (CPSS; n=20) and acquired portosystemic collaterals (APSC; n=26) were studied. An over-the-needle intravenous catheter was inserted into the spleen percutaneously under laparoscopy, and the SPP was measured through a catheter. After measuring the SPP, APSC and CPSS were identified using splenoportography, and liver samples were obtained in the dogs with APSC. The definitive diagnoses included chronic hepatitis/cirrhosis (CH; n=16) and primary hypoplasia of the portal vein (PHPV; n=10). In addition, mesenteric vein pressure (MVP) in healthy dogs was measured at laparotomy. There was no significant difference between the SPP (5.2 ± 0.8 mmHg) and MVP (6.0 ± 0.6 mmHg) in the healthy dogs. The SPP in dogs with APSC was 9.9 ± 3.3 mmHg (CH; 10.1 ± 3.6 mmHg, PHPV; 8.8 ± 2.4 mmHg), and was significantly elevated, as compared with healthy dogs (p < 0.001) and dogs with CPSS (3.5 ± 1.9 mmHg; p < 0.001).
The results of this study indicate that SPP measurement is a simple, minimally invasive technique for assessing portal hypertension in dogs.