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Surgical attenuation of spontaneous congenital portosystemic shunts in dogs resolves hepatic encephalopathy but not hypermanganesemia

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Abstract

Hypermanganesemia is commonly recognized in human patients with hepatic insufficiency and portosystemic shunting. Since manganese is neurotoxic, increases in brain manganese concentrations have been implicated in the development of hepatic encephalopathy although a direct causative role has yet to be demonstrated. Evaluate manganese concentrations in dogs with a naturally occurring congenital shunt before and after attenuation as well as longitudinally following the changes in hepatic encephalopathy grade. Our study demonstrated that attenuation of the shunt resolved encephalopathy, significantly reduced postprandial bile acids, yet a hypermanganasemic state persisted. This study demonstrates that resolution of hepatic encephalopathy can occur without the correction of hypermanganesemia, indicating that increased manganese concentrations alone do not play a causative role in encephalopathy. Our study further demonstrates the value of the canine congenital portosystemic shunt as a naturally occurring spontaneous model of human hepatic encephalopathy.

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Acknowledgments

This study was supported by the RCVS Trust.

Conflict of interest

None declared.

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Authors and Affiliations

  1. Division of Veterinary Clinical Studies, Easter Bush Veterinary Centre, Royal (Dick) School of Veterinary Studies, The Roslin Institute, The University of Edinburgh, Hospital for Small Animals, Roslin, Midlothian, EH25 9RG, UK

    Adam G. Gow & Richard J. Mellanby

  2. Davies Veterinary Specialists, Manor Farm Business Park, Higham Gobion, Hertfordshire, SG5 3HR, UK

    Polly E. Frowde, Clive M. Elwood & Carolyn A. Burton

  3. Powell Torrance Diagnostic Services, Manor Farm Business Park, Higham Gobion, Hertfordshire, SG5 3HR, UK

    Roger M. Powell

  4. Dick White Referrals, Station Farm, London Rd, Six Mile Bottom, Cambridgeshire, CB8 0UH, UK

    Simon W. Tappin & Rob D. Foale

  5. Department of Clinical Biochemistry, Scottish Trace Element and Micronutrient Reference Laboratory, Glasgow Royal Infirmary, Glasgow City, G4 0SF, UK

    Andrew Duncan

Authors
  1. Adam G. Gow
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  2. Polly E. Frowde
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  3. Clive M. Elwood
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  4. Carolyn A. Burton
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  5. Roger M. Powell
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  6. Simon W. Tappin
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  7. Rob D. Foale
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  8. Andrew Duncan
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  9. Richard J. Mellanby
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Correspondence to Adam G. Gow.

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Gow, A.G., Frowde, P.E., Elwood, C.M. et al. Surgical attenuation of spontaneous congenital portosystemic shunts in dogs resolves hepatic encephalopathy but not hypermanganesemia. Metab Brain Dis 30, 1285–1289 (2015). https://doi.org/10.1007/s11011-015-9676-y

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  • DOI: https://doi.org/10.1007/s11011-015-9676-y

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