{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T22:34:19Z","timestamp":1776119659052,"version":"3.50.1"},"reference-count":106,"publisher":"American Veterinary Medical Association (AVMA)","issue":"2","license":[{"start":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T00:00:00Z","timestamp":1769904000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["javma"],"published-print":{"date-parts":[[2026,2,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Investigate lifetime survival of dogs with portosystemic vascular anomalies (PSVA) fed copper (Cu)-restricted liver diets (0.10 to 0.12 mg of Cu\/100 kcal, below National Research Council and Association of American Feed Control Officials thresholds) with different managerial strategies (complete ligation, partial ligation, or medical management).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>377 dogs with extrahepatic PSVA (E-PSVA) and 87 with intrahepatic PSVA (I-PSVA) managed at a single specialty hospital (January 15, 1980, to December 28, 2015) were categorized by managerial strategy and dietary Cu intake (Cu-restricted [0.10 to 0.12 mg of Cu\/100 kcal] vs Cu-replete [\u2265 0.20 mg of Cu\/100 kcal]). Lifetime physical, hematological, and death-associated covariates were inspected for evidence of Cu insufficiency. Survival metrics (last age, survival duration, Kaplan-Meier analytics) were compared. Liver Cu was quantified in 71 of 246 biopsies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>No evidence of Cu insufficiency was associated with dietary Cu restriction. Extrahepatic PSVA survival age exceeded that of I-PSVA (10.3 vs 6.5 years), and complete ligation survival age exceeded that of partial ligation (E-PSVA, 12.5 vs 10.5 years; I-PSVA, 12.0 vs 6.6 years). Survival age of complete and partial ligation exceeded unstratified medically managed dogs (E-PSVA, 9.1 years; I-PSVA, 5.0 years); however, survival age of Cu-restricted medically managed dogs (E-PSVA, 9.7 years; I-PSVA, 6.5 years) did not differ from those that underwent partial ligation. Pathologic liver Cu accumulation occurred in 9 of 30 (30%) biopsies from dogs fed \u2265 0.40 mg of Cu\/100 kcal.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Copper restriction of 0.10 to 0.12 mg\/100 kcal is nutritionally sufficient for dogs with PSVA. While complete ligation achieves best survival, partial ligation and medical management with Cu-restricted prescription liver diets can achieve substantial longevity. Liver Cu accumulation occurred only with diets with \u2265 0.40 mg of Cu\/100 kcal.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Relevance<\/jats:title>\n                    <jats:p>Cu nutritional adequacy, despite intake below regulatory thresholds, warrants reconsideration of current limits. Case-based data provide a survival reference for canine PSVA with different managerial strategies and confirm risk for liver Cu accumulation with a dietary intake of \u2265 0.40 mg of Cu\/100 kcal.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2460\/javma.25.05.0296","type":"journal-article","created":{"date-parts":[[2025,11,21]],"date-time":"2025-11-21T18:30:53Z","timestamp":1763749853000},"page":"181-191","source":"Crossref","is-referenced-by-count":1,"title":["Lifetime survival: surgical versus medical management of portosystemic vascular anomalies in dogs with and without copper-restricted liver diets (1980\u20132015)"],"prefix":"10.2460","volume":"264","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5598-2898","authenticated-orcid":true,"given":"Sharon A.","family":"Center","sequence":"first","affiliation":[{"name":"Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John F.","family":"Randolph","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karen","family":"Warner","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"H. Jay","family":"Harvey","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James A.","family":"Flanders","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kirk","family":"Sapa","sequence":"additional","affiliation":[{"name":"Project volunteer, Ithaca, NY"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew D.","family":"Miller","sequence":"additional","affiliation":[{"name":"Department of Population Medicine and Diagnostic Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joseph J.","family":"Wakshlag","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Raymond","family":"Glahn","sequence":"additional","affiliation":[{"name":"Robert W. Holley Center for Agriculture and Health, USDA, Ithaca, NY"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jason A.","family":"Wiesinger","sequence":"additional","affiliation":[{"name":"Robert W. Holley Center for Agriculture and Health, USDA, Ithaca, NY"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1272","reference":[{"key":"ref1","series-title":"The Merck Veterinary Manual","article-title":"Hepatic portal venous hypoperfusion in small animals","author":"Center SA","year":"2024","unstructured":"Center SA. Hepatic portal venous hypoperfusion in small animals. In: Aiello SE, Moses MA, eds. The Merck Veterinary Manual. 11th ed. Merck & Co Inc; 2024. 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