Why surgery is likely the best option.
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“More than half of dogs treated with medical management alone are euthanized, usually within 10 months of diagnosis, because of uncontrollable neurologic signs and, in some cases, progressive hepatic fibrosis and subsequent portal hypertension. Surgery is therefore considered the treatment of choice for dogs with congenital portosystemic shunts.”
-Karen M. Tobias, DVM, MS, DACVS
From Surgery STAT: CPSS surgery and aftercare