Incidence and risk factors for neurological signs after attenuation of single congenital portosystemic shunts in 253 dogs

Abstract

Surgical attenuation of a single CPSS should not be excessively delayed, and surgeons should stabilize the clinical signs of HE before surgery to prevent postoperative PANS and seizures.

Long‐term clinical outcomes of dogs with single congenital extrahepatic portosystemic shunts attenuated with thin film banding or ameroid ring constrictors

“…Postoperative seizures were recorded in 10 (8%) dogs in our study, with nine of those dogs consequently dying. These findings are similar to those previously published . Preoperative levetiracetam use was different between the TFB and ARC groups, with a larger proportion of dogs in the TFB group receiving preoperative levetiracetam.…”

“…In two recent studies of dogs undergoing gradual attenuation of a CEHPSS, prophylactic administration of levetiracetam did not influence the occurrence of postoperative seizures . Our results provide additional evidence regarding the lack of preventive effects of preoperative administration of levetiracetam on postoperative seizures in dogs undergoing gradual attenuation of CEHPSS …”

“…The surgeon's choice of administration of levetiracetam likely increased after publication of a study that provided evidence that preoperative treatment with the drug reduced the incidence of postoperative seizures . In two recent studies of dogs undergoing gradual attenuation of a CEHPSS, prophylactic administration of levetiracetam did not influence the occurrence of postoperative seizures . Our results provide additional evidence regarding the lack of preventive effects of preoperative administration of levetiracetam on postoperative seizures in dogs undergoing gradual attenuation of CEHPSS …”

“…21 In two recent studies of dogs undergoing gradual attenuation of a CEHPSS, prophylactic administration of levetiracetam did not influence the occurrence of postoperative seizures. 19,20 Our results provide additional evidence regarding the lack of preventive effects of preoperative administration of levetiracetam on postoperative seizures in dogs undergoing gradual attenuation of CEHPSS. 19,20 Limitations of this study include the retrospective nature, and, as previously discussed, postoperative imaging was not routinely performed to determine degree of residual shunting and/or determination of implant positioning.…”

“…These findings are similar to those previously published. 10,[18][19][20] Preoperative levetiracetam use was different between the TFB and ARC groups, with a larger proportion of dogs in the TFB group receiving preoperative levetiracetam. At both institutions, gradual attenuation of CEHPSS with TFB was more frequently performed than the use of an ARC after 2011.…”