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Outcomes of cats undergoing surgical attenuation of congenital extrahepatic portosystemic shunts through cellophane banding: 9 cases (2000–2007)

Julien Cabassu DVM1, Howard B. Seim III DVM, DACVS2, Catriona M. MacPhail DVM, PHD, DACVS3, and Eric Monnet DVM, PHD, DACVS4
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  • 1 Department of Clinical Sciences, Cummings School of Veterinary Medicine, Tufts University, North Grafton, MA 01536
  • | 2 Department of Clinical Sciences, College of Veterinary Medicine, Colorado State University, Fort Collins, CO 80523
  • | 3 Department of Clinical Sciences, College of Veterinary Medicine, Colorado State University, Fort Collins, CO 80523
  • | 4 Department of Clinical Sciences, College of Veterinary Medicine, Colorado State University, Fort Collins, CO 80523

Abstract

Objective—To evaluate the long-term prognosis of cats with a congenital extrahepatic portosystemic shunt (CEPSS) attenuated through gradual occlusion with cellophane banding (CB).

Design—Retrospective case series.

Animals—9 cats with a CEPSS that was attenuated with CB.

Procedures—Medical records of cats surgically treated for CEPSS by means of CB from January 2000 through March 2007 were reviewed. Extracted data included preoperative clinical signs, medications, diagnostic results including serum bile acids concentrations, surgical technique, intraoperative and postoperative complications, and long-term follow-up information.

Results—2 cats that developed refractory seizures were euthanized within 3 days after the CB procedure. Seven of the 9 cats survived to 15 days after surgery. Four cats did not have any clinical signs of CEPSS at long-term follow up. At that time, 5 cats had a postprandial SBA concentration within reference limits and 1 cat had persistent ptyalism. One cat had biurate ammonium stones removed > 2 years after surgery. One cat was euthanized 105 days after surgery because of uncontrolled seizures. The 3-year survival rate was 66%.

Conclusions and Clinical Relevance—Uncontrolled seizure activity was the most common cause of death after CB. Long-term outcome for cats with CEPSS was fair to good after the procedure. Cats with a CEPSS surviving the immediate postoperative period had a fair to good long-term outcome. Cellophane banding without intraoperative attenuation appears to be an acceptable technique for gradual occlusion of a CEPSS in cats. Cats should be monitored closely for development of neurologic disorders in the postoperative period.

Abstract

Objective—To evaluate the long-term prognosis of cats with a congenital extrahepatic portosystemic shunt (CEPSS) attenuated through gradual occlusion with cellophane banding (CB).

Design—Retrospective case series.

Animals—9 cats with a CEPSS that was attenuated with CB.

Procedures—Medical records of cats surgically treated for CEPSS by means of CB from January 2000 through March 2007 were reviewed. Extracted data included preoperative clinical signs, medications, diagnostic results including serum bile acids concentrations, surgical technique, intraoperative and postoperative complications, and long-term follow-up information.

Results—2 cats that developed refractory seizures were euthanized within 3 days after the CB procedure. Seven of the 9 cats survived to 15 days after surgery. Four cats did not have any clinical signs of CEPSS at long-term follow up. At that time, 5 cats had a postprandial SBA concentration within reference limits and 1 cat had persistent ptyalism. One cat had biurate ammonium stones removed > 2 years after surgery. One cat was euthanized 105 days after surgery because of uncontrolled seizures. The 3-year survival rate was 66%.

Conclusions and Clinical Relevance—Uncontrolled seizure activity was the most common cause of death after CB. Long-term outcome for cats with CEPSS was fair to good after the procedure. Cats with a CEPSS surviving the immediate postoperative period had a fair to good long-term outcome. Cellophane banding without intraoperative attenuation appears to be an acceptable technique for gradual occlusion of a CEPSS in cats. Cats should be monitored closely for development of neurologic disorders in the postoperative period.

Contributor Notes

Address correspondence to Dr. Monnet (Eric.Monnet@ColoState.edu).