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Objectives:
Post-attenuation neurologic signs (PANS) are a potentially severe complication after surgical correction of congenital portosystemic shunts (cPSS) in cats. There is no strong evidence that prophylactic treatment with any drug could prevent or reduce the incidence of PANS in cats. This study aimed to report the incidence of PANS in a large cohort of cats who underwent surgical attenuation of a single cPSS and to compare the incidence of PANS in cats that either received or did not receive prophylactic antiseizure medication.
Methods:
The medical records of 11 veterinary institutions were searched to identify cats that underwent surgical attenuation of a single cPSS during 2007–2023. Cats were excluded if they had an arteriovenous malformation, died or were euthanised within 24 hours postoperatively for reasons unrelated to PANS, or had incomplete medical records to permit classification into the appropriate prophylactic treatment group. Univariable logistic regression analysis was performed to investigate the effect of prophylactic treatment with antiseizure medication on PANS development.
Results:
The study included 121 cats, of which 59 (48.8%) developed PANS, and 26 (44.1%) developed post-attenuation seizures (15 generalised, one focal only, nine unknown). Sixty (49.6%) cats received prophylactic levetiracetam, including 33 (55%) who received appropriate protocols. Sixteen (48.5%) of these cats developed PANS, while 32/61(52.5%) cats that did not receive prophylactic levetiracetam developed PANS (P=0.62).
Conclusions:
The incidence of PANS in cats in this study was 48.8%. Prophylactic treatment with levetiracetam did not protect against PANS development.
34th Annual Scientific Meeting proceedings
Stream:
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Session:
Date/Time: 03-07-2025 (18:45 - 19:00) | Location:
Date/Time: 03-07-2025 (18:45 - 19:00) | Location:
Prophylactic Antiseizure Medication Effects on the Incidence of Post-Attenuation Neurologic Signs in Cats Undergoing Surgical Attenuation of Single Congenital Portosystemic Shunts: 121 cases (2007–2023)
Otero Balda I1, Selmic LE*2, Stamenova P3, Simpson M*3, Lipscomb VJ*3, Chanoit G*4, De Rooster H*5, Devriendt N*5, Kummeling A*6, Maggiar A7, Billet JP*7, Oramas A8, Singh A*9, Grzywa KM10, Tivers MS*10, Soto Muñoz R11, Mullins RA*1
1Section of Veterinary Clinical Sciences, University College Dublin, Dublin, Ireland, 2Department of Veterinary Clinical Sciences, The Ohio State University, Columbus, Ohio, USA, 3Department of Clinical Science and Services, Royal Veterinary College, University of London, London, United Kingdom, 4Bristol Veterinary School, University of Bristol, Bristol, United Kingdom, 5Small Animal Department, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium, 6Department of Clinical Sciences of Companion Animals, Faculty of Veterinary Medicine, Utrecht University, Utrecht, Netherlands, 7Centre Hospitalier Vétérinaire Atlantia, Nantes, France, 8Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, Florida, USA, 9Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Ontario, Canada, 10Paragon Veterinary Referrals, Wakefield, United Kingdom, 11Veterinary Specialists Ireland, Clonmahon, Summerhill, Ireland.
Objectives:
Post-attenuation neurologic signs (PANS) are a potentially severe complication after surgical correction of congenital portosystemic shunts (cPSS) in cats. There is no strong evidence that prophylactic treatment with any drug could prevent or reduce the incidence of PANS in cats. This study aimed to report the incidence of PANS in a large cohort of cats who underwent surgical attenuation of a single cPSS and to compare the incidence of PANS in cats that either received or did not receive prophylactic antiseizure medication.
Methods:
The medical records of 11 veterinary institutions were searched to identify cats that underwent surgical attenuation of a single cPSS during 2007–2023. Cats were excluded if they had an arteriovenous malformation, died or were euthanised within 24 hours postoperatively for reasons unrelated to PANS, or had incomplete medical records to permit classification into the appropriate prophylactic treatment group. Univariable logistic regression analysis was performed to investigate the effect of prophylactic treatment with antiseizure medication on PANS development.
Results:
The study included 121 cats, of which 59 (48.8%) developed PANS, and 26 (44.1%) developed post-attenuation seizures (15 generalised, one focal only, nine unknown). Sixty (49.6%) cats received prophylactic levetiracetam, including 33 (55%) who received appropriate protocols. Sixteen (48.5%) of these cats developed PANS, while 32/61(52.5%) cats that did not receive prophylactic levetiracetam developed PANS (P=0.62).
Conclusions:
The incidence of PANS in cats in this study was 48.8%. Prophylactic treatment with levetiracetam did not protect against PANS development.
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