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Objectives:
Development of postattenuation neurologic signs (PANS) is a potentially severe complication after surgical attenuation of congenital portosystemic shunts in cats, with survival to discharge rates ranging from 66.7-100%. Study objectives were to report 30-day survival rate of cats that experienced PANS within 7 days postoperatively and to investigate prognostic factors for 30-day survival.
Methods:
Medical records of 11 institutions were retrospectively reviewed to identify cats that developed PANS within 7 days of shunt attenuation from 2007-2023. Exclusion criteria included cats lost-to-follow-up before 30 days, and cats with arteriovenous fistula/malformation. A control group of non-PANS affected cats was created. Logistic regression was performed to identify factors associated with 30-day survival.
Results:
One hundred twenty-two cats were included, including 59(48.4%) PANS-affected and 63(51.6%) control cats. Twenty-five cats experienced post-attenuation seizures (15 generalised, 1 focal, 9 unknown). The 30-day survival rate of PANS-affected and non-affected cats was 47/59(79.7%) and 60/63(95.2%), respectively (OR: 0.26, 95%CI: 0.083-0.81). Thirteen (52%) of 25 cats that experienced seizures (6/15 generalised, 1/1 focal, 6/9 unknown) survived to 30 days. Increasing bodyweight at the time of surgery (p=0.0432) was positively associated with survival. More severe increases in postoperative chloride concentrations had decreased odds of survival (OR: 0.84. 95%CI: 0.71-0.99).
Conclusions:
Short-term survival of PANS-affected cats appears good but is less favourable for those with generalised seizures. Lower bodyweight and more severe postoperative chloride concentrations prior to PANS onset may have reduced short-term survival.
34th Annual Scientific Meeting proceedings
Stream:
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Session: Resident Forum - Soft Tissue
Date/Time: 04-07-2024 (18:00 - 18:15) | Location: Auditorium 4
Date/Time: 04-07-2024 (18:00 - 18:15) | Location: Auditorium 4
Prognostic factors for short-term survival of cats that experience postattenuation neurologic signs after surgical attenuation of single congenital portosystemic shunts: 59 cases (2007-2023).
Otero Balda I1, Selmic LE*2, Stamenova P3, Simpson M3, Lipscomb VJ*3, Scott P4, Chanoit G*4, De Rooster H*5, Kummeling A*6, Maggiar A7, Billet JP*7, Oramas A1, Fox-Alvarez WA*8, Singh A*9, Grzywa KM10, Tivers MS*10, Soto Munoz 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:
Development of postattenuation neurologic signs (PANS) is a potentially severe complication after surgical attenuation of congenital portosystemic shunts in cats, with survival to discharge rates ranging from 66.7-100%. Study objectives were to report 30-day survival rate of cats that experienced PANS within 7 days postoperatively and to investigate prognostic factors for 30-day survival.
Methods:
Medical records of 11 institutions were retrospectively reviewed to identify cats that developed PANS within 7 days of shunt attenuation from 2007-2023. Exclusion criteria included cats lost-to-follow-up before 30 days, and cats with arteriovenous fistula/malformation. A control group of non-PANS affected cats was created. Logistic regression was performed to identify factors associated with 30-day survival.
Results:
One hundred twenty-two cats were included, including 59(48.4%) PANS-affected and 63(51.6%) control cats. Twenty-five cats experienced post-attenuation seizures (15 generalised, 1 focal, 9 unknown). The 30-day survival rate of PANS-affected and non-affected cats was 47/59(79.7%) and 60/63(95.2%), respectively (OR: 0.26, 95%CI: 0.083-0.81). Thirteen (52%) of 25 cats that experienced seizures (6/15 generalised, 1/1 focal, 6/9 unknown) survived to 30 days. Increasing bodyweight at the time of surgery (p=0.0432) was positively associated with survival. More severe increases in postoperative chloride concentrations had decreased odds of survival (OR: 0.84. 95%CI: 0.71-0.99).
Conclusions:
Short-term survival of PANS-affected cats appears good but is less favourable for those with generalised seizures. Lower bodyweight and more severe postoperative chloride concentrations prior to PANS onset may have reduced short-term survival.
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