Complications and outcome of cats with congenital extrahepatic portosystemic shunts treated with thin film: Thirty‐four cases (2008‐2017)

Abstract

Background: Congenital extrahepatic portosystemic shunts (CEHPSS) are rare in cats.Outcome after attenuation of CEHPSS with thin film has been described in a small number of cases.Objectives: To describe the clinical presentation, postoperative complications, and outcome of cats treated with thin film to attenuate CEHPSS.Animals: Thirty-four cats with CEHPSS were identified from the database of 3 institutions over 9 years.Methods: Retrospective study. Medical records were reviewed to identify cats with a diagnosis of a CEHPSS that underwent surgical attenuation. Congenital extrahepatic portosystemic shunts were suspected from clinical signs, clinicopathologic findings, and diagnostic imaging, and confirmed at exploratory laparotomy. Cats treated with thin film band attenuation were included. Postoperative complications and follow-up were recorded.Results: Complications were recorded in 11 of 34 cats. Deaths related to CEHPSS occurred in 6 of 34; 4 cats did not survive to discharge. Persistent seizures were the cause of death in 4 cats. Seizures were recorded in 8 of 34 cats after surgery; all these cats received preoperative antiepileptic drugs. Serum bile acid concentrations normalized in 25 of 28 of the cats for which data was available. Three cats had persistently increased serum bile acid concentrations and underwent a second exploratory laparotomy. One had a patent shunt, the other 2 had multiple acquired portosystemic shunts. Median follow-up was 8 months (0.5-84 months).Conclusions and Clinical Importance: Congenital extrahepatic portosystemic shunts attenuation using thin film in cats carries a good short-and mid-term prognosis if they survive the postoperative period. Seizures were the most common cause of death. K E Y W O R D S bile acids, feline, seizures, shunt closure, thin film Abbreviations: CEHPSS, congenital extrahepatic portosystemic shunts; CPSS, congenital portosystemic shunt.

Laparoscopic portosystemic shunt attenuation in two cats

“… 6 The bile acid stimulation test is a good indicator of shunt attenuation and the results correlate well with the clinical outcome. 14 This was in agreement with our findings, in which serum bile acid concentration returned to normal after 3 months in case 1 and after 2 months in case 2; clinical signs rapidly returned to normal in both cases.…”

Normal liver-to-heart transit time and shunt fraction after transplenic injection of 99MTC-pertechnetate in healthy cats

“…As this study was performed with cats that resided in the cat colony of the Faculty of Veterinary Medicine and because this colony only consists of adult cats, this was an unavoidable difficulty. Although a wide age range for the diagnosis of PSS in cats has been reported in the literature (which is often not made until the patient reaches adulthood), the results of the present study are deemed to be valid (Blaxter, 1988;Havig, 2002;Kyles, 2002;Palerme, 2013;Vandermeulen, 2013;Valiente, 2020). Later diagnosis is more often seen when a portoazygos or -hemiazygos shunt rather than a portocaval shunt is present (Rothuizen, 1982;Martin, 1993;Kyles, 2002).…”

2022 Update of the Consensus on the Rational Use of Antithrombotics and Thrombolytics in Veterinary Critical Care (CURATIVE) Domain 1‐ Defining populations at risk

“…In a multicenter retrospective study of 34 cats with cPSS, 11 cats developed complications, and 6 of these died. However, thrombosis was not described in any cat, and hence, this study was judged to oppose the PECO question 135 . Two other studies (LOE 5, fair) identified hemostatic abnormalities in cats with cPSS, but neither described thrombosis 136,137 .…”