Aim

To retrospectively evaluate attenuation of congenital extrahepatic portosystemic shunts (CEHPSs) in cats by means of cellophane banding (CB). To report postoperative complications and long-term outcome (clinical response and results of serial bile acid stimulation tests [BAST]).

Methods

Retrospective study. Medical records (from July 2008 through February 2017) of cats with CEHPSs were reviewed. Diagnosis of CEHPSs was made by diagnostic imaging and confirmed during coeliotomy. Cats treated with CB that had BAST performed pre- and postoperatively were included.

Results

Twenty-three cats were included. The study population comprised 8 different breeds with a median age of 8 months (4 to 33) and median body weight of 2.5 kg (1.45 to 4.7). Eleven cats were female (5 entire, 6 spayed), and 12 cats were male (6 entire, 6 neutered).

Common clinical findings included: abnormal behaviour (20/23), ptyalism (16/23), ataxia (12/23), stunted growth (12/23), copper-coloured irides (10/23), inappetence (10/23), depression (9/23) and seizures (4/23). Post-meal BAST before surgery was abnormal in all cats. Only two cats had normal fasting bile acids.

All cats received medical treatment before and after surgery. Treatment included: lactulose (23/23); clavulanate/amoxicillin (19/23), ampicillin (4/23) or metronidazole (2/23); levetiracetam (6/23); phenobarbitone (2/23). Protein-restricted diet was prescribed in 18/23 cats. Median duration of medical treatment was 21 days (8 to 209) prior to surgery and 62 days (range from 14 to 2046) after surgery.

In most cases, CEHPSs were detected by ultrasound. One cat had computed-tomography angiography. Portovenography was performed in 9/23 cats.

BAST was performed following CB after a median of 84 days (14 to 280 days). BAST normalised in 20/23 cats and 3/23 cats had persistently increased results. Two of them developed multiple acquired portosystemic shunts (one remained free of clinical signs until 6 years later, and the other was euthanised due to seizures). Complete closure of a patent shunt was achieved with a second surgery in the remaining cat with abnormal BAST.

Nineteen cats were alive and free of signs at last followup at least 8 months after surgery (3 to 66 months). Three cats developed postoperative seizures. Treatment with anticonvulsants resulted in complete or partial resolution of seizures in two cats. One cat was euthanised due to uncontrollable seizures.

Conclusion

CEHPSs occlusion by CB in cats carries a very good short- and long-term prognosis.

Disclosures

No disclosures to report