Prognostic factors for short-term survival of cats that experienced postattenuation neurologic signs after surgical attenuation of single congenital portosystemic shunts

Abstract

Objective: To report 30-day survival of cats that experienced postattenuation neurologic signs (PANS) after surgical attenuation of a single congenital portosystemic shunt (cPSS), and to investigate prognostic factors for short-term survival. Study design: Multi-institutional retrospective study. Sample population: A total of 59 cats with cPSS that experienced PANS. Methods: The medical records of 10 institutions were retrospectively reviewed to identify cats that underwent cPSS attenuation from January 1, 2010 through June 30, 2023 and developed PANS within 7 days postoperatively. Exclusion criteria were cats with arteriovenous malformation and cats lost-to-follow-up prior to 30 days. Logistic regression identified factors associated with 30-day survival. Odds Ratios (OR) and 95% CIs were calculated. Results: A total of 46 (78.0%) PANS-affected cats survived to 30 days. A total of 13 (50.0%) of 26 cats that experienced postattenuation seizures (PAS) survived to 30 days, with most non-surviving cats experiencing generalized PAS. Cats that experienced PAS (p <.01, OR: 0.015, 95% CI: <0.001–0.281) and treatment of PANS with propofol (p <.01, OR: 0.112, 95% CI: 0.022–0.569) were associated with decreased odds of 30-day survival. Conclusion: Most cats that experienced PANS survived to 30 days; however, short-term survival rate was worse for cats that experienced PAS. Clinical significance: The prognosis for cats that experience PANS is generally good but experiencing PAS and requiring treatment with propofol are negative prognostic factors.