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. 2011 Mar 1;13(3):185–194. doi: 10.1016/j.jfms.2011.01.011

TABLE 1.

Summary of the outcome of surgical management of feline CPSSs, as reported in the literature

Study No. of cats Method of attenuation Postoperative neurological complication rate Mortality rate Short-term outcome Long-term outcome
White et al (1996) 10 6 Suture (5 partial, 1 full attenuation) 16.7% 1/6 cats suffered severe neurological complications 16.7% 1/6 cats died due to neurological complications

  • Excellent in 4/5 (80%) cats (2–18 months): Clinically normal, no medication Two cats died or were euthanased due to unrelated reasons

  • Fair in 1/5 (20%) cat (24 months): Required medication to control signs Died of unrelated causes
Wolschrijn et al (2000) 22 15 Suture 13.3% 2/15 cats suffered severe neurological complications that resulted in status epilepticus and coma 20% 3/15 cats died, two due to neurological complications and one euthanased intraoperatively due to portal vein hypoplasia
Havig and Tobias (2002) 9 12 Ameroid constrictor 33.3% 4/12 cats suffered neurological complications — however, all had neurological signs before surgery 0% 0/12

  • Repeat examination at 3 months postsurgery:

  • 5/12 (41.7%) clinically normal

  • 7/12 (58.3%) continued neurological signs

 Excellent in 2/9 (22.2%) cats (10–60 months): Clinically normal

  • Normal shunt fraction

  • Good in 1/9 (11.1%) cats (10 months): Clinically normal

  • Persistent shunting on scintigraphy

  • Required medication to control signs

  • Fair in 2/9 (22.2%) cats (6 months): Alive but with progression or recurrence of neurological signs

  • Both on medical management

  • Poor in 4/9 (44.4%) cats (6–36 months): Euthanased due to persistence or progression of neurological signs

Kyles et al (2002) 27 23 Ameroid constrictor Up to 77% 17/22 cats suffered some form of complication including blindness (10), hyperthermia (6), frantic behaviour (5), encephalopathy (5), seizures (3), focal seizures (1), coagulopathy (1), tremors (1), seroma (1) and transfusion reaction (1). The precise proportion of cats with neurological complications was unclear

  • 4.5%

  • 1/22 cats died due to status epilepticus

  • Repeat examination at 2–2.5 months postsurgery:

  • 13/14 (92.9%) clinically normal

  • 1/14 (7.1%) dull and intermittent seizures

  • 10/14 still on medical management

  • 8/14 (57%) persistent shunting on scintigraphy (3 multiple acquired shunts)

  • Excellent in 15/20 (75%) cats (3–51 months):

  • Clinically normal

  • No medication (six on low-protein diet)

  • Six with normal shunt fraction

  • Five with persistent shunting on scintigraphy

  • Good in 1/20 (5%) cats (41–42 months):

  • Occasional episodes of lethargy

  • No medical treatment

  • Fair in 1/20 (5%) cats (41–42 months):

  • Occasional episodes of lethargy

  • On medical management

  • Poor in 3/20 (15%) cats (6–44 months):

  • Progression of clinical signs

  • One died in status epilepticus

  • Two euthanased
Hunt et al (2004) 28 5 Cellophane banding

  • 20%

  • 1/5 cats suffered mild neurological complications

  • 0%

  • 0/5

  • Repeat examination at least 2 months postsurgery:

  • 3/5 (60%) clinically normal, normal liver function test

  • 2/5 (40%) clinically normal, increased ammonia tolerance test

  • 1/5 failure of shunt occlusion

  • 1/5 multiple acquired shunts
Lipscomb et al (2007) 21 49 Suture (28 partial, 21 full attenuation)

  • 37%

  • 18/49 cats suffered some form of neurological complication including seizures (11), tremors (8), hyperaesthesia (8), blindness (8), ataxia (8) and depression/weakness (4)

  • 4.1%

  • 2/49 cats euthanased due to seizures

  • Repeat examination 0.25–6 months postsurgery:

  • 12/36 (33.3%) normal bile acids

  • 24/36 (66.6%) abnormal bile acids

  • 12/23 (52.2%) normal ammonia

  • 11/23 (47.8%) abnormal ammonia

  • 12/28 cats with partial attenuation had second surgery:

  • 9/12 full attenuation

  • 2/12 further partial attenuation

  • 1/12 multiple acquired shunts

  • Excellent in 20/36 (56%) cats (6–105 months)

  • Clinically normal

  • No medication

  • Good in 7/36 (19%) cats (10–73 months):

  • Minimal clinical signs

  • No medication

  • Fair in 7/36 (19%) cats (15–79 months):

  • Three with mild signs of hepatic encephalopathy

  • Four with intermittent seizures

  • All on medical management

  • Poor in 2/36 (6%) cats (4–9 months):

  • Euthanased due to persistent seizures
Cabassu et al (2011) 29 9 Cellophane banding

  • 22.2%

  • 2/9 cats suffered severe neurological complications which resulted in persistent seizures

  • 22.2%

  • 2/9 cats were euthanased due to seizures

  • Follow-up postprandial bile acids 3–12 months postsurgery:

  • 5/5 (100%) normal bile acids

  • Excellent in 4/7 (57.1%) cats (>0.5-<36 months):

  • Clinically normal

  • No medication

  • Good in 1/7 (14.3%) cats (>36 months):

  • Persistent ptyalism

  • Fair in 1/7 (14.3%) cats (>36 months):

  • Cystotomy to remove ammonium biurate stones

  • Poor in 1/7 (14.3%) cats (3.5 months):

  • Euthanased due to recurrence of clinical signs