The effect of prophylactic treatment with levetiracetam on the incidence of post-attenuation seizures in dogs undergoing surgical management of single congenital extrahepatic portosystemic shunts

Mullins, Ronan A; Sanchez Villamil, Carlos; De Rooster, Hilde; Kummeling, Anne; White, Robert N.; Thieman Mankin, Kelley M.; Tivers, Mickey S.; Yool, Donald A.; Anderson, Davina M.; Pratschke, Kathryn M.; Gordo, Ines; Brissot, Herve; Singh, Ameet; Olive, Melanie; Billet, Jean Phillipe; Selmic, Laura E.; Kirby, Barbara M.

Abstract

Objectives: To report (1) the incidence of post-attenuation seizures (PAS) in dogs that underwent single congenital extrahepatic portosystemic shunt (cEHPSS) attenuation and (2) to compare incidence of PAS in dogs that either did or did not receive prophylactic treatment with levetiracetam (LEV).
Study Design: Multi-institutional retrospective study.
Sample Population: Nine-hundred-and-forty dogs.
Methods: Medical records were reviewed to identify dogs that underwent surgical attenuation of a single cEHPSS from January 2005 through July 2017 and developed PAS within seven days postoperatively. Dogs were divided into three groups: no LEV (LEV-); LEV at >15mg/kg TID for >24 hours or a 60mg/kg intravenous loading dose preoperatively, followed by >15mg/kg TID postoperatively (LEV1); ); and LEV at less than 15mg/kg TID, for less than 24 hours preoperatively, or continued at less than 15mg/kg TID postoperatively (LEV2).
Results: Nine-hundred-and-forty dogs were included. Seventy-five (8.0%) developed PAS. Incidence of PAS was 35/523 (6.7%), 21/188 (11.2%) and 19/228 (8.3%) in groups LEV-, LEV1 and LEV2, respectively. This difference was not statistically significant (p=0.14). No significant differences between groups of dogs that seized with respect to variables investigated were identified.
Conclusions: The overall incidence of PAS was low (8%). Prophylactic treatment with LEV according to the protocols investigated in our study was not associated with a reduced incidence of PAS.
Clinical Significance: Prophylactic treatment with LEV does not afford protection against development of PAS. Surgically treated dogs should continue to be monitored closely during the first seven days postoperatively for seizures.

Citation

Mullins, R. A., Sanchez Villamil, C., De Rooster, H., Kummeling, A., White, R. N., Thieman Mankin, K. M., …Kirby, B. M. (2019). The effect of prophylactic treatment with levetiracetam on the incidence of post-attenuation seizures in dogs undergoing surgical management of single congenital extrahepatic portosystemic shunts. Veterinary Surgery, 48(2), 164-172. https://doi.org/10.1111/vsu.13141

• Journal Article Type: Article
• Acceptance Date: Nov 6, 2018
• Online Publication Date: Dec 27, 2018
• Publication Date: 2019-02
• Deposit Date: Nov 19, 2018
• Publicly Available Date: Dec 28, 2019
• Journal: Veterinary Surgery
• Print ISSN: 0161-3499
• Electronic ISSN: 1532-950X
• Publisher: Wiley
• Peer Reviewed: Peer Reviewed
• Volume: 48
• Issue: 2
• Pages: 164-172
• DOI: https://doi.org/10.1111/vsu.13141
• Public URL: https://nottingham-repository.worktribe.com/output/1284779
• Publisher URL: https://onlinelibrary.wiley.com/doi/full/10.1111/vsu.13141