Retrospective review of outcome following medical management of a congenital portosystemic shunt in 10 cats

Abstract

Case series summary The objective of this case series was to describe the survival, cause of death, clinical signs and long-term quality of life (QoL) of cats treated medically for a congenital portosystemic shunt (CPSS). Signalment, clinical signs, imaging, medical management and reason for not pursuing surgical treatment were obtained using medical records from two referral centres. Long-term outcome was obtained using a health-related quality of life (HRQoL) owner questionnaire. A total of 10 owners completed a HRQoL questionnaire that included frequency of clinical signs relating to having a shunt, QoL, behaviour, improvement in body condition score (BCS), and date and cause of death (where applicable). Five (50%) cats died or were euthanased because of their shunt. The median follow-up time for all 10 cats (from birth to death or questionnaire completion if still alive) was 26.5 months (range 8 months to 15 years). The mean CPSS score was 30/124 (range 13–57) and all cats medically treated for their CPSS had ongoing clinical signs. QoL scores and BCS were assessed as improved by eight (80%) and nine (90%) owners, respectively, following medical management of a CPSS. Relevance and novel information This is the first case series description of cats managed medically for a CPSS, which demonstrates that all cats medically treated for a CPSS had ongoing clinical signs in the long term, albeit with improved QoL, and that half of cats treated medically can be expected to die because of their shunt. Although this study adds to the current body of knowledge of CPSS management in cats, ongoing research should be conducted to increase the sample size and compare long-term CPSS and QoL scores in healthy cats to groups of cats treated either medically or surgically for a CPSS.