🔍 Key Findings

• 78% of cats that developed postattenuation neurologic signs (PANS) after congenital portosystemic shunt (cPSS) surgery survived to 30 days.
• Postattenuation seizures (PAS) were associated with significantly decreased 30-day survival (50% vs. 78%; OR: 0.015, p = .005).
• Treatment of PANS with propofol was a negative prognostic factor (OR: 0.112, p = .0008).
• Generalized PAS accounted for most seizure cases and were more frequently fatal than focal or unknown-type seizures.
• Pretreatment with levetiracetam (LEV1 protocol) showed a trend toward improved survival (100% vs. 60.6% in untreated cats), though not statistically significant (p = .06).
• Shunt morphology, method of attenuation, and study period (early vs. late) were not significantly associated with 30-day survival.
• Electrolyte, glucose, and ammonia abnormalities were not strongly linked to survival outcomes in this study.
• Majority of PAS-related deaths were due to uncontrolled generalized seizures or euthanasia because of severity.