Outcome from status epilepticus after portosystemic shunt attenuation in 3 dogs treated with propofol and phenobarbital.
OBJECTIVE
To describe outcome of treatment with propofol and phenobarbital for status epilepticus (SE) after portosystemic shunt (PSS) attenuation.


METHODS
Three dogs without preceding seizure activity, were diagnosed with a single extrahepatic PSS. Following standard preoperative medical therapy, an ameroid constrictor was placed surgically. Recovery was uneventful until spontaneous SE developed 46-96 hours after surgery. After unsuccessful seizure control with benzodiazepines, dogs were treated with a bolus of propofol followed by a propofol constant rate infusion. Phenobarbital was concurrently administered and supportive care was optimized. All dogs recovered uneventfully over the next 7-9 days. Over the following months phenobarbital was slowly tapered. All dogs have been free from antiepileptic drugs for several months, without recurrence of neurologic signs.


CONCLUSIONS
In this case series, we describe the treatment of 3 dogs with propofol and phenobarbital for refractory SE following attenuation of a single congenital PSS. After weaning of the propofol constant rate infusion, and tapering and discontinuation of phenobarbital over the following months, all dogs experienced a complete recovery. This study provides evidence that use of propofol in combination with phenobarbital may be efficacious for management of SE in dogs after PSS surgery.
Gommeren
Kris
K
Department of Clinical Sciences, School of Veterinary Medicine, University of Liège, 4000 Liège, Belgium. kris.gommeren@ulg.ac.be
Claeys
Stéphanie
S
de Rooster
Hilde
H
Hamaide
Annick
A
Daminet
Sylvie
S
D000818:Animals; D000927:Anticonvulsants / Q000627:therapeutic use*; D004283:Dog Diseases / Q000151:congenital / Q000209:etiology* / Q000601:surgery; D004285:Dogs; D005260:Female; D008107:Liver Diseases / Q000662:veterinary*; D008297:Male; D010634:Phenobarbital / Q000627:therapeutic use*; D011168:Portal System / Q000002:abnormalities* / Q000601:surgery; D011183:Postoperative Complications / Q000188:drug therapy / Q000662:veterinary*; D015742:Propofol / Q000627:therapeutic use*; D012189:Retrospective Studies; D013226:Status Epilepticus / Q000188:drug therapy / Q000662:veterinary*
D000927:Anticonvulsants; D015742:Propofol; D010634:Phenobarbital