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Outcome from status epilepticus after portosystemic shunt attenuation in 3 dogs treated with propofol and phenobarbital

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Abstract
Objective: To describe outcome of treatment with propofol and phenobarbital for status epilepticus (SE) after portosystemic shunt (PSS) attenuation. Case or Series Summary: 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. New or Unique Information Provided: 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.
Keywords
CONVULSIVE STATUS EPILEPTICUS, REFRACTORY STATUS EPILEPTICUS, AMEROID RING CONSTRICTORS, NEUROLOGICAL DYSFUNCTION, MANAGEMENT, CATS, OCCLUSION, LIGATION, SEIZURES, ameroid constrictor, canine, postoperative complication, seizure

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Chicago
Gommeren, Kris, Stephanie Claeys, Hilde De Rooster, Annick Hamaide, and Sylvie Daminet. 2010. “Outcome from Status Epilepticus After Portosystemic Shunt Attenuation in 3 Dogs Treated with Propofol and Phenobarbital.” Journal of Veterinary Emergency and Critical Care 20 (3): 346–351.
APA
Gommeren, K., Claeys, S., De Rooster, H., Hamaide, A., & Daminet, S. (2010). Outcome from status epilepticus after portosystemic shunt attenuation in 3 dogs treated with propofol and phenobarbital. JOURNAL OF VETERINARY EMERGENCY AND CRITICAL CARE, 20(3), 346–351.
Vancouver
1.
Gommeren K, Claeys S, De Rooster H, Hamaide A, Daminet S. Outcome from status epilepticus after portosystemic shunt attenuation in 3 dogs treated with propofol and phenobarbital. JOURNAL OF VETERINARY EMERGENCY AND CRITICAL CARE. 2010;20(3):346–51.
MLA
Gommeren, Kris, Stephanie Claeys, Hilde De Rooster, et al. “Outcome from Status Epilepticus After Portosystemic Shunt Attenuation in 3 Dogs Treated with Propofol and Phenobarbital.” JOURNAL OF VETERINARY EMERGENCY AND CRITICAL CARE 20.3 (2010): 346–351. Print.
@article{1250636,
  abstract     = {Objective: To describe outcome of treatment with propofol and phenobarbital for status epilepticus (SE) after portosystemic shunt (PSS) attenuation. Case or Series Summary: 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. New or Unique Information Provided: 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.},
  author       = {Gommeren, Kris and Claeys, Stephanie and De Rooster, Hilde and Hamaide, Annick and Daminet, Sylvie},
  issn         = {1479-3261},
  journal      = {JOURNAL OF VETERINARY EMERGENCY AND CRITICAL CARE},
  keywords     = {CONVULSIVE STATUS EPILEPTICUS,REFRACTORY STATUS EPILEPTICUS,AMEROID RING CONSTRICTORS,NEUROLOGICAL DYSFUNCTION,MANAGEMENT,CATS,OCCLUSION,LIGATION,SEIZURES,ameroid constrictor,canine,postoperative complication,seizure},
  language     = {eng},
  number       = {3},
  pages        = {346--351},
  title        = {Outcome from status epilepticus after portosystemic shunt attenuation in 3 dogs treated with propofol and phenobarbital},
  url          = {http://dx.doi.org/10.1111/j.1476-4431.2010.00537.x},
  volume       = {20},
  year         = {2010},
}

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