ABSTRACT
Objective
To investigate and describe the therapeutic potential of manual plasma exchange for controlling seizures and neurologic dysfunction in a dog with postattenuation neurologic signs (PANS).
Case Summary
A 4-year-old neutered female Yorkshire Terrier was initially diagnosed using computed tomography with a congenital extrahepatic portosystemic shunt involving the left gastric and azygos veins. After diagnosis, surgical correction of the anomaly was performed without complications, and the patient was discharged. However, within 48 h of surgery, the dog developed a neurologic condition characterized by generalized tonic-clonic seizures that were poorly responsive to medical treatment. Given the timing and progression of clinical signs despite medical therapy, and after ruling out hepatic encephalopathy as a likely cause, a presumptive diagnosis of PANS was established. A modified, manual therapeutic plasma exchange (MTPE) technique was successfully performed over an 8-h period with minimal complications. After the procedure, marked clinical improvement was observed, with resolution of neurologic signs, and the patient was discharged without further procedure-related complications.
New or Unique Information Provided
PANS has been described in veterinary medicine in both dogs and cats, although its etiology and treatment remain poorly understood. This report describes the use of MTPE as a therapeutic approach, yielding promising results. To the authors’ knowledge, this is the first documented use of MTPE for this condition in dogs, with previous reports limited to a single case in a cat.
Journal of Veterinary Emergency and Critical Care, EarlyView.Wiley: Journal of Veterinary Emergency and Critical Care: Table of Contents