Of the surviving cats, 5 had serum bile acids within normal limits and 4 were clinically normal by 3 months post-op. There were 3 cats which died or were euthanized in the peri-operative period from neurological complications. In the report by Cabassu, 9 cats had cellophane banding for portosystemic shunts. It stands to reasons that if attenuation of the shunting vessel is required intra-op, then portal pressures should be measured to help guide the degree of attenuation to reduce the risk of portal hypertension and acquired shunting.Ĭellophane banding in cats has been reported by both Hunt et al (2004, Veterinary Surgery) and Cabassu et al (2011, JAVMA). These results, along with Frankel et al (JAVMA, 2006) suggest that perhaps attenuation of the shunt to <3 mm may not be required as the risk for continued or acquired shunting is moderate. In that study transcolonic scintigraphy post-op was used to identify continued shunting in 3/16 (18.6%) and multiple acquired shunts in 3/16 (18.6%) of cases. Similar findings were made by Landon et al (Australian Veterinary Journal, 2008) in 16 dogs which had cellophane attenuation to <3 mm. It should be noted however that most dogs in the group that did have cellophane attenuate the vessel to < 3 mm at the time of surgery likely had complete attenuation by 2.25 months, however this group also had increased serum bile acids at 6 months which suggests that the risk of acquired shunt development may be increased in animals which have the vessel attenuated arbitrarily to <3 mm at the time of surgery. Attenuating the shunt to <3 mm was based upon recommendations first made by Youmans and Hunt (AVJ, 1998), however the study by Frankel et al (JAVMA, 2006) questions whether this arbitrary diameter of shunt attenuation is required. This study found no difference in clinical outcomes, however by 6 months post-op, post-prandial serum bile acid assays were within normal limits in the group which only had the cellophane gently wrapped around the vessel rather than securing the cellophane in place whilst attenuating the vessels to <3 mm. 2006) evaluated outcomes in dogs that had cellophane banding placed around their shunts with and without attenuation of the vessel by the band to <3 mm. At CelloVet we provide pure, uncoated, cellulose based cellophane which is free from any additional treatments.ĭebate remains as to how to best apply cellophane around both extra-heptic and intra-hepatic shunts. Moreover, even if you stumble across what may be a cellulose based film, 99.9% of the time it will have some sort of plastic or adhesive coating to improve its material properties, handling and shelf life. As Smith (Veterinary Surgery, 2014) has shown, it is very unlikely that the material peddled as cellophane in your local store is cellulose based, but more likely a plastic. Veterinary surgeons were known to buy cigarettes, flowers or greeting cards in the hopes that the packaging they were supplied in was real cellophane. Before CelloVet, sourcing cellophane for use in veterinary surgery was haphazard. As we have discussed earlier, real cellophane is made from extruded regenerated cellulose. In certain instances however, alternative methods of attenuation such as cellophane banding are required. Despite the risk of persistent shunting due to partial closure, ameroid are excellent for most dog and cat patients with portosystemic shunts.
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