In dogs undergoing extrahepatic portosystemic shunt attenuation, does pretreatment with levetiracetam reduce postoperative seizure incidence?

PICO question PICO   Clinical bottom line Category of research question Treatment The number and type of study designs reviewed Four papers were critically reviewed. All were retrospective cohort studies Strength of evidence Moderate Outcomes reported In one paper levetiracetam was found to reduce the risk of post-attenuation seizures. In the remaining three papers no difference was found between the frequency of post-attenuation seizures and the use of levetiracetam Conclusion That prophylactic levetiracetam is not indicated for the use of preventing post-attenuation seizures in dogs surgically treated for extrahepatic portosystemic shunts   How to apply this evidence in practice The application of evidence into practice should take into account multiple factors, not limited to: individual clinical expertise, patient’s circumstances and owners’ values, country, location or clinic where you work, the individual case in front of you, the availability of therapies and resources. Knowledge Summaries are a resource to help reinforce or inform decision making. They do not override the responsibility or judgement of the practitioner to do what is best for the animal in their care.